Association for Public Policy Analysis & Management

This study documents and compare public policies impacting medication management in primary care in Ontario and Quebec in the first two decades of 21st century, with a focus on older adults. Ontario and Québec are ideal jurisdictions for this study: they are Canada’s most populous provinces and they have both undergone significant reforms to their respective primary care systems, both to strengthen the role of pharmacists in community, and to shift away from a model of independent primary care practitioners toward inter-professional teams. We conducted a comprehensive review of policy documents including legislation, professional regulation, strategies and frameworks relevant to medication management and primary care in Ontario and Quebec. Document analysis revealed some common elements in the targets of the policies that relate explicitly or implicitly to medication management in primary care in the two provinces. Broadly, these policies related to the following areas: 1) the role of pharmacists in primary care teams and in community; and 2) quality improvement initiatives, including the focus on drug safety and with expanded information technology. Though they also revealed some differences in both the timing and scale of policy changes in the two provinces. Overall, medication management has rarely been clear policy target in either province, but rather a peripheral theme addressed indirectly through a range of initiatives. Thus, the infrastructure to tackle medication management has been put in place to some extent which may pave the way to improving medication management and related outcomes.