Island pharmacists welcoming expanded role

Mitch MacDonald
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Neila Auld, registrar of the P.E.I. Pharmacy Board, stands in front of South Shore PharmaChoice in Crapaud. Island pharmacists are welcoming new authorizations allowing them to adapt a patient's prescription as well as substitute a prescribed drug.

Pharmacists on Prince Edward Island are welcoming new authorizations allowing them to adapt a patient's prescription as well as substitute a prescribed drug, says the registrar of the P.E.I. Pharmacy Board.

Adaptation and therapeutic substitution are the terms for the two expansions added to Island pharmacists' scope of practice during this past fall sitting of legislature.

Neila Auld said the changes will both improve efficiencies in the health care system and benefit patients by allowing pharmacists to make those decisions without first having to contact the original physician.

Adaptation will allow pharmacists to adapt prescriptions to modify dosage, formulation, regimen or duration.

"(For example) changing it from a pill to a liquid if the prescription is for a child who can't swallow a pill. It gives pharmacists the authority to make those changes with their expertise," said Auld. "Then what happens is they would put their name on the prescription as the prescriber and then notify the physician of what has been done."

Therapeutic substitution will allow pharmacists to prescribe a patient medication that contains chemically different active ingredients than an originally prescribed drug, but that is still expected to deliver a similar therapeutic effect.

Auld said there are a variety of reasons as to why a pharmacist would substitute a drug.

"There might be a drug shortage so they would pick a drug that's available or it could be based on the patient's drug plan," she said.

Auld said any cash customer without a drug plan who couldn't afford the price of a prescribed medication would possibly be able to get a prescription substituted to a lower-costing drug.

The new authorizations continue the process of expanding the role of Island pharmacists, which was introduced several years ago in the "Continued Care Prescribing Regulation."

That regulation has allowed pharmacists to provide a renewal for a chronic care prescription that has expired if the original prescriber can not be contacted.

The move has saved many patients from going to the emergency room or a walk-in clinic when their physician is not available, said Auld.

The new authorizations are another step in an ongoing transformation allowing pharmacists to play a more integral role in health care delivery through their expertise in medications, she said.

"We have further things we want to implement in P.E.I. This is just the beginning but were getting there," she said.

Auld said pharmacists are also aiming to get authorization to provide immunizations, as well as travel vaccines and preventable disease vaccines.

The ability to prescribe drugs for minor ailments and emergency prescribing are two other roles they're seeking, she said.

Auld said that P.E.I. is not the only province expanding pharmacists' roles and that it has been slower going through the process than many others.

"We're getting there little by little. We're hoping by the spring sitting (of legislature) we'll have more of this ready to go with government."

Organizations: P.E.I. Pharmacy Board

Geographic location: Prince Edward Island

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Recent comments

  • Amazing
    December 10, 2013 - 18:21

    I am absolutely amazed by some of the backward and ignorant comments being made here. I am not a pharmacist but I know only too well how qualified and capable they are of doing so much more than just filling whatever a doctor has written on a piece of paper. They go through extensive training and have more knowledge in everything related to medications and pharmaceutical interventions. Any really good doctor knows this and already consults with pharmacists. Most welcome pharmacist input and questions. I think it all comes down to the fact that some people from the old school still believe doctors are god. They are not gods and most are more than ready and willing to have help from other allied health professionals .

  • Not impressed
    December 09, 2013 - 11:29

    The pharmacist that they just put in jail, would you have wanted her making any decisions about changing of your medication? I think not! I will stick to my doctor making those decisions, thank you.

    • Not Impressed . . . With Your Information
      December 09, 2013 - 14:49

      There has never been a pharmacist jailed in Prince Edward Island. However, in 2008 Judge John Douglas did grant Dr. Grant Matheson a conditional discharge after he obtained a narcotic by false pretences. the doctor was placed on probation for two years.

  • Fed up
    December 09, 2013 - 09:57

    This is, as expected, a step backwards in Ghiz/Currie healthcare. Pharmacists don't know our entire history. Our doctors do! We have a pharmacist that thinks she knows more than any doctor and has already tried changing things she shouldn't. She fights with our doctor...who always wins, and who cures our illnesses. This will be a nightmare!! Having them able to refill...REFILL not WRITE...prescriptions for a month was a really good idea. It should be left at that. People are going to suffer with this...but does government care? Now we will be lining up just to pick up a prescription....the pharmacist will be telling us all how our doctors don't know what they are doing and "they" had to step in and change everything....

    • huh
      December 09, 2013 - 15:13

      I don't think you understand what is being proposed. Its not writing prescriptions, its finding an equal alternative. The experts at understanding the active ingredients in a drug that will have the intended effect are actually the pharmacists, not the doctors. Funny how those who complain the most are also those who seem to resist change.

  • Harold
    December 09, 2013 - 09:05

    This is not a good step. They will not be liable and it is a step back, an erosion, if you will in our PEI health care. There will be no pharmacist adjust my medicine, I can guarantee. That is what our doctors are getting paid for. That is why WE PAY TAXES! Sloughing it off this way is a cop out and people will suffer because of this. PEI is too easy to cow tow to this type of thing.

    • nitpicker
      December 09, 2013 - 12:43

      Your taxes entitle you to quality health care, not a specific delivery method. Doctors should be paid to do stuff that require their abilities and knowledge as an MD. If another health care professional is competent to provide a service, so be it. This is no different than using an LPN or physician's assistant to provide services they are qualfied. If we want solutions to the rising costs of health care, long wait times, and the lack of family physicians we have to accept changes to the status quo.

    • Cranky
      December 09, 2013 - 21:50

      Harold, I hope if there is ever a problem with your prescription (ie you run out of refills) or if your drug plan won't cover a medication your pharmacist refuses to help you ...Go back and wait to see your doctor to fix it.

  • Serious Questions
    December 09, 2013 - 07:39

    This is a potentially positive evolution of responsibilities and services, with at least three caveats. First, certification doesn't guarantee competence; a diploma is a proxy indicator, not necessarily a current and certainly not a measured indicator. Second, in the absence of an accountability system that reports the efficacy of these changes, there's really no accountability at all. Third, allowing pharmacists to expand their roles doesn't ensure that the expanded roles are welcome by either the pharmacists or their clients. And this question matters: Do pharmacists now have customers or patients?