Expanded role brings health & profits

WIDENING the scope of pharmacy practice fulfils the pharmacist’s dual role of health professional and business manager without compromising their ability to serve patients, according to business analyst, Dr Grant Wilson (pictured), from the Edwards School of Business, University of Saskatchewan.

Writing in The Conversation, Wilson said Canada has had expanded pharmacy services for as many as 10 years now, and forms a useful model for Australian pharmacists and government healthcare authorities to consider.

Canadian community pharmacists with appropriate training at one extreme, in the state of Alberta, have the authority to independently initiate prescription of any Schedule 1 drug, independently adapt or manage any Schedule 1 drug, inject any drug or vaccine, as well as order and interpret lab tests.

At the other extreme, in the largest most northerly state of Nunavat, pharmacists have none of these rights, not even for substitution, dosage adjustment, minor ailments, collaborative prescribing, or even in an emergency.

The range of options, across Canadian states in between the two extremes, has created fertile ground for researchers seeking to make comparisons and determine the impact on health outcomes for the different communities.

Wilson said that 81% of Canadian pharmacists have intentionally expanded their role and 45% have said they plan to do so as soon as legislation in their state permits.

A number of significant conclusions arose from Wilson’s study.

“Entrepreneurial pharmacies were the most likely to participate in the expanded services,” he wrote, and “implementation of expanded services was related to favourable patient health outcomes”.

“Favourable patient health outcomes included overall quality of care, patient prescription knowledge and prescription error reduction as reported by the pharmacy owner or manager.

“This suggests the expansion of pharmacy services is working as intended and patients are benefiting from the new activities performed by pharmacists.”

A third critical study finding was that “retail pharmacies financially benefited from the implementation of expanded services”.

The original paper by Wilson and his Saskatchewan co-authors is about to be published in the Journal of Small Business & Entrepreneurship.

See the state distribution of Canadian pharmacists’ authorities at pharmacists.ca.