As of January 1, 2023, the pharmacists' scope of practice has expanded across Ontario with the ability for pharmacists to assess and autonomously prescribe medications for 13 minor ailments.
While new to Ontario, this process is not a novelty, as pharmacists in other countries and Canadian provinces have been improving patient care through pharmacist-led prescribing for years.
Dr. Nardine Nakhla, a professor at the University of Waterloo's School of Pharmacy, served on the Minor Ailments Advisory Group (MAAG), an expert advisory group brought together by the Ontario College of Pharmacists to develop the regulatory changes needed to enable this expansion of scope. MAAG was composed of a diverse group of patients and experts in medicine, public health, health systems research and community pharmacy.
Stemming from her work on MAAG as well as her significant research and expertise in the minor ailment space, Nakhla recognized the need for Ontario to build a customized platform specific to provincial regulations to meet the demands created with this new change to pharmacists' scope. From this need, the Minor Ailment Prescribing Workflow (MAPflow) emerged, a powerful new digital health tool.
Digital health tool assists minor ailment prescribing
MAPflow, partnered with the Ontario Pharmacy Association (OPA), will help catalyze pharmacists' role as vital health-care providers in communities across the province. This industry-specific software was designed by a team of leaders in Ontario pharmacy education, led by community pharmacist and academic Nakhla as CEO, and Hallman Director, COO, Andrea Edginton.
"We wanted to develop an Ontario-specific platform that met the needs of practicing pharmacists and preceptors as well as students and interns," Nakhla says. "MAPflow facilitates evidence-based clinical decision-making when assessing and prescribing for minor ailments, enhances the efficiency and accuracy of the process and streamlines documentation by offering pharmacists a simplified workflow while optimizing patient outcomes."
The software equips pharmacists to make confident, evidence-based decisions while saving time and energy. Nakhla hopes that this tool will allow for seamless integration of the service into Ontario's pharmacy practice environment to create health system capacity and enhance patient access to quality and timely care in the community.
Expanded scope of practice
"Writing prescriptions is a fairly new act for many pharmacists and may be a steep learning curve for some. MAPflow auto-generates prescriptions, when deemed appropriate, and the necessary documentation so pharmacists can feel confident they are meeting regulatory requirements and standards of practice," Nakhla says.
Additionally, the software features clinical pearls for just-in-time learning and highlights opportunities for additional clinical services patients may be eligible for.
"Pharmacists have always been assessing minor ailments but were limited to therapies available without a prescription," Nakhla says. "This expansion in scope has allowed us to add tools to our toolbox, enabling us to provide the best possible care for our patients. Non-drug strategies, over-the-counter agents and natural health products are all embedded in MAPflow, giving the pharmacist other options for adjunctive and sole treatment, based on patient-specific factors."
The expanded scope of practice for pharmacists in Ontario will also help patients who are falling within treatment gaps, for example those who do not have primary care providers and self-treat.
"Hopefully this is just the beginning for building multifaceted, sustainable primary and community-based health-care solutions that optimally utilize clinicians' knowledge and skills while supporting streamlined care pathways that enhance access to care," Nakhla says.
"It also an opportunity to reshape the perception of the profession and redefine who pharmacists are as clinicians."
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