By Janice Harvey, RPh, CDE
In August, two significant changes were made to the scope of practice for BC pharmacists. They’ve come with very little fanfare, as pharmacists and the healthcare system determine how best to accommodate the changes.
Expanding on Adaptations
The first change, which came into effect August 1, is focused on adaptations. Pharmacists can now adapt a prescription that has already been adapted. This could mean that one pharmacist will adapt the prescription to change the dosage form (e.g., from a cream to an ointment), while another pharmacist may want to change the strength of the medication. Previously, a prescription could only be adapted once. Pharmacists can now also adapt a prescription from a former practitioner. This will be particularly handy when a physician or nurse practitioner cancels their license (e.g., if they retire or close their practice for any reason), at it will ensure that you can continue to take your medication as originally intended. Also, in very limited situations, pharmacists may now adapt prescriptions for a narcotic, controlled drug, or targeted substance to renew the prescription for continuity of care, or change the dosage, formulation or regimen. Our pharmacy software will require some updates before some of these adaptations will be possible.
Not all pharmacists are comfortable with these changes. If a pharmacist does not have sufficient knowledge of the patient, their health conditions, and all of the patient’s medications, they may choose not to adapt a prescription. It is up to their professional judgment.
Ordering Lab Tests
The next change could have a more profound effect on patient care. As of August 30, the legislation is in place for pharmacists to order lab tests. Pharmacists who register for this will be able to order specific lab tests and will be responsible for advising patients of the results. We expect this to be most helpful in our practice when we are conducting medication reviews. Sometimes there is no recent lab work, especially if a patient does not have a family doctor. Up-to-date lab work may allow us to make recommendations for medication changes that will improve patient health. This service will be implemented first in hospital settings, then in community pharmacies over the next few months.
Welcoming Change
There have been many changes to our scope of practice in recent years. Prescribing for minor ailments and contraception has been a significant expansion of pharmacist services. The changes described above will add to the clinical tools in our pharmacy toolbox, enabling pharmacists to be more involved in direct patient care. It is a division of labour that we hope allows family physicians and nurse practitioners to focus on those patients with more complex needs.
We welcome these changes and look forward to adding to the professional services that our pharmacists can provide. Read our newsletter and watch our Facebook page for updates when these services are fully implemented.