Abstract
Background: The aim of this document analysis was to characterize information on the current scope of practice and reimbursement models of community pharmacists across Canada regarding sexual healthcare. A secondary aim was to determine how the strategic plans of pharmacy organizations impact expansion, regulation and accessibility of these services, while also addressing the roadblocks to implementation of new services to the community pharmacy landscape.
Approach: A document analysis of pharmacy organizations (such as national/provincial regulators, provincial/territorial pharmacy associations, and government budgets for each representative province or territory) were reviewed to collect data pertaining to provision and reimbursement of sexual health services. Data was screened for inclusion of service reimbursement, prescribing authority, and service availability. Data was confirmed with a practicing pharmacist for each province or region. Data was then compared to themes identified from strategic plan data to identify strategic opportunities, and roadblocks to expansion, implementation and access for patients across Canada.
Results: Services that are available in at least one province in Canada were injections, vaccine prescribing, prescription renewals, pre-exposure prophylaxis (PrEP) assessment/prescribing, post-exposure prophylaxis (PEP) assessment/prescribing, hormonal contraception assessment/prescribing and minor ailment prescribing. Availability and reimbursement of these services was dependent on provincial regulations. Themes identified from the strategic documents that support provision and expansion of sexual health services in pharmacies included: scope of practice expansion, primary care, legislation reconstruction, public education, pharmacist education and interprofessional collaboration.
Implications: Sexual health services are being offered but not consistently across all provinces. The pharmacy profession has strategic goals that align with service provision and expansion, yet provincial legislation frameworks and pharmacy reimbursement models are still barriers to implementation and uptake.