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Friday Five (June 25, 2021)

This week's Friday Five includes a reminder on patient transfers, a federal exemption notice, and a NAPRA consultation notice

Subsection 56(1) Federal Exemption 

The Federal Subsection 56(1) class exemption of the Controlled Drugs and Substances Act (CDSA) for patients, practitioners and pharmacists prescribing and providing controlled substances in Canada during the coronavirus pandemic is NOT in effect in Manitoba, as it has not been fully enabled in the province. Health Canada has recently extended these exemptions until September 2026, and the College will continue working with the provincial government on full implementation of these exemptions. Registrants will be informed of any updates once available.  

In the meantime, please note that verbal orders and prescription transfers of narcotics and controlled drugs are not permitted between pharmacies within Manitoba. Manitoba pharmacies are also not permitted to accept verbal orders and prescription transfers of these drugs from pharmacies in other provinces.  

The Joint Guidance to Physicians, Nurse Practitioners and Pharmacy Professionals: Narcotic and Controlled Drug Prescriptions for Personal Care Home Residents permits verbal orders from physicians and RN(NP)s of narcotics and controlled drugs under the CDSA for residents of personal care homes during the pandemic. The provincial regulation governing the Manitoba Prescribing Practices Program (M3P Program) does not apply to personal care homes and so the Subsection 56(1) class exemption for verbal orders of narcotic prescriptions is in effect for personal care homes only. 

 

 Patient Transfers and Complaints 

Recently, concerns have become prevalent regarding patient transfers: pharmacists are refusing a patient prescription transfer, incentivizing a transfer, unjustly delaying a prescription transfer or contacting a patient regarding a transfer request. Pharmacists are reminded of the Prescription Copies: Pharmacist Obligations & Considerations document pertaining to patient transfers. It clearly states that a patient is entitled to a prescription transfer. It is a patient’s right, addressed in both the federal Food and Drugs Act (FDA), and the Regulation to the Pharmaceutical Act under Standard of Practice 10 –Transfer of Patient Care, whereby it states, “If a patient, or his or her authorized representative, requests that the patient’s care be transferred to another member or to another health care professional, the member must ensure that a copy of the information specified by the patient is provided to the pharmacy or health professional specified by the patient as promptly as the circumstances require.” The Practice Direction Transfer of Patient Care provides additional direction for pharmacists.  

Pharmacists are reminded that their conduct must be consistent with the Code of Ethics. Pharmacists must respect patient autonomy and effectively collaborate with other health care professionals. Any actual or perceived pressure placed on the patient by the pharmacist regarding a prescription transfer is considered a breach of the Code. Additionally, incentivizing patient transfers with an additional gratuity is considered a breach of the Code and is not permitted under section 2.8 of the Advertising in Manitoba Pharmacies Practice Direction.  

A patient’s contact information is personal health information. The Personal Health Information Act (PHIA) empowers the use of personal health information in a trustee’s file for health care use only; this does not include or authorize contact after the transfer of patient care has occurred. Therefore, after a prescription transfer, pharmacists, technicians, and support staff are not permitted to use the contact information on file to contact the patient to discuss the reason for the transfer. If a pharmacist transferring a prescription needs to contact the patient, the pharmacist should clearly document and be prepared to demonstrate that the reason for contact was centred on patient care and not pharmacy service or business interests.    

Pharmacists are encouraged to review the College Professional Development Program Event:  Lessons from Complaints: Trends and Expectations, where patient transfers are discussed in detail.  

Please see the College Provincial Prescription Regulation Summary Chart for a summary on which prescriptions can be transferred. Additionally, note that the transfer of prescription copies is not listed as one of the tasks that may be completed by a pharmacy technician, as per section 60(1) of the Regulation.  

Failure to comply with the regulations mentioned above, Practice Directions, and Code of Ethics may result in the matter becoming a formal complaint.    

 

  NAPRA Principles of Professionalism Consultation  

Professionalism is a fundamental component in the delivery of quality healthcare. Recognizing the importance of a strong culture of professionalism, the National Association of Pharmacy Regulatory Authorities (NAPRA), along with pharmacy professionals and pharmacy stakeholders, has developed eight principles of professionalism. 

These principles, applicable to all who work and contribute to the profession of pharmacy, represent the first steps towards enhancing the culture of professionalism in pharmacy practice. A comprehensive paper on the topic of the culture of professionalism in pharmacy has been written and is available for background reading.    

NAPRA invites all pharmacy professionals, pharmacy stakeholders, and members of the public to provide feedback on the draft Principles of Professionalism. 

The consultation will remain open until August 3, 2021, and feedback can be provided using the following link: https://forms.office.com/pages/responsepage.aspx?id=KBN-LZNiGEWWCZgSA8N5mWnROJgGf-ZOncWP5N2hQaJUMzRZRUkyVzZVRVkzSFVGMDlNOTlJUERZRy4u  

Questions about the consultation process can be directed to professionalism@napra.ca. 

 

Reminder: Consultation on Prescribing for Uncomplicated Cystitis  

Manitoba Health and Seniors Care (MHSC) has advised the College of Pharmacists of Manitoba that it is a priority to implement prescribing authority to pharmacists for uncomplicated cystitis and is proceeding with an amendment to pharmacy practice legislation.   

The amendment would add a new subsection, 118(5), to the Pharmaceutical Regulation permitting pharmacists who have completed a training program approved by Council to prescribe a drug specified to treat uncomplicated cystitis in a product monograph authorized by Health Canada.  

Please review the draft amendment and further information found on the CPhM website News Page and provide your feedback by email to feedback@cphm.ca by July 9th, 2021.    

 

CPSM consultation: Standard of Practice for Virtual Medicine 

The College of Physicians and Surgeons of Manitoba (CPSM) has launched a consultation process to seek feedback from its members, stakeholders, and the public regarding the provision of Virtual Medicine. The draft Standard of Practice can be found here. 

To ensure the consultation is readily accessible to the public, it is available as an online survey. The public is encouraged to review the draft Standard, but is not required in order to respond to the survey. 

The deadline for feedback is July 16, 2021. 

 

 CPhM Office Hours Notice 

Please be advised that the College of Pharmacists of Manitoba office will be closed: 

  • Thursday, July 1, 2021 
  • Friday, July 2, 2021.    

The office will resume regular hours of operation, 8:30 a.m. to 4:30 p.m., on Monday, July 5, 2021. 

 

Upcoming Events & Professional Development Opportunities

ISMP Medications Safety Considerations for Compliance Packaging E-learning Module 

Complete the module here.

Community Connector Training Workshop: Identifying and Referring Socially Isolated Older Adults

July 29, 2021 7:00 p.m.
Register here