For over a decade, OPA has been advocating for the expansion of pharmacists’ scope of practice to include the authority to assess and, if necessary, prescribe for minor ailments.
Following extensive advocacy work, regulations authorizing Part A pharmacists, registered pharmacy students and interns in Ontario to prescribe certain medications for thirteen minor ailments came into effect on January 1, 2023. Furthermore, on October 1, 2023, the regulations were amended to include an additional six minor ailment conditions. The nineteen minor ailments included within scope are:
- Allergic rhinitis
- Conjunctivitis (bacterial, allergic and viral)
- Dysmenorrhea
- Hemorrhoids
- Impetigo
- Tick bites, post-exposure prophylaxis to prevent Lyme disease
- Urinary tract infections (uncomplicated)
- Acne (mild)
- Diaper dermatitis
- Nausea and vomiting of pregnancy
- Candidal stomatitis (oral thrush)
- Dermatitis (atopic, eczema, allergic and contact)
- Gastroesophageal reflux disease (GERD)
- Herpes labialis (cold sores)
- Insect bites and urticaria (hives)
- Musculoskeletal sprains and strains
- Aphthous ulcers (canker sores)
- Vulvovaginal candidiasis (yeast infection)
- Pinworms and threadworms
OPA also successfully advocated for the establishment of a publicly funded minor ailment program in Ontario pharmacies that is based on the following principles:
As a result of OPA’s continued advocacy efforts to pursue an expanded scope of practice that is consistent with most other provincial jurisdictions, in addition to the success of the program to date, the government is exploring the addition of further minor ailments to scope including those that may require additional scope of practice expansions to support safe and effective prescribing. The following list of minor ailments has been submitted by the Ontario College of Pharmacists to the Minister of Health for consideration:
- Acute pharyngitis (sore throat)
- Birth control
- Calluses and corns
- Emergency contraception
- Erectile dysfunction
- Headache (mild)
- Herpes zoster (shingles)
- Minor sleep disorders (insomnia, could also include disturbances in circadian rhythm)
- Onychomycosis (fungal nail infections)
- Otitis externa (swimmers’ ear)
- Pediculosis (head lice)
- Rhinitis – viral (nasal congestion)
- Seborrheic dermatitis (dandruff)
- Tinea corporis (ringworm)
- Tinea cruris (jock itch)
- Verrucae (vulgaris, plantar) (warts)
- Xerophthalmia (dry eye)
Some of these may be subject to certain conditions or restrictions that will be determined and included in the draft regulations to be proposed by the Ontario College of Pharmacists should the Minister decide to move forward with any or all of these minor ailments.
OPA’s continued priorities related to minor ailments include but are not limited to:
- Advocating for the addition of more minor or common ailment conditions to scope in addition to other expansions of scope of practice that are required to support safe and effective prescribing (e.g., authority to order lab tests, therapeutic substitution)
- Removal of prescriptive drug lists from the regulations
- Ensuring that new scopes of practice are appropriately remunerated for under the publicly funded program
- Enabling pharmacists in all settings to practice to full scope
- Expanding the publicly funded program to provide remuneration for all minor ailment assessments provided by pharmacists regardless of where it is provided (e.g., long-term care, family health teams, etc.)
OPA Resources
Prescribing for Minor Ailments - 6 Conditions, October 2023
OPA is working on developing additional tools and resources to support the profession with adopting this new scope into practice. As these become available, OPA will notify members through our email communications and will update this page accordingly.
Additional Resources
MAPflow Annual Subscription
Minor Ailments Prescribing Workflow Tool
MAPflow is a web-based clinical decision support tool designed specifically for the Ontario pharmacy practice environment by Dr. Nardine Nakhla. MAPflow subscriptions are fully portable across multiple sites, enabling pharmacists to use the tool in any practice environment where they perform minor ailments assessments.
OPA Members Save on Annual Subscription