What services do people seek when they visit a community pharmacy primary care clinic: a cross-sectional descriptive study

Abstract Introduction National surveys estimate that up to 22% of Canadians do not have a regular primary healthcare provider and, of those who have a family physician or nurse practitioner, only about 40% are able to get an appointment on the same/next day. Therefore, many consider primary healthcare in Canada to be in crisis. In the absence of having primary healthcare provided by a family physician or nurse practitioner, many Canadians seek care at emergency departments and walk-in clinics. This displacement of primary care not only places a large burden on acute care systems but also jeopardises continuity of care. In response to this crisis, community pharmacy care clinics were established. Aim To characterise who accesses services offered in a community pharmacy care clinic and the reasons for visiting. Methods This cross-sectional descriptive study used information collected from paper-based intake forms that were provided to individuals when they entered the clinic seeking care. Individuals who visited the clinic in Lethbridge, Alberta, Canada between June 24, 2022 and January 31, 2023 were eligible for inclusion. Data were summarised using descriptive statistics. Visit frequency and reasons for visiting the community pharmacy care clinic were stratified according to having a family physician and compared using Chi-squared test. Results There were 3305 people who visited the clinic 4962 times. They submitted 3831 intake forms with 4611 reasons for seeking care. Median age was 32 years (IQR 20 to 51) and 62% were female. Almost one in three (32%) reported not having a family physician and 5% reported usually seeking medical care in an emergency room (ER) or urgent care clinic. Reasons for seeking care were: 79% common ailments (e.g. upper respiratory symptoms, urinary tract infections); 16% chronic disease management (CDM; e.g. diabetes, hypertension); 4% point of care testing or immunisation; or < 2% other. Reasons for seeking care differed whether an individual had a family physician or not (p < 0.01). CDM was more frequently reported as a reason for the visit for people without a family physician (29%) compared to those with one (9%). In contrast, people with a family physician sought care for common ailments more frequently (86%) compared to those without one (63%). Of those who usually seek care in an emergency room or urgent care clinic, 25% of pharmacy clinic visits were for CDM while 69% were for common ailments. Conclusion Our findings indicate that the community pharmacy care clinic has improved access to primary care services to a wide variety of individuals regardless if they had a family physician or not. According to self-reported data, the clinic provided another avenue for continuity of care for CDM, particularly for those who do not have a family physician, as well as assessment and management of common ailments and public health services. The fact that we used information collected from self-reported paper-based intake forms that were not intended for research purposes limited the available data. Using the data for only the first seven months of operations, may have underrepresented the need for the clinic’s services.