Uptake of pharmacist services for common ambulatory conditions: A repeated cross-sectional evaluation of the Ontario Minor Ailment Services program

Abstract Background: Pharmacists’ scope of practice in Ontario expanded in January 2023, allowing them to assess and prescribe for 19 ambulatory conditions (minor ailments). We described the uptake of Ontario's Minor Ailment Services program, including characteristics of patients receiving these services and the community pharmacies that delivered them. Methods: We conducted a repeated cross-sectional study using health administrative data from January 2023 and December 2024. We included data from all Ontario community pharmacies. We plotted trends in uptake and compared pharmacy characteristics after stratifying by their weekly volume of claims for ambulatory conditions. Results: There were 1,471,459 claims during the study period, with an immediate uptake that stabilized within 10 months. Claims for urinary tract infections and conjunctivitis were highest, accounting for 59% of claims. Most services were delivered in-person (88%), in urban settings (83%), and by corporate-owned pharmacies (59%). The mean weekly number of claims per pharmacy was 2.7 (standard deviation 4.4). Compared to pharmacies with no claims, those with high claim volumes (average >7 claims/week) were more often corporate-owned, located in urban areas and areas with a higher neighbourhood income quintile, employed more pharmacists, had pharmacists with fewer practice years, more female pharmacists, and more pharmacists educated in Canada. Interpretation and conclusion: Our study demonstrated rapid, immediate uptake of ambulatory condition services in Ontario, driven mainly by urinary tract infections and conjunctivitis. We identified variation in uptake, suggesting a potential mismatch between those with a greater need for access to care and the pharmacies that most often delivered ambulatory condition services.