Identifying potential for pharmacist ambulatory conditions prescribing in an urgent care centre
Celeste Giovanatti, Bruce Li Shing Pun, Denise Kreutzwiser, Adriana TooAbstract
Background:
In Ontario, pharmacists are authorized to treat 19 ambulatory conditions, self-limiting conditions involving minimal follow-up. At St. Joseph's Hospital in London, Ontario, the urgent care centre (UCC) frequently reaches full capacity early in the day and must temporarily stop accepting patients. Pharmacists may be well-positioned to manage patients presenting to UCC for these lower-acuity conditions, enabling physicians to focus on more complex cases while potentially enhancing overall health care system capacity.
Objectives:
The primary objective of this study was to quantify the proportion of UCC visits that could have been managed by a pharmacist through ambulatory conditions prescribing. The secondary objective was to characterize the specific ambulatory conditions treated within the UCC and the drug classes prescribed for these conditions.
Methods:
Retrospective chart review of 300 randomly selected St. Joseph's Hospital UCC encounters from January 1, 2024 to December 31, 2024.
Results:
Of 300 encounters, 59 could have been managed by a pharmacist. Eleven different ambulatory conditions were diagnosed and 8 classes of medications within pharmacist scope were prescribed. The most commonly diagnosed ambulatory conditions were urinary tract infection, conjunctivitis, and gastroesophageal reflux disease. The most frequently prescribed drug classes for ambulatory conditions were oral antibiotics, proton-pump inhibitors, and antihistamines.
Conclusion:
Pharmacists can play a significant role in mitigating Ontario's health care access crisis through ambulatory conditions prescribing, although public awareness of their full scope of practice remains limited. Redirecting cases of ambulatory conditions from UCC to pharmacists could preserve capacity for higher acuity cases and optimize use of health care resources.