M INOR AILMENT PRESCRIBING IN S ASKATCHEWAN Jahnaya Mann, BSP Erin Read, BSP Leah Perrault, BSP Pharmasave Swift Current, Sk H S ISTORY OF PRESCRIBING IN K First province in the country to be remunerated for  minor ailment services All Sask. Residents (includes: Drug Plan beneficiaries  and Federal beneficiaries-NIHB,DVA,RCMP) Feb 1st, 2012  Minor Acne  Insect Bites  Cold Sores  May 24th, 2012  Allergic Rhinitis  Diaper Dermatitis  Oral Thrush  Oral Aphthous Ulcer  HOW IT ALL CAME ABOUT! Oct 2009: Sask College of Pharmacists (SCP) contracted  Sask Drug Info Services (now know as medSask) to do a lit review medSask-provide advice to SCP for future expansions/changes  to the services The SCP Interdisciplinary Advisory Committee for  Prescriptive Authority MDs, NPs, Midwives, Pharmacists, Ministry of Health rep,  medSask Consultations and Pharmacist focus groups compiled a list  of conditions and rx drugs Developed criteria for conditions  Can be reliably self-diagnosed by patient  Self-limiting conditions  Lab test are not required for diagnosis  Treatment will not mask underlying conditions  Medical and medication histories can reliably differentiate  more serious conditions Only minimal or short-term follow-up needed  C P RITERIA FOR RESCRIPTION DRUGS CHOSEN Has an official indication for the self-care  condition Has valid evidence of efficacy for self-care  condition Has a wide safety margin  Not subject to abuse  Dosage regimen for treatment of self-care  conditions is not complicated R P ESULTS OF HARMACIST FOCUS GROUP Time frame for follow up  Referral criteria  Comparisons (efficacy, side effects, etc)  Age considerations  Dosage protocols, limits, flow charts, algorithms  Web access  W ? HY PHARMACISTS Often the first point of contact for patients  Trusted healthcare professionals  Accessible (many pharmacies open 24hrs)  We have the needed drug knowledge  No appointment required  Wait time to speak to a pharmacist is minimal  Increased access to needed medical  advice/treatment for patients without a family doctor W P ? HY HARMACISTS Healthcare studies show that a large majority of  patients self-treat Pharmacists prescribing for these conditions allow  these patients to more confidently self-diagnose and receive correct treatment Pharmacists can intervene and quickly identify  situations where a doctor referral is required M AIN GUIDING PRINCIPLES INTERdependent (not dependant or  independent) prescriptive authority in collaborative practice environments Team relies upon one another to achieve common  goal of optimal pharmacotherapy “Collaborative Practice environment”  Exists when practitioner can reasonably rely upon:  The basic skills of the pharmacist  To prescribe in best interest of patient  Communicate to practitioner (prescribing decision or  referral) Presumed to exist when prescribing under the bylaw  Does NOT exist when practitioner communicates  otherwise M AIN GUIDING PRINCIPALS Competency based (optimize use of current  competencies-not expanded scope of practice) Current standards remain (monitoring, follow-  up, continuity of care) Compatible with current health system  Enabling legislation with limits  Accountability framework  Self-regulation (ethics, standards)  Transparency through communication  (Pharmaceutical Information Program(PIP) and Patient Assessment Record(PAR)) and collaboration L EVEL I Characterized as “Basic”  Leverages the existing skills of all pharmacists  Conventional interdisciplinary collaboration  Includes minor ailments prescribing (training  mandatory for all Sask Pharmacists) Live training sessions hosted by SCP and U of S  Online training subsequently available 