- Joined
- Mar 18, 2003
- Messages
- 2,271
- Reaction score
- 8
*Canadian Medical Association Journal* (vol. 175, #5, Aug 29) includes
an article: "Alberta pharmacists may get prescribing powers" by Alicia
Priest.
Here's the article:
Confusion and accusations of conflict-of-interest surround new
regulations that would give Alberta's roughly 3500 pharmacists the
broadest scope of practice in Canada and one of the broadest in the
developed world.
The regulations will allow pharmacists to prescribe many Schedule 1
drugs and blood products, as well as administer some injections. But
they will be prohibited from prescribing narcotics and controlled drugs
such as barbiturates and anabolic steroids. The change is expected to
take effect in 2007.
Dale Cooney, deputy registrar of the Alberta College of Pharmacists
(ACP), says the move has been in the works since the Health Professions
Act was passed 7 years ago."We believe allowing pharmacists to prescribe
will give patients increased access to the medications they need. It
will allow them to benefit more fully from the pharmacists' expertise
regarding medications."
Although many of the details (like accepted standards of practice) have
yet to be ironed out, the regulatory change will allow pharmacists to
alter the dose, formulation and regimen of a drug; renew prescriptions;
substitute another drug for a prescribed Schedule 1 drug; administer flu
and travel vaccines; and assess patients and prescribe without
necessarily obtaining physician authorization.
Essentially, pharmacists will be allowed to initiate new prescriptions
under 3 circumstances: if they deem it appropriate after conducting
a"patient assessment," if they've received a recommendation from an
authorized health professional that drug therapy is warranted, or if, in
consultation with a health professional, it is determined that a
Schedule 1 drug or blood product is appropriate.
A pharmacist's capacity to prescribe will be conditional on compliance
with standards and a code of ethics established by the ACP, completion
of an orientation course and proof of $2-million in personal
professional malpractice insurance.
Cooney knows of no other jurisdiction where pharmacists have taken on a
primary prescribing role although British pharmacists "sponsored" by a
physician can prescribe certain drugs.
The move worries the Alberta Medical Association. President Dr. Tzu-
Kuang Lee says concerns include patient safety, proper diagnosis,
liability and conflict-of-interest. Doctors, he notes, are forbidden to
both dispense and prescribe drugs."Who would be responsible if there
were side effects from any prescription, especially if that resulted in
admission to hospital? And who has access to the patients' medical
records to document the changes?"
A prescribing pharmacist would have to perform physical exams, as a
diagnosis cannot be made from a patient's history alone, Lee adds. "You
can't prescribe in isolation -- prescribing is part of a total package
of caring for a patient."
The Alberta chapter of the Consumers' Association of Canada has also
weighed in with concerns that the change will inevitably result in
accrued costs to consumers; increased fragmentation of care and
decreased confidentiality.
"We seriously question a number of assumptions about the benefits of
enhanced prescribing powers and anticipated uses," said spokesperson
Wendy Armstrong.
an article: "Alberta pharmacists may get prescribing powers" by Alicia
Priest.
Here's the article:
Confusion and accusations of conflict-of-interest surround new
regulations that would give Alberta's roughly 3500 pharmacists the
broadest scope of practice in Canada and one of the broadest in the
developed world.
The regulations will allow pharmacists to prescribe many Schedule 1
drugs and blood products, as well as administer some injections. But
they will be prohibited from prescribing narcotics and controlled drugs
such as barbiturates and anabolic steroids. The change is expected to
take effect in 2007.
Dale Cooney, deputy registrar of the Alberta College of Pharmacists
(ACP), says the move has been in the works since the Health Professions
Act was passed 7 years ago."We believe allowing pharmacists to prescribe
will give patients increased access to the medications they need. It
will allow them to benefit more fully from the pharmacists' expertise
regarding medications."
Although many of the details (like accepted standards of practice) have
yet to be ironed out, the regulatory change will allow pharmacists to
alter the dose, formulation and regimen of a drug; renew prescriptions;
substitute another drug for a prescribed Schedule 1 drug; administer flu
and travel vaccines; and assess patients and prescribe without
necessarily obtaining physician authorization.
Essentially, pharmacists will be allowed to initiate new prescriptions
under 3 circumstances: if they deem it appropriate after conducting
a"patient assessment," if they've received a recommendation from an
authorized health professional that drug therapy is warranted, or if, in
consultation with a health professional, it is determined that a
Schedule 1 drug or blood product is appropriate.
A pharmacist's capacity to prescribe will be conditional on compliance
with standards and a code of ethics established by the ACP, completion
of an orientation course and proof of $2-million in personal
professional malpractice insurance.
Cooney knows of no other jurisdiction where pharmacists have taken on a
primary prescribing role although British pharmacists "sponsored" by a
physician can prescribe certain drugs.
The move worries the Alberta Medical Association. President Dr. Tzu-
Kuang Lee says concerns include patient safety, proper diagnosis,
liability and conflict-of-interest. Doctors, he notes, are forbidden to
both dispense and prescribe drugs."Who would be responsible if there
were side effects from any prescription, especially if that resulted in
admission to hospital? And who has access to the patients' medical
records to document the changes?"
A prescribing pharmacist would have to perform physical exams, as a
diagnosis cannot be made from a patient's history alone, Lee adds. "You
can't prescribe in isolation -- prescribing is part of a total package
of caring for a patient."
The Alberta chapter of the Consumers' Association of Canada has also
weighed in with concerns that the change will inevitably result in
accrued costs to consumers; increased fragmentation of care and
decreased confidentiality.
"We seriously question a number of assumptions about the benefits of
enhanced prescribing powers and anticipated uses," said spokesperson
Wendy Armstrong.
