When a tick bite no longer means a trip to the emergency room
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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% after the change. These findings suggest that by offering such services for preventive health, community pharmacists may decrease the burden on other parts of the health care system.
In the Canadian Pharmacists Journal study, 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% resulted in preventive doxycycline treatment. The rate of tick-bite visits fell from 0.7% of all emergency department visits before implementation to 0.35% 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 the 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.
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.
Black (shown left), a professor in the College of Pharmacy, was lead supervising author on the study, along with 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."—Black, professor in the College of Pharmacy
More information
Larissa Doiron et al, Impact of pharmacist-led prescribing for Lyme chemoprophylaxis on emergency department visits, Canadian Pharmacists Journal / Revue des Pharmaciens du Canada (2026). DOI: 10.3138/cpj-26-0005
Key medical concepts
Emergency Room VisitsLyme DiseaseBlack legged Tick
Clinical categories
Infectious diseasesCommon illnesses & PreventionAllied healthEmergency medicinePreventive medicine Provided by Dalhousie University Who's behind this story?
Gaby Clark
MA in English, copy editor since 2021 with experience in higher education and health content. Dedicated to trustworthy science news. Full profile →
Andrew Zinin
Master's in physics with research experience. Long-time science news enthusiast. Plays key role in Science X's editorial success. Full profile →
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