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B.C. pharmacists welcome new prescription powers, but eye administrative burden

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VANCOUVER — Pharmacists in British Columbia are welcoming an expansion of their powers to prescribe drugs and give vaccines, but they also say that how the changes are implemented will matter.

Cathy Wang, pharmacist and owner of 360Care Denman Pharmacy in Vancouver, described the shift as “very positive.”

“It’s a very exciting day for us,” she said, adding it will mean more access to care for patients.

Health Minister Adrian Dix announced the expansion last week as part of a plan to address human resource challenges that are contributing to an ongoing health-care crisis.

Starting Oct. 14, B.C. pharmacists will be able to administer more vaccines and renew prescriptions for up to a two-year period for people whose family doctors have retired or left their practices.

Next spring, they will begin prescribing drugs for minor ailments like urinary tract infections and allergies, as well as contraception.

The changes bring British Columbia in line with guidance from Health Canada and other provinces. Alberta gives pharmacists more leeway, including allowing them to administer things like cosmetic injections and order lab work, while Ontario was the last province before B.C. to empower pharmacists to issue prescriptions for minor ailments.

As the changes are rolled out, B.C. pharmacists said the smoothness of the transition will depend on the reimbursement model, staffing supports and whether there’s an added administrative burden.

Like many health professionals, pharmacists have faced burnout and labour shortages since the COVID-19 pandemic began.

A survey of 1,399 pharmacists and pharmacy technicians early this year commissioned by the Canadian Pharmacists Association found almost all pharmacy professionals — 92 per cent — reported being at risk of burnout. Nearly half report abuse or harassment from patients on a weekly basis.

“The unrelenting demands, coupled with added administrative burdens and staffing challenges, have pushed us to a tipping point,” chief pharmacist officer Danielle Paes said in a statement when the survey was released in May.

As an independent, Wang said she has some control over the workload, but she said she’d like to see supports in place to protect others from unreasonable demands.

At the same time, she said expanding the scope of pharmacists may actually help with retention. It’s been discouraging for some pharmacists not to use their skills and training to their full potential, she said.

“There’s actually a lot of young practitioners who have left the profession because there’s not enough reward. There’s a huge gap in what we learn in school, in terms of clinical practices,” Wang said.

“I think, in short, there may be a little bit more workload but it will probably increase the morale.”

Wang also said she’ll be keeping an eye on the reimbursement model. Currently, when doctors give an injection, they receive a fee for service, she said. Unless the government supports the same for pharmacists, the costs may be passed on to patients, she said.

In a submission to the B.C. government ahead of Budget 2023, the Neighbourhood Pharmacy Association of Canada proposed a professional services fee of $20 per assessment, which it said is in line with other provinces with remuneration frameworks. In Saskatchewan, it estimates that every $1 invested in the program saves the health-care system $2.53.

The association estimates B.C. pharmacies could assess about 60,000 minor ailments a year for $1.2 million.

A pharmacist working in the Fraser Valley, who wished to go unnamed because he didn’t want to put his job at risk, said he supports the changes but hopes they don’t come with too much extra administrative work, which already involves one to two hours per day.

“We already have a lot of filings that we have to do behind the scenes,” he said.

Giving COVID-19 and flu shots has added extra work, he said. However, the bigger concern is the need to report data through a provincial portal that is cumbersome, taking more than 15 minutes per patient, he said.

“The COVID shots and this year’s flu shots, they changed the whole system. That is definitely a little bit more pressure to us,” he said.

However, the pharmacist said it’s overall positive to expand the scope of pharmacists to better use their skills and training.

It should also help reduce bottlenecks, like when a patient asks for a refill and the pharmacist has to contact the doctor — a process that can take one or two days, he said.

Parm Johal, pharmacist and owner of Wilson Pharmacy, said he’s generally happy with the news.

The COVID-19 pandemic gave pharmacists the opportunity to step up and show their value, he said. The new changes mean they’ll continue being able to help relieve pressure on other health-care providers and ensure continuity of care.

“We feel it’s a long time coming,” he said. “There’s a few of us who have always been advocating for it.”

This report by The Canadian Press was first published Oct. 6, 2022.

 

Amy Smart, The Canadian Press

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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

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The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.

It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.

Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”

Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.

Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.

A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.

On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.

Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”

But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”

“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.

Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.

Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.

Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.

“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.

“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”

This report by The Canadian Press was first published Sept. 13, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.

The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.

Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.

“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”

The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.

A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.

Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.

“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.

Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.

The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.

“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.

This report by The Canadian Press was first published Sept. 11, 2024.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

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