Pharmacists' Prescribing Powers In New Brunswick

In New Brunswick, pharmacists can prescribe medication for a range of health conditions, including certain minor ailments. This means that eligible residents can access care and treatment for ailments such as cold sores, urinary tract infections, and allergies without having to visit a doctor's office or after-hours clinic. The expansion of the role of pharmacists in New Brunswick is aimed at improving access to primary care and reducing strain on the healthcare system. This move has been welcomed by the New Brunswick Pharmacists' Association, which has long advocated for expanded coverage for pharmacists.

Eligibility requirements for antibiotic prescriptions

To be eligible for antibiotic prescriptions in New Brunswick, you must meet the following requirements:

Firstly, you must be a resident of New Brunswick and possess a valid NB Medicare card. It is important to note that individuals residing in nursing homes or correctional facilities are not eligible for this service.

Secondly, the service is intended for minor ailments that do not require lab or blood tests. These typically include short-term conditions that can be managed with minimal treatment or self-care strategies. Examples of such ailments include cold sores, uncomplicated urinary tract infections, allergies, conjunctivitis, and mild acne.

Additionally, certain eligibility criteria are specific to each type of ailment. For instance, to receive treatment for acne, you must be between 12 and 30 years old, while eligibility for conception management is limited to those aged 12 to 50.

It is worth noting that while most pharmacies in New Brunswick provide minor ailment assessment and prescribing services, not all pharmacies offer this service for every minor ailment. Therefore, it is advisable to check with your local pharmacist to confirm if they can provide the service you require.

Conditions pharmacists can prescribe medication for

In New Brunswick, pharmacists can prescribe medication for a range of conditions, often referred to as minor ailments. These include:

• Allergic Rhinitis (hay fever)
• Conjunctivitis (allergic and bacterial)
• Contact Allergic Dermatitis (allergic skin rash)
• Dysmenorrhea (pre-menstrual and menstrual pain)
• Dyspepsia (indigestion)
• Emergency Contraception
• Fungal Infections of the Skin
• Gastro-esophageal Reflux (heartburn) Disease (GERD)
• Herpes Simplex (cold sores)
• Herpes Zoster (shingles)
• Mild to Moderate Eczema
• Mild Urticaria (hives, bug bites and stings)
• Minor Sleep Disorders
• Non-infectious Diarrhea
• Oral Fungal Infection (thrush)
• Oral Ulcers (canker sores)
• Severe Acute Respiratory Syndrome (SARS)
• Threadworms and Pinworms
• Upper respiratory tract conditions (cough, nasal congestion and discharge, sore throat, fever, malaise)
• Urinary Tract Infection (uncomplicated)
• Vaginal Candidiasis (yeast infection)
• Warts (excluding facial and genital)
• Xerophthalmia (dry eyes)

Pharmacists in New Brunswick can also prescribe certain vaccines and/or drug products for preventable conditions, including:

• Meningococcal disease
• Pneumococcal disease
• Pregnancy (i.e., prescribe birth control)
• Severe Acute Respiratory Syndrome (SARS)
• Varicella zoster (chickenpox)

In addition, New Brunswick pharmacists can renew prescriptions, such as for blood pressure medication, without referring patients to a doctor or outpatient clinic. They can also prescribe medication for Lyme disease prophylaxis after a high-risk tick bite.

Conditions requiring a doctor's visit

In New Brunswick, pharmacists can prescribe medication for a variety of minor ailments. However, for certain conditions, a visit to the doctor's office or a consultation with a physician is necessary. Here are some conditions that require a doctor's visit:

Urinary Tract Infections (UTIs):

UTIs are bacterial infections that require antibiotics for treatment. While pharmacists in New Brunswick can assess and prescribe medication for uncomplicated UTIs in eligible patients aged 16 to 64 who have been previously diagnosed, more complex or recurrent UTIs may require a doctor's visit. Doctors can determine the appropriate course of treatment, especially if the infection is severe or has spread to the kidneys.

Sinus Infections:

Sinus infections can be caused by bacteria or viruses, and only bacterial sinus infections should be treated with antibiotics. While most sinus infections resolve on their own, if symptoms persist for more than 10 days, a doctor's visit may be necessary to determine the underlying cause and prescribe antibiotics if needed.

Pneumonia:

Pneumonia can be life-threatening, especially in people with weak immune systems, and all cases of bacterial pneumonia should be treated with antibiotics. A doctor's visit is essential to receive a proper diagnosis and prescription for this condition.

Cellulitis:

Cellulitis is a serious bacterial skin infection that requires prompt medical attention and antibiotic treatment. While pharmacists can treat minor skin conditions, cellulitis may require a doctor's visit to ensure effective management and prevent potential complications.

Chronic Conditions:

While pharmacists in New Brunswick can provide chronic disease management for conditions like diabetes, COPD, asthma, and cardiovascular disease, more complex or unstable cases may require ongoing care from a physician. This is especially important for patients with comorbidities or those requiring specialized treatment.

Complex Infections:

Some infections can be complex and require a thorough evaluation by a physician. For example, bacterial meningitis or a kidney infection may necessitate a doctor's visit to ensure appropriate diagnosis and treatment.

It is important to note that this list is not exhaustive, and there may be other conditions where a doctor's visit is necessary. Pharmacists play a crucial role in assessing and treating minor ailments, but for more complex or severe conditions, seeking medical attention from a physician is essential.

Services covered by Medicare

In New Brunswick, Medicare covers the following services provided by pharmacists:

• Assessment and prescribing for cold sores (herpes labialis)
• Assessment and prescribing for conjunctivitis
• Assessment and prescribing for contact allergic dermatitis
• Assessment and prescribing for contraception management
• Assessment and prescribing for gastroesophageal reflux disease (GERD)
• Assessment and prescribing for impetigo
• Assessment and prescribing for Lyme disease prophylaxis
• Assessment and prescribing for mild acne
• Assessment and prescribing for mild to moderate eczema
• Assessment and prescribing for shingles (herpes zoster)
• Assessment and prescribing for uncomplicated urinary tract infections
• Prescription renewals

Medicare coverage for tests, items, and services depends on where you live. However, the following services are covered by Medicare in New Brunswick:

• Inpatient hospital care
• Skilled nursing facility
• Hospice
• Lab tests
• Surgery
• Home health care
• Doctor and other healthcare provider services
• Outpatient care
• Durable medical equipment
• Preventive services
• Ambulance services
• Emergency department services
• Eye exams (for diabetes)
• Hearing and balance exams
• Mental health care
• Physical therapy services
• Prescription drugs (outpatient)
• Wheelchairs and scooters
• And more

Role expansion of pharmacists

The role of pharmacists is expanding, with more pharmacists taking on new opportunities and participating in direct patient care. This expansion is driven by pharmacists in ambulatory clinics, health systems/hospitals, and home delivery pharmacies. They are taking on roles as advisors to patients with specific diseases and working with larger care teams to manage complex patient care. This evolution is in response to the changing needs and expectations of patients, technological advancements, sociopolitical changes, and a shift to multi-disciplinary working.

Pharmacists are now responsible for prescribing a wider range of medications and treatments, including antibiotics, and managing drug therapy. They are also involved in vaccination services and chronic disease management. This expansion improves access to primary care and reduces the strain on the healthcare system, as patients can seek treatment for minor ailments at a pharmacy instead of a doctor's office or after-hours clinic.

Pharmacists are well-trusted by patients and are expected to play an increasingly integral role in care management. Their accessibility and expertise in medicines make them essential members of the healthcare team. The expansion of their roles includes wellness screenings, telepharmacy counseling, providing diagnoses for acute conditions, and prescribing medications to treat them.

However, there are challenges to the expanded role of pharmacists, including scope-of-practice limitations and reimbursement issues. Additionally, the expansion of their roles must be carefully managed to ensure that the best interests of patients and the public are served, and that professional boundaries and expectations are clear.

Overall, the role expansion of pharmacists is a positive development that improves patient care and accessibility to healthcare services.

Frequently asked questions