Saskatchewan pharmacists expanded the scope of their practice, as new legislation came into force March 4. The legislation expands their prescribing authority, providing the patient benefit of more efficient and accessibly health care services.
There are many questions and concerns surrounding this new legislation, therefore, the Observer has adapted a list of commonly asked questions from the My Pharmacist Knows website that was launched in conjunction with the announcement of the new legislation.
What does prescriptive authority for pharmacists mean?
It means changes to provincial laws to recognize pharmacists as prescribers of drugs.
Under a combination of federal and provincial laws, most drugs are only available by prescription. That is because it takes a trained professional to make the decision that these drugs are appropriate for you. When that decision occurs, that professional can issue a prescription for you when the law permits.
The federal law over regular prescription drugs recognizes pharmacists as prescribers when the same occurs under provincial laws. The laws in Saskatchewan have been changed to allow pharmacists to issue prescriptions under certain circumstances where they are trained to do so.
Does that mean that pharmacists cannot prescribe some drugs?
Yes, the pharmacist cannot prescribe Controlled Substances.
They include Narcotics and other mood-modifying drugs that can cause addiction or dependency and abuse. There are other federal laws over this group of drugs that imposes added conditions over how they are distributed in Canada. This law does not recognize pharmacists in the same way. A special and lengthy federal process must occur before pharmacists can be recognized as prescribers of these Substances.
Does this mean that I no longer need a doctor for my medications?
Certainly not.
The pharmacist as a prescriber of drugs is NOT intended to replace your doctor or other health care providers. It is quite the opposite. The new laws depend upon a close working relationship between you, your doctor and your pharmacist. The new laws give the pharmacist added tools to work with you and your doctor get the most benefit out of your drug therapy.
Prescribing will be allowed in various circumstances - continuing maintenance therapy, emergencies, incomplete prescriptions, physician's absence, self-care for minor ailments and seamless care, and when pharmacists have advanced skills. Instead of having to contact your doctor first, your pharmacist can make these prescribing decisions for you and then tell your doctor about them.
Examples include:
Continuing maintenance therapy - You are taking medications regularly, your prescription has run out and you can't get in to see your doctor for several days. Your pharmacist can provide the supply you need until you are able to visit your doctor, and will let your doctor know.
Emergencies - You take a medication once in a while when needed, or perhaps regularly. You are on a trip, have left this medication at home and need it. Your pharmacist can provide you with a supply until you return home, and will let your doctor know.
Incomplete prescriptions - Sometimes your doctor will inadvertently forget to include some details important to your pharmacist about the drug being prescribed for you. Because your pharmacist knows you and your doctor and is reasonably certain of your doctor's intent, he or she fills in the details to complete the prescription. Again, your pharmacist will let your doctor know.
Physician's absence - Doctors sometimes temporarily leave their practices for extended periods of time, such as for vacation or education. When that happens, they can leave instructions with your pharmacist to continue the medications for you and other patients if prescriptions run out while he or she is away.
Seamless care - When you are ill and admitted to a health care facility, your medications can change. If you are transferred from that health care setting to another, for example are discharged and return to your community, your pharmacist can make sure that your new medication therapy continues uninterrupted. Again, your pharmacist will let your doctor know.
What do you mean by added tools?
The new laws provide the pharmacist with added flexibility to respond to a variety of situations without having to check with your doctor first.
Pharmacists are not trained like doctors to diagnose the more serious ailments for which you cannot look after yourself and need a medical diagnosis. But, they are trained to recognize what might be the best medication for you for the diagnosis made by your doctor. That is why we are not intending to replace your doctor, but are intending to work more closely with him or her.
Does this happen in other provinces?
Pharmacists can prescribe in most, but not all provinces at this time.
Different provinces are in different stages of allowing pharmacists to prescribe. Those that do may have different rules. What we are describing here applies to pharmacists in Saskatchewan.
What is a minor ailment and what can the pharmacist do to help?
A minor ailment is generally a condition that is less serious and may not last long and for which you can look after yourself. It is a condition for which you may not need to see your doctor. For some ailments the new laws will allow your pharmacist to provide you with a limited course of treatment with a prescription drug that may be more effective than an over-the-counter medication.
Minor ailments, besides being less serious, can also be self-limiting meaning that they only last for a short period of time. Many medications and remedies are available to you over-the-counter without a doctor's prescription to help you treat these ailments yourself. Your pharmacist can continue to help you with selecting the most appropriate remedy or medication, but soon will be able to provide prescription drugs for some ailments under certain circumstances. We are working on deciding which drugs can be available for which ailments and the training on the processes and standards that pharmacists will need.
The following is an example of such a self-care situation:
- You or a member of your family has experienced severe insect bites; or,
- You or a member of your family has a cold sore; and,
- Over-the-counter remedies you have tried do not help.
Your pharmacist will help you assess your need for relief and may be able to provide a prescription drug that is a better option for you.
Note: Minor ailments' prescribing by pharmacists has been delayed for a while for the above reasons. We are working with doctors and others to decide on which prescription drugs the pharmacist can prescribe, for which ailments and under what circumstances. Pharmacists must also take special additional orientation training on the processes and standards they are asked to follow. This training will be available some time after March 4, 2011.
