The Lieutenant Governor-in-Council has approved an amendment by the Council of the Ontario College of Pharmacists to the general regulation under the Pharmacy Act, 1991 to allow pharmacists to prescribe certain drugs to treat minor ailments.1 As of January 1, 2023, pharmacists will be authorized to prescribe specified drugs to treat the following conditions:

  1. Allergic rhinitis
  2. Candidal stomatitis (oral thrush)
  3. Conjunctivitis (bacterial, allergic or viral)
  4. Dermatitis (atopic/eczema, allergic or contact)
  5. Dysmenorrhea
  6. Gastroesophageal reflux disease (GERD)
  7. Hemorrhoids
  8. Herpes labialis (cold sores)
  9. Impetigo
  10. Insect bites and urticaria
  11. Tick bites, post-exposure prophylaxis to prevent Lyme disease
  12. Musculoskeletal sprains and strains
  13. Urinary tract infections (uncomplicated)

These ailments are usually short-term conditions, which can be reliably self-diagnosed and managed with minor treatment and minimal follow-up care. Prior to prescribing a drug, pharmacists will be required to conduct a therapeutic assessment to determine whether the prescribed drug is the most appropriate treatment for the patient's minor ailment.

The Practice of Pharmacy in Ontario

Regulated health professions in Ontario are self-governing. There are 26 regulatory colleges governing 29 health professions under the Regulated Health Professions Act, 1991.2 Each health profession has a respective statute sets out the profession's scope of practice and authorized acts. Each college is responsible for ensuring that its members provide healthcare services in a safe, professional and ethical manner, in accordance with their professional statute and relevant standards of practice.

The Ontario College of Pharmacists ("OCP") is responsible for governing the profession of pharmacy in Ontario. As set out in the Pharmacy Act, 1991, the practice of pharmacy involves:

a) the custody, compounding, dispensing and prescribing of drugs;

b) the provision of health care aids and devices;

c) the provision of information and education related to the use of anything mentioned in (a) and (b) above; and

d) the promotion of health, prevention and treatment of disease, disorders and dysfunctions through monitoring and management of medication therapy.

The Ontario government has been working to enable certain regulated health professionals, including pharmacists, to use their education and training more effectively by expanding their scope of practice. In 2019, the Minister of Health and Long-Term Care invited the OCP to make regulations that would authorize pharmacists to administer the flu vaccine to children as young as two years old, renew prescriptions in quantities of up to a year's supply, administer certain substances by injection and/or inhalation, and prescribe drugs for certain minor ailments.3 The latest regulatory amendment accomplishes the final item on this list.

Scope of Pharmacists' Prescribing Authority

Ontario pharmacists are authorized to perform certain controlled acts, one of which is prescribing drugs that are specified in the regulations under the Pharmacy Act, 1991. For example, since 2012, pharmacists have had the authority to prescribe drugs (Varenicline Tartrate and Bupropion Hydrochloride) for the purpose of smoking cessation.4

The latest regulatory amendment broadens pharmacists' prescribing authority to include prescribing drugs for the 13 minor ailments listed above. Pharmacists who provide patient care (as well as interns and registered pharmacy students) will be authorized to prescribe drugs for the specified minor ailments if:

  • the pharmacist possesses sufficient knowledge, skill and judgment respecting the drug and the patient's condition to prescribe the drug for the patient;
  • the pharmacist has considered whether prescribing the drug for the patient is appropriate, given the known risks and benefits of prescribing the drug for the patient and other relevant factors respecting the patient;
  • the prescription is given to the patient or their authorized agent;
  • the pharmacist advises the patient or their authorized agent, at the time of giving the prescription, that they may elect to take it to a pharmacy of their choosing for dispensing;
  • the pharmacist notifies the patient's primary care provider (if any) within a reasonable time that the pharmacist prescribed a drug for the patient and provides details respecting the prescription;
  • the pharmacist complies with certain record-keeping requirements relating to information recorded on the prescription and patient records; and
  • the pharmacist has determined, through a therapeutic assessment, that the drug is the most appropriate treatment for the patient's minor ailment.5

Looking Forward

Currently, patients who require prescription drugs to treat minor ailments must visit their physician, a walk-in clinic or a hospital. Authorizing pharmacists to prescribe these drugs is intended to lessen pressure on other healthcare providers and improve patients' access to routine healthcare in their communities. In the coming months, the OCP intends to develop and share training materials, guidance and practice resources to support the profession in implementing this new prescribing authority.6

Footnotes

1 See O. Reg. 460/22: General under Pharmacy Act, 1991, S.O. 1991, c. 36.

2 Regulated Health Professions Act, 1991, S.O. 1991, c. 18.

3 See letter from Christine Elliott, Deputy Premier and Minister of Health and Long-Term Care to Laura Weyland, President of Ontario College of Pharmacists, dated May 30, 2019 [PDF].

4 See O. Reg. 202/94: General, section 35(1).

5 See O. Reg. 460/22: General, section 1(3), amending O. Reg. 202/94: General, section 35(4).

6 See Ontario College of Pharmacists, Minor Ailments.

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