Our Expanded Scope of Practice is Big News!

Expanded pharmacy services

Community pharmacists in BC will soon be able to play a larger role in patient care as a result of expanded scope of practice changes that will go into effect on October 14, 2022. Let’s look at how this might affect the services we can provide in our pharmacy.

Pharmacists can renew a prescription for any condition, except prescriptions for cancer chemotherapy. There are still restrictions. We cannot renew a prescription that has expired and we can only renew prescriptions for medications where the dosage has not changed for at least six months. This means we still cannot renew a prescription for an antibiotic or other medications that would be used only for a short period of time. Previously we had been restricted to renewing medications for specific conditions only, so this is a huge improvement.

Pharmacists now have more flexibility to make therapeutic changes to prescriptions for a wider variety of medications, not including those for chemotherapy and narcotic or controlled drugs. Therapeutic changes include changes to the dose, formulation (cream vs. ointment, tablet vs. liquid, etc.) and regimen (instructions for use, frequency of dosing, duration of use). Again, we had been able to adapt prescriptions before, but only for specific types of medications. This should help to reduce the faxes to doctors when we simply need to make a small change.

For those instances where a renewal or adaptation is not possible, pharmacists can continue to provide an emergency supply to ensure access to medications. In the past, emergency supplies were usually for 7 to 10 days, to provide enough medication until the patient could see their doctor. Unfortunately, there are now many people who do not have a family doctor and may not be able to access an online/virtual care doctor. We can now provide an emergency supply of up to 90 days in these circumstances, the medication is for a chronic health condition and the dose has not changed for at least six months.

Most restrictions on what pharmacists can administer by injection and intranasally have been removed. Previously, we were able to administer vaccinations only. We are often asked if we can give B12 injections, so the answer soon will be, “Yes!” We still cannot administer cosmetic drugs or allergy serums.

There is one additional change that will perhaps make the biggest difference for patients. Prescriptions will soon be valid for 24 months from the date written, rather than 12 months. People are often surprised when their prescription expires, sometimes with refills remaining on it. As we can adapt a prescription only if it is still valid, this gives us an opportunity to extend your prescription before you run out of your medications.

These changes all come into effect on October 14. They may not seem too significant, but they should allow pharmacists to relieve some of the stress on our health care system by decreasing the number of people going to the emergency department or walk-in clinics simply for prescription renewals. These changes also set the stage for an even bigger change: granting pharmacists the ability to prescribe contraceptives and medications for minor ailments, such as urinary tract infections, acne, and allergies. Expanding our scope of practice allows us to act more fully as part of your health care team.

It’s important to note that not all pharmacists will feel comfortable taking on added responsibilities, especially at a time when pharmacies are also providing the majority of COVID vaccinations, which adds a significant amount of extra work and stress for all pharmacy staff. We are happy to provide these extra services and we are taking steps to ensure we have sufficient staffing to support these initiatives. If you have a family doctor, you should still be seeing your family doctor for your prescription renewals when possible, as this is the best way for your doctor to be fully engaged in your care. But know that we are here to support you, as always, and will do whatever we can to ensure your medication needs are met.

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