Premier David Eby knows how problematic it can be when a prescription expires for a medication you need. Speaking at a press conference to launch the ImmsBC online booking system for Minor Ailments and Contraceptive Services (MACS), Eby recognized pharmacists as accessible, trusted medical experts for the public.
“They are familiar faces in the community. They are trusted medical experts and they are really easily accessible to most British Columbians that need help. For these reasons, and so many others, we gave pharmacists the ability to issue prescriptions,” Eby said.
“We saw 25,000-plus people in just one month see a pharmacist for treatment of a minor ailment. That’s tens of thousands of people who were able to access care quickly, when they needed it, freeing up doctors and hospitals for those with more complex care needs.”
British Columbian pharmacists were enabled to prescribe for minor ailments on June 1, as part of B.C.’s health human resources strategy to ensure the public can access health care when and where they need it. As part of the new scope, pharmacists can now assess and prescribe for a list of 21 minor ailments — among the highest in Canada — in addition to contraception.
Minor ailments are considered diseases, disorders or conditions that present a low risk of masking something else underlying and can be readily diagnosed without the need for laboratory or imaging tests, with the patients’ symptoms being reasonably expected to resolve with only short-term or episodic treatment.
R-L: Premier David Eby announces the launch of the ImmsBC online booking platform for minor ailments and contraception services with Health Minister Adrian Dix, BCPhA President Chris Chiew and patient Robin Rivers.
More than 1,200 pharmacies are now participating in MACS. From June 1 to July 11, pharmacists performed more than 43,000 assessments!
BC Pharmacy Association President Chris Chiew said he is proud of the work pharmacists are doing and the early numbers show it is clear patients have confidence in community pharmacists to perform the new duties. Since June 1, pharmacists have consistently performed more than 1,000 minor ailment assessments per day. Approximately 79 per cent of assessments have resulted in a prescription.
“These are incredible figures. I’ve heard so many stories of patients sharing how thrilled they are. On the first day of service, I know of at least one pharmacy that had 10 patients come in after 7 p.m. when other clinics were closed or full,” Chiew said.
“There have been stories of patients waiting outside for a pharmacy before it opened to get the service. This just shows you what we’ve known for a long time, that our patients have trust and confidence in us, and that there’s a demand for this service.”
Poll finds 91% of pharmacists report patients prefer walk-in for minor ailments
On July 25, the BC Pharmacy Association held an all-member town hall to gather feedback from pharmacists after nearly two months since the Minor Ailments and Contraception Service (MACS) was implemented in British Columbia on June 1.
At its peak, more than 450 members attended the town hall. It was an opportunity for the Association to hear feedback and questions from members about the new scope of practice. BCPhA Pharmacy Practice Support Executive Director Bryce Wong and pharmacist Lawrence Woo were on hand to answer technical questions from the audience. The Association also took the opportunity to conduct a series of polling questions to learn more about how the profession has engaged with the new services.
The results of the polls are below. If you missed the town hall and would like to hear the recording, please visit bcpharmacy.ca/town-halls.
1. Have you done an assessment for minor ailments or contraception?
- Minor ailments only - 27%
- Contraception only - 2%
- Both - 44%
- Neither - 27%
2. What types of prescribing have you done for contraception?
- Emergency contraception - 20%
- Continuing or modifying an existing contraception - 20%
- Initiating a new prescription for contraception - 4%
- Both emergency contraception and continuing/modifying existing contraception - 22%
- All of the above - 33%
3. In terms of education, which of the following supports have you found most valuable?
- MedSask guidelines & Updated documentation templates - 41%
- BCPhA's Removing Barriers to Support Expanded Scope e-training - 2%
- The College's mandatory regulation training module - 3%
- UBC's prescribing for fundamentals course - 9%
- All have been valuable - 32%
- Unsure - 13%
4. Are you using the Medsask guidelines and documentation templates?
- Using the guidelines only - 32%
- Using both the guidelines and documentation templates - 59%
- Not using the medsask guidelines at all - 9%
5. In your experience are you seeing more patients as walk-ins or who make an appointment?
- Walk-ins - 91%
- Appointments - 9%
Enabling pharmacists to prescribe for minor ailments has been a goal of the Association for more than 10 years, with the Association making its first formal request in 2016, to the previous government, to have pharmacists empowered to prescribe. Adrian Dix, Minister of Health of the current government, recognized that pharmacists, and the Association, have contributed significantly to ensuring the public’s access to health services.
“The other thing we need to do is adapt and redesign our health care system to allow the extraordinary-trained people, such as pharmacists, to work to the full extent of their scope of practice. Over the last number of years, the BC Pharmacy Association, I want to acknowledge the work of Chris and Geraldine and everyone at the Pharmacy Association, who have done an exceptional amount of work in this area,” Dix said. “When I became Minister of Health, about a third of vaccinations occurred in community pharmacy, now it is the vast majority of vaccinations and we have a record year for influenza vaccination, which made a very significant difference for everyone during respiratory illness season.”
Eby, the Premier, said his government recognizes the realities of families and seniors in getting access to health care in the post-pandemic world.
“It can be a hassle to get a prescription from a doctor for something routine, like contraception, or something minor, like allergies,” Eby said. “We’re all better off when we can ease the pressure on our health-care system as a whole. It takes pressure off emergency rooms and limited resources in the health-care system, while still delivering quick access to people for the care that they need.”
Since the launch, the provincial government has supplemented the MACS program with the ImmsBC appointment booking system, which previously was only used for COVID-19 and influenza vaccines. The appointment booking tool, available at bookapharmacist.gov.bc.ca, was rolled out on June 29. As with the Get Vaccinated vaccine booking system, a team at the Association is working in partnership with the provincial government in the booking system's day to day operations.
London Drugs pharmacist Penny Lehoux (right) explains the minor ailment prescribing process to Minister Adrian Dix (centre) and Premier David Eby (left).
Penny Lehoux, a London Drugs pharmacist, said the new online booking system means patients will have even more access to getting an appointment at pharmacies.
“Until now, patients have had to phone the pharmacy or drop in to make an appointment. With the provincial online booking system, it’ll be easier for patients to find the services they need and to make an appointment at a time and location that’s convenient for them,” Lehoux said. “From the pharmacy’s perspective, though, the booking system also helps us to manage our workflow so that we can open appointments for the times of day that work for our team… it’s also a way for us to connect with new patients who have not been to our pharmacy before, just like we saw with COVID and flu vaccines in the fall.”
To support the public’s adoption of MACS, the Association launched a comprehensive multimedia public awareness campaign that began on May 31.
The campaign included an updated seeyourpharmacist.ca website, which serves as a brochure to the public advertising all the various services — not just MACS — that pharmacies can provide, in addition to a map of pharmacies throughout B.C.
“The BC Pharmacy Association knew that it was imperative that we guide and educate the public about this new service, and that’s why we started the See Your Pharmacist advertising and marketing campaign on June 1,” said Geraldine Vance, CEO of the BCPhA.
“Early figures have shown us that more than 1 million British Columbians have seen our ads, and we believe that this has helped pharmacists at the counter engaging with patients who may have many questions about the new scope of practice.”
Kylee Power, an owner with Central Drugs on Vancouver Island and a Director on the BCPhA Board, said from what she has seen, patients have embraced the new pharmacy services.
“It is so encouraging to see how patients truly appreciate this service,” she said.
“The patients I have assessed so far would otherwise be heading to urgent care, emergency departments, or going without care and risking their condition worsening.”
Patients appreciate the new pharmacy services!
I've had the same pharmacist for about 12 years. On June 1, I saw a social media post about the BC Pharmacy Association opening up a program that allowed me to go into my pharmacist and get prescriptions for small things. I had had a rash on my eye for about three months and I wasn't really doing anything about it, because we haven't had a family physician for about three years after he retired.
So I went in immediately, and I was patient number one at our pharmacy.
They looked at my eye, decided that it was a bit of eczema, and they gave me a cream and told me how to use it. Within 15 minutes, I was out the door with my prescription. They called me about a week later, and I came in to do a follow up with them.
I really felt like I got some of the some of the best care I’ve had in a long time. I'm extremely grateful for this, because we haven't had a doctor in quite some time, and I really don't have much access other than emergency room or a clinic that is very difficult to get into.
It's been a real game changer for us. Now we don't feel like we must live with the basic everyday problems that we have. We can go in and talk to our pharmacist.
For my story, it was a Friday afternoon when I realized I may have a bladder infection. My husband is a retired pharmacist who had worked in one of the Central Drugs locations in Nanaimo, so I knew the pharmacists who worked there, and it had been my pharmacy for probably more than 10 years.
I didn’t want to bother my doctor on a Friday afternoon – I’m lucky to have a doctor at all – so the pharmacy was my first choice. I called, Kylee picked up the phone, I told her what the problem was and she told me to come down for an assessment. She has given me advice before on many occasions.
At 76 years old, my health is a priority for me and despite how busy the pharmacy is, they stop and take the time to listen to me.
This change to allow pharmacists to prescribe should have happened a long time ago. Before June 1, if the same thing had happened it would mean suffering for a few days before I could get to a doctor.
So many people cannot get a doctor now and it’s wonderful that they can now visit a pharmacist to look after many of their needs. It’s perfect, and there are so many pharmacists out there who are willing to help.