Monday, June 25, 2012

Canadians embracing larger role for pharmacists in health care: poll ...

OTTAWA ??? On the cusp of a milestone for medicare and in the lead-up to a much-anticipated report on health care innovation, Canadians have indicated that they have an appetite for thinking outside the box on how they can access health-care services.

The majority of Canadians would be open to seeing private-sector pharmacies such as Shoppers Drug Mart extend their products and services into new avenues of health care, according to the results of an Ipsos Reid poll released to Postmedia News, and Canada?s leading health-care professional associations and policy analysts agree that it?s a conversation worth having.

?Enabling all health-care professionals to deliver the full range of care that they?re able to makes a lot of sense for our health-care system,? said Barbara Mildon, the president of the Canadian Nurses Association.

?The long-term financial model to support our health-care system is of great concern across the country. Cost-effective ways of delivering services that keep Canadians healthy are very important, and innovation is important in how we deliver care and services.?

The poll, which surveyed a sample of 1,030 adults across Canada, asked respondents to assess their level of support for the idea of private pharmacies offering a range of health services.

The results were released as Canada nears the 50th anniversary of its national health-care insurance program and as a working group of Canada?s provincial and territorial premiers prepares to release its first report on new ways to help ensure the sustainability of health care services.

In the poll, support was strongest for having trained pharmacists administer doctor-prescribed vaccines and other drugs on site, at 88 per cent. Support remained strong across the board for other proposals, such as having pharmacies provide in-home nursing or medical care, offer outpatient clinics for physiotherapy or sports medicine, offer hospitals for specific treatments, and provide nursing homes.

More than 80 per cent of respondents said they believed that the products and services owned and offered by pharmacies would be higher than or as good as those currently available. Only 17 per cent said they believed the quality of any of the services would be lower if they were owned and offered by pharmacies.

While Quebec and the Atlantic Provinces showed the strongest support for the range of potential services, support remained high in all regions of Canada.

The poll purposely did not delve into who would pay for these services, their profitability, or the issue of whether public or private institutions should be delivering them, said John Wright, the senior vice president of Ipsos Global Public Affairs.

?We wanted it devoid of that. We simply wanted to test the saliency of it. And I think what it demonstrated is that there?s a lot of acceptance,? Wright said.

Pharmacists are among the most trusted professionals in the country, Wright said. In fact, in January ??? for the second year in a row ??? pharmacists claimed the top spot in an Ipsos Reid poll of the most trusted professions in Canada.

And the scope of the work done by pharmacists in Canada is expanding already.

Many pharmacists are giving injections in Alberta, British Columbia and New Brunswick, said Janet Cooper, the senior director of membership and public affairs at the Canadian Pharmacists Association. A lot of seniors? homes also have pharmacists as part of the health care team. And pharmacists can order and review lab tests in Alberta, Quebec and New Brunswick.

It?s a shift that?s welcomed by pharmacists, many of whom have felt constrained by a business model that has them spending much of their time on the technical aspects of dispensing prescriptions, Cooper said.

?Most of us have thought, ?I could be doing so much more. With my knowledge, my skills, I could be doing so much more?,? Cooper said. ?There?s been a desire across the pharmacy profession for a long time for this.?

The more that care can be integrated, the better, said Dr. Michael Rachlis, one of Canada?s leading health policy analysts.

But most Canadians don?t know how good their health-care services could be for what they?re already paying, Rachlis said, and have little knowledge of the integrative models already available to them such as community health centres.

It?s no wonder the poll results were so positive, Rachlis said.

?People are desperate for one-stop shopping,? he said. ?They want to go somewhere besides an emergency department and be able to get in the same day. They want to be able to get their needs met without wasting a lot of time.?

The Canadian Medical Association believes that some expansions to pharmacists? scope of practice could benefit patient care and doctors within a collaborative care framework, said Dr. John Haggie, the association?s president, in an email to Postmedia News.

?Pharmacists are essential members of the health care team. Their expertise, like that of all health professionals, should be used to its fullest extent and integrated into a comprehensive system of effective patient care,? Haggie said.

The Canadian Nurses Association agreed that collaboration was necessary to avoid duplication of services and fragmentation of care. The notion of pharmacists expanding their services lends itself well to the development of community-based teams, Mildon said.

In January, Canada?s provincial and territorial health ministers announced that they?d formed a health-care innovation working group to drive a collaborative process for transformation and innovation to help ensure the sustainable delivery of health care services.

The group, chaired by Prince Edward Island Premier Robert Ghiz and Saskatchewan Premier Brad Wall, will release its first report in July.

The working group presents a real opportunity to think about health care in broader ways, including the role pharmacists can play, said Douglas Angus, a health economist and health care management expert at the University of Ottawa.

?If all Wall and Ghiz are going to be doing is sort of looking at ways to massage the way we currently do things, then my recommendation to them would be just to wrap it up and move onto some other issues,? Angus said.

?We?ve been studying, studying, studying, doing commissions and special reports after special reports. It doesn?t matter which part of the country you?re from ? we all recognize the same issues and we?ve come up with pretty much the same recommendations.

?We?re stuck in first gear. It?s time to get out of first gear and do some of these things.?

The Ipsos Reid poll was conducted from April 26-60. Weighting was employed to balance demographics.

A survey with an unweighted probability sample of the same size and a 100 per cent response rate would have an estimated margin of error of plus or minus 3.1 percentage points, 19 times out of 20, of what the results would have been if the entire population of Canada had been polled.

Fact Box: Total support in Canada for pharmacies offering the following extended products and services:

- 88 per cent: Having trained pharmacists administer doctor-prescribed vaccines and other drugs on site.

- 87 per cent: Outlets in malls or storefronts for medical services such as wheelchairs or other devices.

- 84 per cent: In-home nursing or medical care for seniors or others requiring attention.

- 81 per cent: Outpatient clinics for physiotherapy or sports medicine.

- 79 per cent: Laboratory or X-ray services.

- 75 per cent: Hospitals for specific treatments such as geriatric care.

- 74 per cent: A hospice for those in need of palliative care.

- 71 per cent: Ambulance or medical transport services.

- 70 per cent: Nursing homes.

- 69 per cent: Retirement homes

Source: Ipsos Reid

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