Expanding Role of Pharmacy in Primary Care Flashcards
Does Canada have a robust primary healthcare system?
No, primary care is an afterthought with more focus on emergency and hospital care
Post-pandemic, many HCPs departed primary care or elected not to enter this area of practice
How is the role of pharmacists changing in the face of a struggling primary healthcare system?
17% of Canadians are unattached, meaning they have no regular family MD
Therefore increasingly they are turning to pharmacists for care
How are pharmacists well positioned to play a larger role in primary care?
- Highly accessible for those seeking care
- Many already have an established relationship with a particular pharmacy
- Scope of pharmacy practice is expanding (chronic disease management, treatment of self-limiting conditions)
What are some factors that are preventing pharmacists from playing an even larger role in primary care?
Regulatory (scope of practice)
Economic (incentives)
Organizations (resource constraint)
Conditions in the communities and pharmacies in which pharmacists practice
Review slide 6 for differences in pharmacy scope of practice across Canada
What are the Level 1 Pharmacist Prescribing changes?
Ability to provide emergency supply in cases where interruption will cause imminent harm
Alter dose or regimen in situations of imminent hamr, obvious error, and to assist with antibiotic stewardship
Administrative prescribing to obtain third-party drug coverage (ex. covering citro-mag before colonoscopy)
What is the benefit of pilot programs for scope of practice expanision?
Good template for rolling out scope expansion
Show competency & patient safety, and then expand to all pharmacies following formal evaluation
What is a professional hurdle to increasing the role of pharmacists in primary care?
Role ambiguity, and the lack of a clear patient care role
Many pharmacists continue to identify with the dispensing or drug distribution role
Why do some pharmacists hesitant about taking on new responsibilities for patient care?
Lack of confidence
Fear of repercussions
Paralysis in the face of ambiguity
Need for approval
Risk aversion
Lack of understanding regarding extent of role expansion
What are some factors that may improve pharmacist engagement in primary care?
Clarity of roles
Effective communication through a shared health record
What are some issues with scope of practice expansion for pharmacists?
Increased demand for pharmacy services by both attached and unattached patients
Pharmacists felt increased pressure to weigh regulations, standards of practice, codes of ethics, and their patient’s best interest
How effective are pharmacists at consulting patients for their healthcare needs?
Pharmacists were able to manage 85% of consultations without referring to other healthcare resources
94% of patients were highly satisfied with pharmacy consultation preventing them from going to another HCP (ER, walk-in clinic, or GP)
What is the benefit of interprofessional collaboration, particularly between physicans and pharmacists?
Enhance quality of care
Increase patient engagement
Improve provider satisfaction
Retention
Provider perceptions of empowerment and recognition
What is a factor that makes creating working relationships between pharmacists and physicians more difficult?
Most community pharmacists work apart from family physicians and other primary care providers
- Effective communication and connectivity is less likely
- Interactions are usually reactive and limited to one-way communication via phone or fax
- Co-location allows MDs to gain appreciation for the possible roles of a pharmacist and develop better relationships
What is a pharmacist-led clinic?
No standard definition, but must follow their provincial regulator’s standards of pharmacy practice
- Must also differentiate their services from those of a physician-led clinic when advertising
See slide 23 for how pharmacist-led clinics are being implementes in different provinces
What are some issues and challenges faced by pharmacy clinic issues and challenges?
Scope of practice (insufficient in many jurisdictions)
Access to medical charts and lab results (difficult to make therapeutic decisions without this info)
Funding models (need to cover infrastructure investments, logistics, staffing support)
Physical assessment skills (many pharmacists lack these skills)
Practice standards/guidelines (lack of established national guidelines)
