Without access to a family doctor, more and more Quebecers are turning to a pharmacist to renew their drug prescriptions. From January to September, pharmacists performed 582,850 extensions, according to data obtained by The duty with the Régie de l’assurance maladie du Québec (RAMQ). This is 67% more than during the whole of 2020.
Pharmacists have been in great demand by patients since the start of the pandemic. “We do a lot, a lot of prescription extensions because there is less access [aux médecins de famille], confirms Benoit Morin, president of the Quebec Association of Owner Pharmacists. There are places where people no longer have a family doctor and we can extend [leur ordonnance]. »
Since June 20, 2015, pharmacists have the power to extend an expired prescription when the patient’s doctor is not available or when he is inactive (if he is convalescing, retired or struck off, for example). In five years, they have carried out a growing number of extensions: from 64,391 in 2015 to 349,230 in 2020, then to 582,850 in 2021 (from January to September).
“There has been a very big increase [des prolongations] in March 2020, at the start of the pandemic, when people found themselves no longer able to see their doctor, ”notes Bertrand Bolduc, president of the Ordre des pharmaciens du Québec.
Another jump in 2021, following the abolition, on January 25, of the fees payable by the patient to renew a prescription from a pharmacist. “This brake is lifted, rejoices Benoit Morin. The patient, I will not tell him: it costs $ 15 for the drugs plus $ 12.50 for the consultation. There is just going to be the price of the medicine, as if he had gone to see the doctor. That is a big, big difference. “
It is to improve access to the first line that the Minister of Health, Christian Dubé, at the beginning of the year eliminated the financial contribution of patients for several services offered in pharmacy, in particular the extension of prescriptions.
Quebec has also granted new powers to pharmacists, such as allowing a patient to start treatment for shingles until he gets an appointment with a doctor. “For shingles, we have 72 hours to start treatment, otherwise, there’s no point afterwards,” says Benoit Morin.
Despite these measures, access to the first line remains a glaring problem. Patients end up in emergency rooms to renew their prescriptions, says Dr.r Gilbert Boucher, President of the Quebec Association of Emergency Medicine Specialists. “I saw two [mardi matin] Says the doctor.
These patients, emphasizes Dr Boucher, did “their homework” before going to the hospital in desperation. They asked their pharmacist to help them out by renewing their prescription for 12 months – the maximum allowed when the length of the initial prescription is at least 12 months. They then tried to get a consultation at a walk-in clinic. In vain.
Bertrand Bolduc believes that “we must improve access to doctors”. Pharmacists are not a “quick fix”, he said. The President of the Order recalls that its members have contributed to the COVID-19 vaccination campaign and that they are preparing to begin, on 1is November, the one against the flu.
“Can we do more follow-up, more adjustments [de médication] ? Bertrand Bolduc asks. Of course, we can do it. We do a lot for everything [touche les] anti coagulants. More can be done for diabetes, hypertension, thyroid, migraines. We can do anything. We are already doing it. But it is still necessary to see a doctor once in a while. “
Pharmacies are also facing a staff shortage. “There is a lack of pharmacists and technical aids everywhere in Quebec,” says Bertrand Bolduc. We are told about compulsory vaccination [contre la COVID-19 dès le 15 octobre]. We too will make holes. According to the president of the Order, 97% of pharmacists are vaccinated. “There are a few hundred who resist”, specifies Bertrand Bolduc.
More can be done for diabetes, hypertension, thyroid, migraines. We can do anything. We are already doing it. But it is still necessary to see a doctor once in a while.
The Quebec Association of Owner Pharmacists still says it does not know who, among the pharmacy employees, should be vaccinated. “Our understanding is that for pharmacists and nurses who work in pharmacy, it will be mandatory,” says Benoit Morin. For the rest of the staff, we did not receive clear instructions from the department to tell us whether this will affect all the employees in the laboratory or the entire pharmacy. “
The group says it agrees with compulsory vaccination. “But we want a certain flexibility on the part of the application of the decree towards technical assistants if they were included,” says Benoit Morin. Especially, he emphasizes, that the deadline to be adequately vaccinated by October 15 has already expired.