- Combating Prescription Forgeries: Key Trends and Precautions for Pharmacy Professionals
- Prescribing Authority Table Updates
- Updated Provincial Prescription Regulation Summary Chart
- Acknowledging National Indigenous Peoples Day: A Message to Pharmacy Professionals
- CPhM Office Closure Notice
- Professional Development Opportunities & Upcoming Events
Combating Prescription Forgeries: Key Trends and Precautions for Pharmacy Professionals
Identifying and reporting forgeries helps contribute to the safety of our communities. CPhM continues to receive a high volume of forgery reports. Although it is not yet clear how the recent changes to the M3P program will affect forgery patterns, pharmacy professionals should take note of the following trends:
Commonly Forged Drugs
Prescription forgeries for Cotridin and Percocet are most commonly reported, often for 120 tablets of Percocet and/or 210 ml of Cotridin.
Pharmacy professionals must assess the prescribed drug in the context of the M3P program and CPSM’s prescribing standards for opioids. If the prescription is assessed as inappropriate, this may also be a sign that it is a forgery.
Method of Transmission
Prescription forgeries are increasingly being transmitted to pharmacies by fax, often from an out-of-province area code. This allows for easy transmission to a wide range of pharmacies in a short amount of time. Prescription forgeries are not limited to Winnipeg; pharmacies throughout the province have been affected.
When receiving a faxed prescription, be aware of where the prescription originated from. Many forgeries are faxed from out-of-province area codes, even if the fax receipt states it was sent by a specific clinic in Manitoba. This information can be falsified using technology.
Patient Demographics
Forged prescriptions are often for out-of-province patients. A Manitoba address may or may not be listed on the forgery; however, a valid Manitoban PHIN is typically not included.
Pharmacy professionals must verify patient information in these scenarios, such as asking for photo identification of new patients receiving a prescription for a narcotic or controlled substance, especially if the patient does not have a PHIN. If the patient cannot provide a photo ID, pharmacy professionals should consider additional steps to confirm the patient’s identity.
Prescriber Demographics
A wide range of Manitoban and out-of-province prescribers have been affected by prescription forgeries. Forged prescriptions generally contain false clinic contact information directed to an individual involved with the forgeries. Additionally, after receiving a forged prescription, many pharmacies report being contacted over the phone by an individual impersonating the prescriber or patient, verifying the prescription is available and ready for pickup.
Pharmacy professionals should verify the prescriber’s contact information on a prescription against a verified source. When contacted by a prescriber over the phone, pharmacy professionals must verify the prescriber’s identity.
In Summary
Pharmacy professionals are reminded to diligently review all prescriptions for authenticity. The identification and reporting of forgeries helps keep drugs out of the illicit market and allows for the appropriate monitoring and follow-up to occur.
CPhM thanks all pharmacy professionals for their continued due diligence and reporting. For detailed information on identifying and responding to a prescription forgery, visit the following webpage.
Prescribing Authority Table Updates
After discussions with the College of Physicians and Surgeons of Manitoba (CPSM), the following clarifications were made to the Prescribing Authority Table:
- Co-signatures are NOT required on prescriptions written by post-graduate medical residents (regardless of whether they were specifically authorized to prescribe by CPSM);
- Post-graduate medical residents (regardless of whether they were specifically authorized to prescribe by CPSM) cannot prescribe M3P drugs, but CAN prescribe NON-M3P controlled substances (narcotics, controlled drugs, benzodiazepines and other targeted substances) if all prescribing conditions are met; and
- A general statement that prescribing authority for physicians is determined by licensure and not participation in a residency program. Pharmacists can verify a prescriber’s licensure on the CPSM website.
The Prescribing Authority Table provides general guidance to pharmacists related to prescribing within community practice in Manitoba for outpatients, based on information provided by the respective regulatory bodies. Prescribing practices within a hospital or healthcare facility for inpatients may vary depending on the policies and procedures of the individual hospital or regional health authority.
Please direct any thoughts or suggestions you may have to improve this resource to info@cphm.ca.
Updated Provincial Prescription Regulation Summary Chart
CPhM has updated its Provincial Prescription Regulation Summary Chart (M3P and non-M3P) due to the recent changes in prescription transmission and M3P requirements.
M3P Prescription Content Requirements:
- The summary chart now includes updated content requirements for M3P prescriptions.
- Prescribers are encouraged, but not required, to use templates available through their regulator’s registrant portals.
- Pharmacy professionals can access these templates in the “M3P Prescription Guidance: Requirements & Recommended Templates” document on the CPhM Registrant Portal.
- For more details, refer to the M3P FAQ.
Verbal Orders for Controlled Substances for Outpatients:
- There are NO changes to verbal orders for controlled substances for outpatients.
- M3P prescriptions and Non-M3P Part I controlled drugs (stimulants previously removed from the M3P) CANNOT be prescribed via verbal order.
- All other non-M3P narcotic preparations, and Part II and III controlled drugs, can still be prescribed via verbal order.
Faxing and E-prescribing:
- Faxing and e-prescribing of all prescriptions (including M3P) are now permitted according to the revised Electronic Transmission of Prescriptions Practice Direction.
- Prescriptions CANNOT be emailed, nor can images of prescriptions be sent via text message or email to a patient or pharmacy.
- For more details, refer to the Electronic Transmission of Prescriptions FAQ.
Federal Subsection 56(1) Exemption:
- The exemption under federal subsection 56(1), which allow for the transfer of all controlled substances, are now in effect.
- For more details, refer to the Subsection 56(1) Exemption FAQ.
For additional information, please refer to the June 7, 2024, Friday Five publication.
Acknowledging National Indigenous Peoples Day: A Message to Pharmacy Professionals
June marks National Indigenous History Month, a time to celebrate the achievements and resilience of Indigenous Peoples in Canada while reflecting on the ongoing trauma caused by residential schools and paying tribute to survivors and their families. As pharmacy professionals, you play a crucial role in supporting Indigenous Peoples within the healthcare system.
Recognizing and Addressing Social Injustices
Throughout June and on National Indigenous Peoples Day, it is important to take the time to understand the social injustices Indigenous Peoples often face when accessing healthcare. This understanding is crucial for all healthcare professionals, including those in pharmacy, to better address these issues and provide more equitable care. All Manitoban pharmacy professionals must commit to creating open and safe environments for everyone accessing pharmacy services.
Fostering Relationships and Promoting Cultural Understanding
As a regulator, CPhM recognizes the importance of fostering relationships between pharmacy professionals and patients. Our focus remains on ensuring that pharmacy care is accessible and respectful to all Manitobans, including Indigenous Peoples. We are committed to integrating cultural safety and competence into our core functions and strategic initiatives to promote exceptional person-centered care for all.
Commitment to Reconciliation and Continuous Learning
CPhM is committed to continually learning and listening to Manitobans to meet their needs in accessing pharmaceutical care in the province. We aim to advance reconciliation efforts by taking concrete actions that safeguard the health and well-being of all individuals within our regulatory purview.
Resources for Further Learning
CPhM encourages all pharmacy professionals to use this month to educate themselves better to help understand and support Indigenous Peoples. The Canadian Society of Hospital Pharmacists (CSHP) has gathered some valuable resources:
- Indigenous Pharmacy Professionals of Canada website
IPPC recently launched their own website which is full of information about the work that the organization does, opportunities for Indigenous pharmacy professionals and members, information on upcoming events, and more. - Movement Forward with Truth and Reconciliation within Hospital Pharmacy
As part of our 2023 Hospital News special section, Amber Ruben from Indigenous Pharmacy Professionals of Canada authored an article that provides crucial insight from an Indigenous pharmacy professional and provides ways that allies can help move pharmacy towards Truth and Reconciliation. - Resource Spotlight: Indigenous History Month (2022)
This Resource Spotlight offers materials to aid pharmacy professionals in enhancing their cultural competency and clinical expertise regarding the unique health needs of Indigenous patients. - Indigenous Health and Reconciliation in Pharmacy
In 2019, Dr. Jaris Swidrovich led a comprehensive webinar exploring various Indigenous communities, detailing past and present government policies affecting Indigenous health, and discussing prevalent health challenges within these communities. The session also included practical examples of cultural safety and a summary of the Truth and Reconciliation Commission of Canada, with suggestions for how pharmacy professionals can respond to the TRC Calls to Action.
For a full list of resources from CSHP click here.
Additionally, CPhM is pleased to share a new educational opportunity from the Association of Faculties of Pharmacy of Canada (AFPC) to recognize and celebrate National Indigenous Peoples Day on June 21 and Indigenous History Month. The Indigenous Terminology module has been designed for pharmacists, pharmacy students, pharmacy technicians, and pharmacy technician students to help deepen their understanding of terminology with respect to Indigenous Peoples. The module is now available free of charge at https://elearnhcp.ca/course/view.php?id=164 (first create an account on the AFPC eLearnHCP.ca site). This program will take you up to 1 hour to complete. You will receive a certificate of completion after you complete the quiz and evaluation. Feel free to share with your pharmacy colleagues who may be interested.
The Indigenous Terminology module was developed by Marie Rocchi (University of Toronto) and has been endorsed by the Indigenous Pharmacy Professionals of Canada (IPPC). Additional modules on equity, diversity, and inclusion (EDI) and Indigenous health and cultural safety will be launched later this year.
“By advancing your knowledge on Indigenous Terminology, you will build a foundation on a journey to understanding the needs, value, and ancestry of diverse Indigenous Peoples in what is now called Canada,” said Amy Lamb, Executive Director of IPPC.
By engaging with these resources and CPhM’s current and previous mandatory webinars, we can all contribute to creating a more inclusive and equitable healthcare system for Manitoba’s Indigenous Peoples.
CPhM Office Closure Notice
Please be advised that the CPhM office will be closed on Monday July 1, 2024.
The office will resume regular hours of operation, 8:30 a.m. to 4:30 p.m., on Tuesday, July 2, 2024.
Professional Development Opportunities & Upcoming Events
2SLGBTQ+ Professional Development:
- CPhA’s Resource Round-up: 2SLGBTQI+ patient health
- Pharmacy Perspective: Providing Safe Spaces Podcast – Affirming Ways People Self-Identify, offered by USask Continuing Pharmacy Education and the Alberta College of Pharmacy
- USask EDI Continuing Education Resources – 2SLGBTQIA+
College of Pharmacy’s Essentials in Advanced Patient Care for Pharmacists Micro-Certificate Program
Interested pharmacists can visit the program website for detailed information and to begin the application process. For further inquiries, please email PharmacyPD@umanitoba.ca.
Targeting Social Isolation Together E-Modules
To register for the self-paced e-modules and for further information click here.
This learning activity provides information on the health impacts of social isolation and loneliness.
The e-module and Quiz take about 45-60 minutes to complete, and participants obtain a statement of completion.
- 2.0 accredited CEU
Medical Examiner PD Webinar – Engaging Patients with Care: Tapering, Brief Interventions, and Substance Use Insights
- Click here to view the live event recording
- 1.5 accredited CEU
- Click here to complete the Learning Activity Evaluation Form
Lessons from Complaints: A Series on Injection-Related Best Practices Part 1: Best Practices Review for Pharmacists & Part 2: Trends in Injection-Related Complaints
- Click here and here to view the recordings.
- Each is 0.75 accredited CEU
- Click here to complete the Learning Activity Evaluation Form
Managing Drug Shortages in Pediatric Patients