Scope of Practice Round-up: Aug. 15, 2024

August 15, 2024 Scope of Practice Round-up

All pharmacists in B.C. receive the monthly Scope of Practice Round-up produced by the BC Pharmacy Association, highlighting important changes to the profession's scope. Updates will be distributed quarterly on the 15th, or the closest business day.

Past editions can be found at bcpharmacy.ca/scope-practice-round.

Informational webinar recording on pharmacy initiatives

On July 25, 2024, the BC Pharmacy Association, in collaboration with the Ministry of Health and the College of Pharmacists of BC, presented an informational webinar on upcoming changes to pharmacy practice. To access the webinar recording, visit bcpharmacy.ca/etraining and select the BC Provincial Pharmacy Initiatives Update Webinar in the available courses.

A BCPhA account is required to access the recording. If you do not have a login account or if you are unsure if you have a login, please fill out the Account Creation Form and a member of the BCPhA team will contact you.

The following are highlights summarizing what was discussed (timestamps in webinar recording):

  • Lab ordering and interpreting: Pharmacists will be able to order and interpret laboratory test results when it is necessary for medication management, effective Aug. 30, 2024. A list of lab tests that can be ordered by pharmacies has been published and pharmacists will have access to a pharmacy-specific requisition form. (8:52)
  • Changes to PPP-58: Adapting a Prescription take effect on Aug. 1, 2024. These changes will allow further adaptations of a previously adapted prescription, allow adaptations of a valid prescription from a former practitioner, permit renewals of a prescription for a narcotic, controlled drug or substance longer than prescribed, change dosage, formulation or regimen of such prescriptions and more. (34:26)
  • The Provincial Prescription Management (PPM) project will be expanding PharmaNet information access to other health providers, so eventually all pharmacists and prescribers will have real-time access to patients’ complete medication profiles. The new PPM is currently being rolled out by pharmacy software providers, with full deployment expected in 2025. (1:07:37)
  • The OAT-Compliance and Management Program for Pharmacy has been updated to reflect the latest opioid use disorder guidelines published in November 2023. (1:36:39)
  • Other upcoming initiatives from the BC Ministry of Health, including: the Opioid Treatment Access Line, a service for patients with substance use disorders; expanding networking for community and primary care pharmacists; introducing pharmacy clinics; and establishing the Pharmacists Council, an advisory group representative of pharmacists across B.C. (1:45:14)

Key resources about pharmacists lab test referrals

Effective Aug. 30, 2024, pharmacists will be recognized as referring practitioners in the Laboratory Services Regulation under the Laboratory Services Act, allowing them to order certain laboratory tests for medication management. The change will equip pharmacists with more clinical tools to provide medication management services.

Implementation will start in some hospital inpatient settings on Aug. 30, with expansion to community settings in the following months. No specific fees will be available to pharmacists for ordering laboratory tests. The new authority is intended to enhance pharmacists’ ability to perform comprehensive patient assessments for drug therapy management.

Training on laboratory workflow and procedures will be available on the Ministry of Health's website and participation in the training is highly recommended. Optional accredited clinical education on interpreting laboratory results will be offered through UBC Continuing Pharmacy Professional Development.

Resources:

Patient information sheet on new pharmacy services

PharmaCare has created a new patient information sheet that explains pharmacy services in B.C., including prescription adaptations, the minor ailment and contraception service (MACS), and drug administrations. The information sheet is available in 15 languages.

Please use the most up-to-date B.C. version of the medSask guidelines and forms

For pharmacists using the medSask Minor Ailment and Self-Care guidelines and Pharmacist Assessment Records (PARS) for documentation of MACS assessments, please use the most up-to-date BC version of the forms available on medSask’s portal. The PARS have been updated to support compliance with PharmaCare documentation requirements. As well, further updates have been made to the following guidelines to support regulatory alignment:

  • Headache - Tension-Type only (Removal of migraine headache)
  • Impetigo (Removal of folliculitis)
  • Vulvovaginal Candidiasis (Remove of complicated or prophylactic treatment options)
  • Pinworms (New addition)
  • Cold sore PAR – (Drug products eligible for prescribing now reflect BC regulations for available antiviral medications)

You will notice that the current versions of the forms have confirmatory checkboxes for “Informed Consent”, “PharmaNet Check” and “Patient Eligible” at the top of the PARs. Recommended follow-up “time frames” have been added to the majority of the PARs.

To access the medSask guidelines please visit https://www.bcpharmacy.ca/medsask (ensure you are on the B.C. tab once you are on the medSask site). To view updates to the medSask guidelines, please visit https://medsask.usask.ca/professional-practice/restricted-guidelines/guideline-updates.php

By the numbers: Minor Ailments and Contraception Services

Between June 1, 2023 and May 31, 2024:

  • Over 430,000 MACS were conducted
  • More than 310,000 patients received MACS
  • More than 1,400 pharmacies provided MACS (92% of community pharmacies*)
  • Over 4,000 pharmacists provided MACS, which is approximately 61% of licensed B.C. pharmacists, or 77% of active community pharmacists*

*Submitted a PharmaCare claim in the year before program launch

The greatest number of assessments were for:​

  • Contraception - 20%
  • Urinary tract infections (uncomplicated) - 20%
  • Conjunctivitis - 9%
  • Allergic rhinitis - 7%
  • Herpes labialis (Cold sores) – 7%

Of the minor ailment and contraception assessments, approximately 79% resulted in a prescription and 9% resulted in advice to see another healthcare provider.

Our MACS Portal is available to all: no BCPhA membership required

On June 1, 2023, B.C.'s pharmacists saw the largest change in scope of practice in decades. Pharmacists are now able to prescribe for minor ailments and contraception. The MACS Portal provides you to links for resources, videos, FAQs, educational modules and more.

BCPhA MACS Portal