by Nicole Hartnell M.Sc. (Pharm.)
Interdisciplinary Ph.D. Student, Dalhousie University
Research Assistant, College of Pharmacy

What is primary health care? What does it look like? What does it include? Before we answer these questions, let’s take a look at what it isn’t. Primary health care isn’t just about the doctor you see when that old sports injury starts acting up again, and it isn’t just about getting a refill of your monthly prescription. It isn’t just about easy access to a doctor or nurse, nor is it just about treating disease and illness.

While it includes each and every one of these things, primary health care is about much more. Rather than simply having access to a physician for the treatment of everyday ailments, primary health care represents easy access to a wide variety of health care providers like doctors, nurses, nurse practitioners, social workers, public health providers, midwives, and pharmacists. It also represents the availability of necessary resources so people can do their best to keep from getting sick. All in all, primary health care is about a community-centered approach to providing the best, most comprehensive health care possible to all Nova Scotians.

The description above does not paint a completely accurate picture of primary health care in Nova Scotia right now, but it does give us hints as to where it is headed. In May 2003 the Nova Scotia Department of Health released a report outlining plans for the future of primary health care in this province. (www.gov.ns.ca/health/phcrenewal/acphcr_report.htm) These plans are exciting and encouraging and include a move towards the creation of primary health care teams. Some areas of Nova Scotia already use teams of different health care professionals to provide care, and the recognition that one kind of health professional can’t be an expert at everything is pushing this train forward. Your local community pharmacist is, and will continue to be, an essential member of these teams.

There are about 250 community pharmacies in Nova Scotia. Because most people can get to a community pharmacy quite easily, sometimes more easily than a physician’s office, community pharmacists are well situated to play an important role in primary health care, especially in preventing chronic disease, such as heart disease or diabetes, and in helping people manage their medications. For the most part, community pharmacies are conveniently located, open longer hours than physician offices, and allow people to talk about health concerns when the next available appointment with a physician might be days or weeks away.

Pharmacists have been involved in delivering primary care services for a long time. Some of these services have included blood pressure clinics, flu clinics, and healthy living seminars, but perhaps the greatest contribution pharmacists can make to primary health care teams is providing information and education to people about their medications. Pharmacists are drug therapy experts who use their knowledge and expertise about medications to improve a person’s health by making sure he or she is on the best medication for his or her condition. Among other things, pharmacists can also make sure the different medications a person may be taking are not interacting with each other in harmful ways. Because most people consistently use one pharmacy for their prescription needs, the pharmacist is in an excellent position to keep track of all a person’s medications, while at the same time serving as a link between that person and his or her different physicians.

Pharmacists are the logical choice when it comes to deciding who should inform people about their medications. A study done during the summer of 2003 asked primary care physicians, community pharmacists, nurses, and dieticians in Nova Scotia what they thought pharmacists could do to help improve the health of people with diabetes. These health professionals identified seven specific things pharmacists could do for people with diabetes. The most common thing was giving patients education and information about their diabetes-related medications.

Primary health care in Nova Scotia is only going to get better, especially with the move towards developing a team-based approach to the delivery of care. Pharmacists are experts in drug therapy and will continue to make a solid contribution to these teams.

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