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The discovery
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In 2021, Nova Scotia began allowing pharmacists to prescribe preventive treatment for Lyme disease after high-risk tick bites. Researchers found that emergency department visits for tick bites dropped by roughly 50 per cent after the change.ÌýThese findings suggest that by offering such services for preventative health, community pharmacists may decrease the burden on other parts of the health-care system.

Key findingsÌý
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• In the , researchers — including lead supervising author Dr. Emily Black and PharmD student Larissa Doiron — reviewed 1,019 patient encounters for tick bites across three Nova Scotia emergency departments over three years. After pharmacists gained authority to prescribe Lyme disease chemoprophylaxis, visits for tick bites declined from 617 cases before implementation to 402 afterward.
  
  
• The researchers compared emergency department visits during the 1.5 years before and after pharmacists began prescribing Lyme disease prevention medication. Among 1,019 eligible patient encounters, 67.7 per cent resulted in preventive doxycycline treatment. The rate of tick-bite visits fell from 0.70 per cent of all emergency department visits before implementation to 0.35 per cent afterward, a statistically significant decline.
  
  
• More than half of patients had spent over two hours in the emergency department for assessment of a tick bite. The results suggest that giving pharmacists authority to manage straightforward tick-bite cases functions a bit like opening a new lane on a busy highway: patients still reach care, but congestion is reduced for everyone else.
  
  
• The reduction occurred despite growing Lyme disease risk in the province and increasing use of preventive doxycycline. The findings provide rare real-world evidence that expanding pharmacists’ prescribing authority for tick bites has the potential to improve access to treatment while reducing burden on emergency departments.

Why it matters

Lyme disease is increasing across many parts of Canada and other regions where blacklegged ticks are spreading. At the same time, health systems face persistent pressures, including overcrowded emergency departments and limited access to primary care. This study highlights how targeted scope-of-practice changes can help address both challenges at once. Rather than requiring people with low-risk, time-sensitive concerns to visit an emergency department, trained pharmacists can provide assessment and preventive treatment in the community.Ìý

The findings are relevant to policymakers, health-care leaders, and public health planners seeking practical ways to improve access to care while preserving emergency department capacity for more urgent medical needs.

Dr. Emily Black (shown left), a professor in the College of Pharmacy, was lead supervising author on the study, along with Larissa Doiron, who is now a pharmacy resident with Nova Scotia Health and served as research assistant and lead author on the study.

"Nova Scotians shouldn't have to visit an emergency department for a preventable condition when appropriate care can be provided in the community. Our study shows that expanding pharmacists' prescribing authority for Lyme disease prevention can improve access to care while easing pressure on busy emergency departments."

Dr. Emily Black, professor in the College of Pharmacy

Learn more
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• Paper:Ìý
  
  
• Researcher: Dr. Emily Black