Nova Scotians no longer need to see a doctor or visit a walk-in clinic to get prescriptions for birth control, routine bladder infections or shingles.

Those are some of the changes to the scope of practice for pharmacists that are intended to improve the way patients in the province access health care.

Pharmacists can now continue a prescription that has been expired for up to 180 days. That used to be limited to 30 days for chronic conditions.

"The goal [is] making sure that patients don't go without medications that they need because of inability to access primary health care," said Beverley Zwicker, CEO of the Nova Scotia College of Pharmacists.

The changes came into effect Dec. 1.

Pharmacists have been able to write prescriptions for most minor ailments, like heartburn and cold sores, since 2013, but Zwicker said they recognized that could be expanded.

The new regulatory framework was developed in consultation with physicians, nurses and the Department of Health.

Pharmacists are now permitted to extend a prescription that has been expired for up to 180 days. That used to be limited to 30 days for chronic conditions. (CBC)

There are protocols, Zwicker said, to make sure pharmacists know when it's appropriate to write a prescription and when they need to refer a patient to a physician or nurse practitioner.

For example, a pharmacist can write a prescription for a bladder infection, but if the patient has had two or more bladder infections in the last six months they would need to be referred to a physician, she said.

Pharmacists are required to bring patients into a private consultation room to conduct assessments, Zwicker said.

"I'm very excited that we're going to be able to do these," said Carolyn Cox, a pharmacy manager in the Annapolis Valley. "We certainly, living in Middleton, have a lot of people without access to a family doctor or even a hospital depending on when or what day of the week it is."

Out-of-pocket cost

But the assessments aren't covered by provincial health care or private plans, Cox said, so patients will still need to pay out of pocket to be assessed by a pharmacist.

Cox said her pharmacy charges $22.50 for an assessment for birth control, bladder infections or shingles.

"We certainly live in an area where people have limited income, and we also have a lot of seniors in the area," she said. "So that is a barrier for people."

Still, she said, for many people it can be preferable to waiting hours in outpatients for a simple assessment and prescription.

When it comes to prescribing contraceptives, that's not something that needs to be diagnosed, and it's within a pharmacist's knowledge and skills to provide it, Zwicker said.

A training course in contraception management is being offered at Dalhousie University for pharmacists who want to be able to provide the service.

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