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11/21/2023

6 steps to take before you add minor ailment prescribing to your pharmacy

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Jane Xia

We find ourselves in an exciting era for the pharmacy profession! Pharmacists in British Columbia, Alberta, Saskatchewan, Ontario, Quebec, New Brunswick, Nova Scotia, Prince Edward Island, and Newfoundland and Labrador in Canada now have the authority to prescribe for various minor ailments1. While not identical, this marks a significant step forward for pharmacists as they strive to shape clinical service-based community pharmacy practice.

However, amidst the excitement, it's important to address the practical challenges that this transition brings. We are currently grappling with a nationwide shortage of pharmacists2. Although employers are responding with higher wages, positions remain unfilled. Due to staff shortages, most pharmacists are contending with a backlog of tasks, from filling prescriptions to addressing patient requests and informing customers about delayed prescription fills. While offering services like medication reviews, follow-ups, and minor ailment prescribing in pharmacies is attractive, especially in lean pharmacy business models, many pharmacists struggle to fulfill all the promises made by their businesses because of the staffing shortage.

In addition, regulatory changes occurred rapidly in provinces like BC and ON, leaving many pharmacists with insufficient time off to become familiar with the prescribing algorithms, regulatory requirements, and legal obligations associated with the expanded scope of practice. From a business operational perspective, this situation is uncharted territory, presenting new administrative demands, potential conflicts with other healthcare providers, and numerous questions.

Given these realities, a pressing question emerges: How can a pharmacy run more efficiently and effectively with an expanded scope of practice for clinical services such as minor ailment prescribing? Here are some suggestions to consider, helping you maintain operational efficiency and provide regular clinical services to keep your customers engaged and interested:

1) Reflect on the clinical services offered by your pharmacists

One of the first steps in embarking on a new venture or initiative is assessing your resources, funding, and your staff's willingness to learn and motivation to perform more clinical services. It's crucial to engage in discussions about training, workflow, and workload expectations. Additionally, understanding your staff's opinions regarding the thoroughness, completeness, and efficiency of their work is essential.

2) Revisit your vision and mission for your pharmacy

It's often easier to align with your pharmacy's vision and mission rather than adding as many services as possible which may dilute the quality of your services. Does minor ailment prescribing align with your business model? If not, why? Is your vision or mission more product-focused than service-oriented? These are fundamental questions to answer before implementing minor ailment prescribing. Additionally, consider the types of minor ailments you want to address based on your patient population. Ensure your pharmacists have the time to learn and gain confidence in prescribing for these specific areas to enhance your patient experience and outcomes.

3) Assess staff engagement and availability

If your pharmacy is already operating at maximum capacity, your staff might view minor ailment prescribing as an additional burden. Determine your staff's level of interest and engagement. Hiring additional help may be a sensible solution to ensure everyone is on board with providing this service. Furthermore, offering and marketing these services can attract more patients to your pharmacy for assessments and treatments.

4) Identify peak hours for clinical services

If you have already started offering minor ailment prescribing services, monitor the trends of peak hours. These observations are valuable for operational efficiency. Staffing accordingly will maintain operational efficiency and patient satisfaction. The last thing you need is stressed pharmacists handling additional workload while patients wait for an extended period and having a less than ideal experience. 

5) Evaluate return on investment

Financial considerations are paramount. If your pharmacy isn't generating revenue, additional services may not be sustainable and could become a large cost. Streamlining operations to ensure clear, efficient assessments will enhance the return on investment and profitability. Always review and re-evaluate so your business stays profitable!

6) Implement patient consent and self-screening

It will take time for pharmacists to become proficient at minor ailment prescribing. Incorporating a minor ailment tool into your computer software system can streamline the process, improving operational flow and efficiency. Consider developing patient self-assessment forms similar to the process we have for vaccinations. By having patients declaring medical conditions, signs, and symptoms related to a specific disease, pharmacists will have more time and this process will help facilitate more productive discussions, ensuring a good patient experience, accurate medication prescribing and operation efficiency.

I welcome your thoughts and comments.

  1. Canadian Pharmacists Association. Prescribing Authority of Pharmacists Across Canada. Canadian Pharmacists Association. July 20, 2023. Accessed Oct 4, 2023 https://www.pharmacists.ca/cpha-ca/assets/File/pharmacy-in-canada/PharmacistPrescribingAuthority_July23_EN.pdf
  2. Canada Visa. Pharmacists. CanadaVisa.com. Accessed Nov 2nd 2023.  https://www.canadavisa.com/pharmacists-3131.html
  3. Tran T, Moczygemba LR, Musselman KT. Return-On-Investment for Billable Pharmacist-Provided Services in the Primary Care Setting. Journal of Pharmacy Practice. 2022;35(6):916-921. doi:10.1177/08971900211013194
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