Pharmacy clinics fill a void: “If this isn’t transformation of health care, I don’t know what would be”

After 16 years as a pharmacist, Colleen MacInnis was ready to celebrate.  It was February 9, and she and her staff at the TLC Pharmasave in Shelburne were joined by the local MLA for a ribbon-cutting ceremony, marking the opening day as one of 12 Community Pharmacy Primary Clinics in Nova Scotia.

“The very first morning, we stood together, the whole team, and it was like we needed to take a moment to recognize the fact that we are among the first in our profession to be stepping into this space,” said MacInnis.

The clinics are a pilot program to improve access to health care under Nova Scotia’s Action for Health plan. The province is providing funding for pharmacists to dedicate 40 hours a week to see patients with chronic diseases that require management, such as diabetes or cardiovascular disease.  They can also assess and prescribe treatment for 31 minor ailments such as eczema, strep throat and cold sores. 

A quarter of people living in the Yarmouth health care zone do not have a doctor. Many go untreated because they are unable to travel to an emergency department or can’t afford to take a day off work to wait to be seen. 

“The sad thing is a lot of these people simply have not seen a health care provider in some cases for many years,” said MacInnis. “They’ve fallen through the cracks.” 

One of those patients recently made his way to the Shelburne pharmacy clinic at the suggestion of his regular pharmacist in a neighbouring community. He had diabetes, high cholesterol and high blood pressure and was trying to manage his health after losing his doctor two years ago.  After running tests, MacInnis found all five of his medications needed adjustment. 

“The blood pressure medication was no longer working.  Despite him taking his medication every day, his blood sugar was not well controlled, and his cholesterol was elevated.  For this man who is still out working…he did not have time to sit in outpatients …but he was concerned about his health because before his doctor retired, he impressed upon him that he needed to have his diabetes under control.”

That patient is now enrolled at a chronic disease program at the pharmacy where MacInnis and her team will see him regularly and get him back on track.

“If this isn’t transformation of health care, I don’t know what would be,” said MacInnis.  “It is literally changing these people’s lives and that’s what they say to us. And that is what makes me proud to be a part of it.” 

Even families who have a primary health care provider are finding out how important it is to have access to a pharmacy clinic.  Meghan Luis moved to Ohio, Nova Scotia two years ago with her husband and three children.  They have a doctor but knowing the pharmacy clinic is available is a relief.  “Those clinics were the next best thing to moving here.  Just to have that extra layer of medical access is great for any family and for anyone who moves here and is concerned about not having a doctor or not being able to get in.” 

This month, Luis’ 10-year-old son Mason sat out his hockey team’s championship game because he wasn’t feeling well.  She suspected a virus, but when his fever spiked again three days later, she took him to the TLC Pharmasave clinic rather than waiting days for an appointment with the family doctor. 

“Within six minutes after he was swabbed, we had a positive test result for strep throat, and a few hours later he was on medication and 24 hours after that he returned to school, which is great,” said Luis.

MacInnis sees this gratitude every day. “People are just so grateful. There is a sense of relief and an overwhelming sense of hope for people.  And I know it doesn’t solve all the problems, but it definitely fills in a gap that we are totally prepared to cover for people. It’s been really positive.” 

When MacInnis graduated as a pharmacist, this is the work she thought she’d be doing. Instead, she quickly learned it wasn’t. “All the profit that went toward our salaries and even keeping the lights on came from the dispensing of drugs, not from the knowledge base…not from the clinical services a pharmacist can provide.”   

While pharmacists have long had the training and the knowledge to do more, there was no business model that paid them to offer primary health care without charging a fee.  Under this pilot project, the province is paying each pharmacy $7,000 a month to cover the cost of staffing the clinic.  The pharmacist’s time in the clinic will be fully dedicated to seeing patients, rather than answering the phone and filling prescriptions. 

MacInnis says it took a health care crisis to get here.  “Finally, they were looking under every stone to say what can we do. It seems that all aspects of health care are finally being looked at and all professions are being considered with what they can bring to the table. Not just us. Paramedics, nurses, everybody.”

Click here https://pans.ns.ca/cppcc for the full list of Community Pharmacy Primary Clinics and the conditions that can be treated.