Nova Scotia Pharmacist Prescribing Authority Halves Tick-Related ER Visits
A study led by Dalhousie University researchers reveals that granting Nova Scotia pharmacists the authority to prescribe doxycycline for tick bites in August 2021 significantly reduced emergency room visits. The rate of tick cases in ERs dropped by half, while prescriptions for Lyme disease prevention increased substantially, improving access to timely care.
A recent study led by researchers at Dalhousie University has found that a policy change allowing Nova Scotia pharmacists to assess tick bites and prescribe medication has significantly reduced the burden on emergency departments. 
Before August 2021, residents at risk of contracting Lyme disease from a tick bite were required to see a family doctor, visit a walk-in clinic, or go to an emergency department for treatment. During the 16 months prior to the policy change, over 600 people visited emergency rooms due to tick bites, facing an average wait time of 2.7 hours.
In August 2021, Nova Scotia implemented a change giving pharmacists the authority to assess tick bites and write prescriptions for doxycycline. A subsequent study examined three emergency departments in the province and found that tick bite cases in ERs decreased to a total of 402 in the 16 months following the change. 
The frequency of tick patients in emergency rooms decreased by half, dropping from 0.70 per cent (617 out of 88,512 total patients) before the change to 0.35 per cent (402 out of 115,847 total patients) after the change. Emily Black, a pharmacy professor at Dalhousie University, is the lead supervising author of the study regarding the impact of pharmacist prescribing on ER visits.
According to a 2024 study involving Black, the number of doxycycline prescriptions rose from 3,900 in the 16 months before the change to 8,649 in the 16 months after. Pharmacists have become the primary prescribers in Nova Scotia for Lyme disease treatment, responsible for 61.3 per cent of prescriptions.
Tick bites need to be treated within 72 hours of removing the tick to best prevent Lyme disease. The change is noted to increase access to timely care, especially for people in rural communities where pharmacies may be easier to access than emergency departments.