AI in pharmacy practice: Devolutionary or evolutionary?

Sixteen years ago, we wrote a commentary asking, "Are phar- macists the ultimate barrier to pharmacy practice change?" 1 (It has been one of the most-read papers in CPJ to date).In that commentary, we described a series of traits/characteristics, based on observations of pharmacists' behaviour, that could explain the lack of uptake of advanced practice opportunities. 1 These included lack of confidence, fear of new responsibilities, paralysis in the face of ambiguity, risk aversion, and need for approval.Given the number of practice advancements that have occurred since then and the advent of new technologies, we recently revisited these observations to see what might have changed since then.As you might expect with such a topic when considered by a group of seasoned academics, our conversations were wideranging and expansive.On the one hand, a lot has changed.Today, most pharmacists across the country can prescribe medications for ambulatory conditions, smoking cessation, and in an emergency.2 Most pharmacists can also make therapeutic substitutions; change drug dosage, formulation, or regimen; renew and extend prescriptions for continuity of care; and provide injections of drugs and vaccines.2 A growing number of pharmacists can also order and interpret lab tests. 2 Have these advanced practice opportunities translated into action?Yes, more pharmacists are engaging in these opportunities.A recent review of ambulatory conditions prescribing in Ontario found that pharmacists submitted more than 1.47 million claims in 2023 and 2024, and that pharmacist prescribing under this mechanism has increased over time.3 In Alberta,