Pharmacist Prescribing and Primary Health Care Access

Not all Nova Scotians have access to a family doctor or nurse practitioner. Pharmacists are accessible health care providers, as pharmacies are often centrally-located and typically open at least 12 hours a day. Pharmacists also have the ability to provide primary care services related to medications, for example prescription renewals and assessments of minor ailments. Over the past few years, pharmacists’ scope of practice has expanded—increasing the services they can provide—and thus potentially improving access for patients.

In 2010, Nova Scotia introduced legislation to expand pharmacists’ scope of practice to include prescribing. Yet, a survey of Nova Scotian pharmacists completed in 2014 found that self-reported prescribing was not common among pharmacists.

About this project

This project is studying how often pharmacists are prescribing, as well as factors that support or hinder pharmacist prescribing in Nova Scotia. This research may help to identify ways to support pharmacist prescribing in order to increase access to primary care, including assessment and providing needed medications to Nova Scotians. Access to high-quality primary care supports better health outcomes for patients. By understanding how pharmacists are supporting the primary care system and how we can improve current practices, our research will help Nova Scotians get access to the care they need.

Pharmacists’ scope of practice and its relation to primary health care access was identified as a priority health topic for discussion at the MSSU Nova Scotia Bridge Event in November 2018.  A team including researchers, a patient partner, representatives from the NS Department of Health and Wellness, the Nova Scotia College of Pharmacists, and the Pharmacy Association of Nova Scotia was formed to conduct the research.

The research team is using two approaches to study pharmacist prescribing activities in Nova Scotia:

  1. A baseline assessment of data from the Drug Information System (DIS), which houses data on prescriptions filled in community pharmacies in Nova Scotia
  2.  A survey to improve our understanding of pharmacists’ experiences when prescribing and to better understand the supports needed to improve the quality and uptake of pharmacist prescribing

Pharmacist prescribing survey

The research team updated the 2014 survey, based on lessons learned and changes in pharmacist prescribing in recent years. The updated survey asked pharmacists to provide some demographic and geographic information, and to describe their prescribing activities including the volume and types of prescribing that they do. The survey captured information on prescribing activities (for example, a drug substitution vs. a prescription renewal) which are not identifiable through the DIS, as well as self-reported facilitators and barriers. We also assessed some of the changes in prescribing that have happened since the COVID-19 pandemic began.

The survey was open to pharmacists who:

  • Have a direct patient care license in Nova Scotia; and,
  • Have worked at least part-time in a community pharmacy in Nova Scotia within the last 12 months.

The survey was open from July 7 – August 5, 2020.

The research team presented findings from the study at: the Canadian Association for Health Services and Policy Research (CAHSPR) 2021, Thinking Qualitatively Conference 2021, Canadian Association for Population Therapeutics 2021, and OPEN Summit 2021.

Project leads

  • Dr. Jennifer Isenor, Associate Professor, College of Pharmacy, Faculty of Health, Dalhousie University
  • Dr. Judith Fisher, Manager, Drug Technology Assessment, Nova Scotia Department of Health and Wellness (retired)
  • Dr. Amy Grant, Senior Health Policy Researcher, MSSU, Nova Scotia Health
  • Juanna Ricketts, Patient Partner

Pharmacist Prescribing and Primary Health Care Access