The majority of Quebec physicians are in favour of expanding pharmacists’ responsibilities, however, they still have concerns over some details.

Quebec physicians would be largely in favour of expanding pharmacists’ responsibilities, according to a survey conducted by the Quebec Medical Association (QMA).

The QMA asked Quebec doctors for their opinions on the five new professional activities put forth by the Quebec Order of Pharmacists last spring. These new responsibilities include extending and adapting certain prescriptions, resolving simple health problems, administering medicine as a teaching or public health measure, and requesting lab tests to monitor medication therapy.

The results show that doctors of all kinds are largely in favour of four out of the five responsibilities pharmacists proposed.

Just like doctors, pharmacists want these new responsibilities to be clear and well-defined.

When it comes to pharmacists extending prescriptions, 83% of respondents said they were mostly or completely in favour of the idea. The response was equally positive for allowing pharmacists to adapt a prescription if required (79% in favour).

As for pharmacists administering medicine as a teaching or public health measure, 93% of doctors participating in the survey were in favour.

Even the more controversial issue of allowing pharmacists to resolve simple health problems, such as seasonal allergies or cold sores, received strong support. More than three-quarters (78%) of respondents would be in favour of this proposal.

More than 1300 of the 10,000 doctors contacted replied to the QMA’s questions by email at the end of June. The survey’s margin of error is 2.5%, 19 times out of 20. “The QMA is in a good position to survey the opinions of different kinds of doctors, including general practitioners, specialists, residents and students,” says QMA President Ruth Vander Stelt. “These findings could be useful in discussions by the joint committee of the College of Physicians and the Quebec Order, or possibly in a parliamentary commission.”

Some concerns

A quantitative evaluation clearly shows doctors’ support, but it’s important to note that a qualitative evaluation reveals doctors have several concerns about the Order’s proposals, Vander Stelt says.

The QMA president says doctors participating in the survey felt these new activities for pharmacists should have clear boundaries to ensure patient protection.

“Diagnosis must remain strictly part of medical practice and not be entrusted to pharmacists or patients themselves,” says Vander Stelt. “Doctors also have other concerns, especially regarding potential conflicts of interest for pharmacists selling medication.”

Another concern involves allowing pharmacists to request lab tests in order to monitor medication therapy. Less than half of respondents (47%) agreed with this idea.

Doctors surveyed felt it was their job to make clinical decisions based on lab test results, says Vander Stelt.

“What doctors are telling us is that this question in particular requires careful examination. For example, if a pharmacist thinks a patient is suffering from kidney disease, what would he do? Tell the patient? Call the treating physician? Doctors have a lot of problems with this issue,” she says.

Quebec Order delighted

The Order’s President, Diane Lamarre, says she is delighted with the QMA survey results. “This reflects the cooperative spirit of doctors and pharmacists,” she says.

At the same time, she acknowledges doctors’ concerns and offers reassuring words: “Just like doctors, pharmacists want these new responsibilities to be clear and well-defined. In order to come to an agreement that will satisfy everyone, we’ll discuss these issues with the Quebec College of Physicians in a joint committee and in two subcommittees.”