Ontario pharmacists should soon be able to write and fill prescriptions for minor ailments without need of a doctor's order, a report released this week by the provincial health ministry suggests.

As well, your local pharmacy could become your first stop for prescription extensions, drug adjustments and medication monitoring through pharmacist-ordered lab tests, the Health Professions Regulatory Advisory Council has recommended.

"We're very happy (to) collaborate with other health professionals and really play our role in delivering health care to patients in Ontario," says Dennis Darby, head of the Ontario Pharmacists' Association.

"The good news is the advisory council agreed ... that pharmacists should be tasked with a higher level of care to patients."

The report, presented to the Ministry of Health and Long-Term Care in September was released publicly Tuesday evening. The advisory council is comprised of seven members of the public who offer policy recommendations to the minister.

Having prescribing pharmacists would take the pressure off emergency rooms and doctors' offices.

And while the paper leaves it up to the ministry, doctors, nurses and pharmacists' organizations to work out limitations and protocols – a job that will doubtless take months – it broadly sets out expanded practice guidelines for druggists.

Perhaps the most intriguing of these is the potential for pharmacists to dispense prescription drugs for some minor ailments.

"For example, things like dermatitis, you come in with poison ivy, and (the pharmacist) prescribes a cortisone," Darby says. "Or you come in with red eye or pink eye and they would be able to prescribe a short course (antibiotic) therapy."

There are some 11,000 pharmacists in Ontario and about 3,000 drugstore outlets.

Darby, who cites the United Kingdom as a model for such doctorless diagnoses programs, suggests conditions such as urinary tract and yeast infections might also be identified and treated in a pharmacy.

Pharmacists would then report their diagnosis and drug selection to a patient's physician, reversing the traditional flow of information.

"This is the beginning of a process and something I am eager to work to," provincial Health Minister David Caplan said, adding next steps include determining if legislative or regulatory changes would be required to allow the new powers.

The report also recommended pharmacists be allowed to:

Adjust prescriptions. Darby says, pharmacists may be able to change a prescribed gel medication to a liquid form, or adjust dosages.

Extend some refills.

Order lab tests to ensure medications are working properly. Darby says this might include tests for blood glucose levels to determine diabetes medications are working.

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Teach people how to inject themselves with medications and use blood-testing devices.

Initiate smoking-cessation treatments, including the use of prescription addiction suppressors.

Ridgeway, Ont. pharmacist Donnie Edwards praised this last initiative. "You don't want to say to the person `I know you're ready to stop smoking but you have to make an appointment with your physician and you might not get in for three or four weeks,'" he says.

Toronto pharmacist Ruth Henry welcomed the potential to expand her practice. But any newly proffered responsibility would have to be accompanied by appropriate retraining, says Henry, who works out of an Economy Prescriptions facility on Lawrence Ave. W.

"There are certain things I would not be that comfortable with, like diagnosing urinary tract infections. You could be missing something much more serious," Henry says.

Darby says the current crop of students at Ontario's two pharmacy schools will graduate with the skills to perform the new duties they could eventually be allowed to take on. He says current pharmacists would be offered training appropriate for each new duty.

While no pharmacist would be forced to take on new responsibilities, practice expansion would be especially useful in rural and medically under-serviced areas.

Pharmacists would be paid for extra services, but Darby says it's unclear if pay would come from OHIP.

Spokespeople for both the Ontario Medical Association and the College of Physicians and Surgeons of Ontario said they would like to analyze the entire report before making comments. The Ontario College of Pharmacists was likewise cautious about judging the proposals.

- With files from Tanya Talaga