September 3, 2021

Friday Five (September 03, 2021)

This edition of the Friday Five includes a notice from the College regarding Ivermectin and guidance on managing narcotic and controlled drug inventory.

Unsupported Claims for the Use of Ivermectin in the Prevention or Treatment of COVID-19 

Over the last several months there have been increasing reports and misleading claims through the media and online (including signage alongside Manitoba highways) regarding the purported use of the veterinary antiparasitic agent ivermectin in the treatment of COVID-19, similar to previous claims surrounding hydroxychloroquine.  

Ivermectin is an essential medication approved by Health Canada for human use only in the treatment of strongyloidiasis (parasitic worm infections). However, ivermectin is primarily used in veterinary medicine for deworming of livestock. As of January 2021, ivermectin has been listed on shortage by Drug Shortages Canada due to increased demand for the drug.  

There is no evidence that either formulation of ivermectin (human or veterinary versions) is safe or effective when used for the prevention or treatment of COVID-19. In fact, the veterinary drug version of ivermectin, especially at high doses, can be dangerous to humans and may cause serious health problems. There have been multiple reports of patients in the U.S. being hospitalized after using ivermectin intended for livestock, and some feed stores across Canada are reporting increased sales of the drug. In response to this, Health Canada issued an advisory notice on August 31, 2021, to the public and all healthcare professionals outlining the potential serious health dangers posed.   

Manitobans have an expectation that their healthcare providers and team members continue to work together to ensure that all health information provided, including all prescribing and dispensing practices, are current, evidence-based, and in the best interest of patient and public safety. The following resources may be helpful to all practitioners in their conversations with the public: 

CPhM recognizes and appreciates the extraordinary efforts of all registrants in upholding patient safety and battling misinformation as the pandemic continues. 

 

Narcotic and Controlled Inventory Management During a Permanent Pharmacy Closure or Relocation 

Pharmacies undergoing a permanent closure, or relocation to a new address, must ensure the narcotic and controlled drug inventory is managed appropriately.  

Permanent Closure 

A pharmacy that will permanently close must ensure its narcotic and controlled substance inventory is secure from loss, theft, or diversion using one of the following methods: 

  • return the narcotic and controlled drug inventory to the licensed dealer who sold or provided it; 
  • transfer the narcotic and controlled drug inventory to a dealer who is licensed to destroy the substances pursuant to a written order;  
  • destroy the narcotic and controlled drug inventory locally following the appropriate Health Canada and CPhM Guidelines; or 
  • transfer the narcotic and controlled drug inventory to another pharmacist in good standing. Both pharmacists involved in the transfer must  
  1. take inventory of the substances;  
  2. sign the inventory record; and 
  3. keep record of the inventory for two years in an auditable format that can be made available to a Health Canada inspector upon request. 

You must also submit a physical inventory count of controlled substances using the Pharmacy Closure Form  to Health Canada by email to hc.compliance-conformite.sc@canada.ca within 10 days of closure. You must keep these records for a period of two years in a manner that is auditable and can be presented to a Health Canada inspector on request. 

Relocation 

Pharmacies that are relocating must submit a physical inventory count of transferred narcotic and controlled substances to Health Canada within 10 days of the pharmacy relocation using the same form used for closures to document the transfer of narcotics between the two facilities. Submit the form by email to hc.compliance-conformite.sc@canada.ca. You must keep these records for a period of two years in a manner that is auditable and can be presented to a Health Canada inspector on request.

Pharmacists are reminded they must take all reasonable steps to protect narcotics and controlled drugs that are under their control against loss or theft, including while the drugs are in transit between two pharmacies and report any loss or theft.

 

Clarification on Prescription Forgery Reporting  

Health Canada no longer requires pharmacies to report attempted (unfilled) prescription forgeries. Health Canada continues to require pharmacies to report loss and theft of narcotic and controlled substances. Forged prescriptions that are filled are considered theft. 

Pharmacists are requested to continue reporting all prescription forgeries (including attempts) to the College. The College website is updated with information on identifying and reporting prescription forgeries and a new reporting form. The College is working on modernizing its reporting, and any future changes will be communicated to registrants. 

Please take note of the following reporting procedure for unfilled and filled forgeries:  

Forgery Attempts (unfilled)  

If the forgery was an attempt and the prescription was not filled by your pharmacy, you must report the attempt to 

  1. the pharmacy’s local police service; and   
  2. the College of Pharmacists of Manitoba by fax (204-237-3468) (including a copy of the forged prescription) using the following form: https://cphm.ca/wp-content/uploads/Resource-Library/Signs-and-Forms/Attempted-Forgery-Report.pdf 

Forgeries (filled)  

All prescription forgery attempts that were filled by your pharmacy must be reported to 

  1. the pharmacy’s local police service;  
  2. Health Canada using the loss/theft report form https://www.canada.ca/content/dam/hc-sc/documents/services/publications/healthy-living/loss-theft-controlled-substances-precursors/loss-theft-report-form-controlled-substances-precursors.pdf. Please see the Guidance Document: Reporting Loss or Theft of Controlled Substances and Precursors (CS-GD-005) for additional information on reporting successful forgeries, losses, and thefts to Health Canada; AND  
  3. the College of Pharmacists of Manitoba. Please print and fax your Health Canada report to the College by fax (204-237-3468), including a copy of the prescription. In the description area of the form, please indicate that this was a filled prescription forgery. 

 

Save the Date: World Patient Safety Day 2021 

The theme of World Patient Safety Day 2021 is Safe maternal and newborn care: Act now for safe and respectful childbirth. Globally, approximately 810 people die every day from preventable causes related to pregnancy and childbirth. In addition, around 6,700 newborns die every day, amounting to 47% of all under-5 deaths. 

Healthcare Excellence Canada, formerly the Canadian Foundation for Healthcare Improvement and the Canadian Patient Safety Institute, is offering a number of valuable resources and activities to keep you engaged for this year’s event: 

  1. Join the webinar: Participate in our virtual discussion on Safe and Respectful First Nations, Inuit and Métis Maternal and Newborn Care on September 17, 2021. 
  2. Participate on social media: Share World Patient Safety Day messages on your social media channels – let’s get #PatientSafety, #WorldPatientSafetyDay and #SafeChildBirthForAll trending across Canada. 
  3. Access and share maternal and newborn safety tools and resources 
  4. Submit your art to the HeART of HealthCARE art exhibition 

The College looks forward to celebrating World Patient Safety Day with all registrants and stakeholders.

 

Professional Development Opportunities & Events 

Pharmacists Manitoba Fall Conference

September 18, 2021   

View the full program and register here. 

Opioid Agonist Therapy 101 Introduction to Clinical Practice  

September 23 and 24 2021 Killarney MB 

Register here. 

ISMP Medications Safety Considerations for Compliance Packaging E-learning Module  

Complete the module here. 

Community Connectors Workshops 

For a list of accredited workshops and dates, click here.