The pharmacist will do an assessment to determine if it is safe and effective for you to continue to take the medication(s). If appropriate, the pharmacist will prescribe renewals (refills) for your medication(s). The pharmacist may also at this time recommend dosage adjustments or other changes to ensure your medication is doing what is expected.

This service is covered with your NS Health card up to 4 times per year.

Note: Pharmacists may assess and renew for narcotic and controlled drugs and substances, however there are limitations on the amounts that can be prescribed. The pharmacist will do an assessment to determine if it is appropriate to renew and in what quantity.

Patients that take the medication Warfarin can now participate in the Community Pharmacy-led Anticoagulation Management Program (CPAMS). The service includes INR Testing with a finger stick blood test that gives results in 5 minutes. The pharmacist can provide dose changes and advice based on the results. Pharmacies use a hospital grade testing device. Patients no longer need blood work completed at the lab nor wait for results.

The service also includes:

• A review with the pharmacist to assess factors that may be affecting your test results.

• Pharmacist recommendations that could include continuing with your usual warfarin dose, or the pharmacist prescribing a change to your warfarin dose. They will also provide other recommendations to assist with managing your medications and other factors that can affect your INR results where applicable.

• A calendar print-out with your dosing instructions.

*Results will also be sent to your family physician or nurse practitioner.

This service is only for those seeking a method of hormonal contraception. Pharmacists cannot provide this service if you require birth control for reasons other than contraceptive purposes (such as managing menstrual cramps, acne, etc).

During the assessment process, the pharmacist will work with you to determine the therapy that best meets your needs. You and the pharmacist will select the most appropriate method of birth control based on your medical history, medications, risk factors, guidelines and your preferences. Pharmacists may only prescribe intra-uterine methods (also known as IUD or IUC) of birth control when practicing as part of an arrangement with a primary care provider who can conduct an appropriate physical exam and insert the device. An initial three-month trial is usually prescribed for new treatment. The pharmacist will follow up with you to re-assess. Once an appropriate therapy is established, your prescription may be valid for up to one year.

During your consultation, the pharmacist will provide you with information on proper use of your birth control, what to do when you miss a dose, and possible adverse reactions. Your pharmacist will provide you with information and resources pertaining to other sexual health topics (such as sexually transmitted diseases, sexual dysfunction, assault, abortion, and screenings for cancer). They will also assess for any potential sexual health risk factors.

A notification of any medications prescribed or test results will be sent to your physician or NP. If you do not have one following your care, records are available to patients and available on the pharmacy file for 10 years.

Patients diagnosed with heart disease and high blood pressure qualify to receive chronic disease care from a pharmacist.

The pharmacist will provide an initial assessment to collect your information, identity any potential medication problems and discuss your goals for care.

Together, you and the pharmacist will create a plan which could include:

• Prescribing changes to your medications to help reach A1C, glucose, blood pressure and other goals.

• Guidance in minimizing or avoiding adverse effects from your medication

• In-pharmacy finger-stick testing for A1C and cholesterol (reducing the number of lab visits required).

• Training and support with home blood glucose or home blood pressure monitoring.

• Support and coaching to meet any lifestyle goals you set such as diet, exercise or smoking cessation.

• Ensuring you are up to date on the recommended immunizations for your condition.

• Setting a follow-up plan with the pharmacist to support you in achieving your goals.

Patients diagnosed with asthma or COPD qualify to receive chronic disease care from a pharmacist.

The pharmacist will provide an initial assessment to collect your information, identify any potential medication problems and discuss your goals for care.

Together you and the pharmacist will create a plan which could include:

• Prescribing changes to your medications to help you feel better and/or prevent worsening of your symptoms.

• Guidance in minimizing or avoiding adverse effects from your medication.

• Counseling and support with proper inhaler technique.

• Support and coaching to meet any lifestyle goals you set such as diet, exercise or smoking cessation.

• Ensuring you are up to date on the recommended immunizations for lung conditions.

• Setting a follow-up plan with the pharmacist to support you in achieving your goals.

Patients diagnosed with diabetes qualify to receive chronic disease care from a pharmacist.

The pharmacist will provide an initial assessment to collect your information, identify any potential medication problems and discuss your goals for care.

Together you and the pharmacist will create a plan which could include:

• Prescribing changes to your medications to help reach A1C, glucose, blood pressure and other goals.

• Guidance in minimizing or avoiding adverse effects from your medication.

• In-pharmacy finger-stick testing for A1C and cholesterol (reducing the number of lab visits required).

• Training and support with home blood glucose or home blood pressure monitoring.

• Support and coaching to meet any lifestyle goals you set such as diet, exercise or smoking cessation.

• Ensuring you are up to date on the recommended immunizations for diabetes.

• Setting a follow-up plan with the pharmacist to support you in achieving your goals.

Pharmacists can assess and prescribe for ear infections and sinus infections.

This includes both otitis media and otitis externa (commonly known as swimmers ear). This service is available to NS residents aged 3 years or older. If you or your child are experiencing symptoms such as ear pain, fever, or discharge, we can help! After the appointment, a copy of your assessment will be sent to your primary care provider. *Not eligible for patients who have tubes or previous ear surgery, or have recurrent otitis media ( 3 or more episodes in 6 months).

For sinusitis - often, (90%) sinus infections are viral, however the 10% of infections that are bacterial, require antibiotics to treat. If you are experiencing nasal discharge, obstruction, facial pain/pressure or your symptoms have been lasting more than 7 days without improvement, you may benefit from an assessment.

If you have been bitten by a tick, the pharmacist can assess the need for treatment to help prevent Lyme disease. Pharmacists can determine whether a preventive antibiotic is appropriate. The assessment will include questions to determine:

• whether the tick bite was from a black-legged tick

• whether the tick was removed in the previous 72 hours

• whether the tick was attached for at least 36 hours

The treatment is only recommended if it can be administered within a 72-hour window after the tick is removed. If there are any symptoms of Lyme disease, such as a rash or bull's eye rash at the bite site, then patients will be referred to their primary care provider for other treatment options

A notification of any medications prescribed or test results will be sent to your physician or NP. If you do not have one, records are available to patients and available on the pharmacy file for 10 years.

A pharmacist can support you with your mental health or substance use in several ways, including:

1. MEDICATION ASSESSMENTS - A pharmacist can help in managing medication-related issues and provide one-on-one care. Patients must have one or more mental health / substance use diagnoses and have a medication problem that they would like to work on with their pharmacist.

2. NICOTINE DEPENDENCE / SMOKING CESSATION Pharmacists are effective in providing a smoking cessation program and contributing to patient quit rates or reductions in the amount of nicotine used. They help smokers and those that use nicotine products reduce their use by providing behavioural counselling, creating quit plans, recommending nicotine replacement therapy and scheduling follow-up visits.

3. TAKE HOME NALOXONE KITS & TRAINING Naloxone is a medication that is injected to provide a partial or complete reversal of an opioid overdose. This medication can prevent death and respiratory depression associated with opioid overdose. Pharmacies can provide you with a free take home naloxone kit, recommended for those at risk of an opioid overdose and those who are most likely to witness and respond to an opioid overdose. The pharmacist will provide opioid overdose prevention education as well as training on the administration of naloxone.

4. INJECTIONS FOR: Opioid Addiction Treatment Anti-psychotic medications Other Prescription from another provider may be required for some injectable medications. The pharmacist will conduct an assessment before each injection to ensure it is safe/suitable to administer.

Pharmacists participating in the Community Pharmacy Primary Care Clinic Project can assess patients age 3 and over that have a sore throat to confirm if they have strep throat (Group A Streptococcal infection) which will require antibiotics. The pharmacist will ask questions about medical history, signs and symptoms that the patient is experiencing and perform a head, neck and throat exam. If the patient has signs of strep throat confirmed by the exam, the pharmacist will also take a swab of the back of the throat and perform a rapid molecular test in the pharmacy which will take approximately 10 minutes. If positive, the pharmacist may prescribe antibiotics.

Pharmacists can asess and prescribe for the following minor / common ailments:

1. GASTROINTESTINAL / DIGESTIVE TRACT Diarrhea (non-infectious) Heartburn/Reflux Hemorrhoids Nausea

2. INFECTIONS Bladder Infections Shingles Strep Throat (pilot in 12 project sites only) Vaginal yeast infections Fungal infections of the skin Impetigo Cold Sores Lyme disease prevention after black legged tick bite Eye Infections (pink eye)

3. HEAD/ NOSE/ THROAT Allergy Symptoms including the eyes and nose Headache (mild) Oral Thrush Oral Ulcers Sore Throat (4)

4. REPRODUCTIVE HEALTH Birth Control Dysmenorrhea (menstrual cramps) Emergency Contraception Vaginal Yeast Infections

5. SKIN CONDITIONS - Acne (mild) Calluses and Corns Contact & Allergic Dermatitis Dandruff Eczema (mild to moderate) Fungal Infections of the skin Hives (mild) Impetigo Warts (excluding facial and genital)

6. OTHER - Dry Eye, Joint Pain (minor), Muscle Pain (minor), Sleep Disorders (minor), Smoking Cessation, Threadworms and Pinworms

The pharmacist will have a detailed discussion with you to assess your ailment. They will ask what medical conditions you have, what medications you take, what kind of symptoms you are having, and how long you have had them. The pharmacist will then recommend an over-the-counter medication or a prescription medication. If a medication is recommended during the assessment, the pharmacist will write a prescription. If the pharmacist believes your condition is more serious, they will refer you to your primary care provider. A notification of any medications prescribed or test results will be sent to your physician or NP. If you do not have one following your care, records are available to patients and available on the pharmacy file for 10 years.

Medication Reviews