MAPflow Updates
Pharmacists serving underserved communities with MAPflow
December 21, 2023
When University of Waterloo Pharmacy student, Siobhan O'Connor, introduced herself to her local community pharmacist, Aly Govindji, she learned that he delivers daily safe supply and opioid agonist therapy to underserved communities in the Kitchener Waterloo region, and he felt that he could do even more for his clients with additional administrative help. She volunteered to join him and a unique project was born.
Their project is a pharmacist-led, patient outreach service, providing pharmacy services to underserved communities. The duo make regular visits to community centres, shelters, tent cities, and provide follow-ups with patients. Being mobile helps them reduce the barriers that might stop someone from using a walk-in pharmacy clinic such as access to transportation or chronic pain. And the new expanded scope of practice for pharmacists in Ontario allows the team to address more needs in this population.
Govindji explains, ‘We discovered a need for additional healthcare services in these communities through our opioid agonist therapy, and the new expanded scope has been a great tool to meet some of those needs.’
The pair use MAPflow for their minor ailment prescribing in a unique way.
‘While in the community, we're using MAPflow to help patients who may be stigmatized or suffer from other barriers that hinder them from visiting a pharmacy. We utilize MAPflow for minor ailments prescribing and identifying patients requiring further referrals,’ adds O’Connor.
A typical day for the outreach service includes visiting a shelter to distribute methadone and other safe supply medications. The pair go to the shelters to distribute methadone, and while there, they talk with clients about any other health issues that need to be addressed. With the broadened scope of minor ailment practice, the pharmacist can now address additional issues, for example, eczema in an unhoused person, treating this kind of ailment before it requires a hospital visit.
O’Connor admits that she found the work somewhat startling in the beginning. She found it surprising to see drug paraphernalia out in the open. And the values-led work is satisfying. In addition to the expanded scope of minor ailment assessing and prescribing, the pharmacist-led team also focuses on increasing health literacy in this underserved population, using posters with minor ailment symbols as a starting point for discussions about symptoms and common physical ailments.
In the future, the team hopes to see further expansion for their scope of care including constipation, a common ailment for opioid users. They currently use MAPflow to refer to a nurse practitioner for constipation, but a NP might not be on site for another week to follow up on the referral. This is not ideal for the patient. They also hope to see billing changes that would help this type of service for uninsured people, or people covered by ODB, to be financially sustainable.
For now, they are doing what they can to meet the needs of the underserved populations in their community.
