PHARMACY PHARMACY - Ontario College of Pharmacists
PHARMACY PHARMACY - Ontario College of Pharmacists
PHARMACY PHARMACY - Ontario College of Pharmacists
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<strong>PHARMACY</strong><br />
C ONNECTION<br />
THE ONTARIO COLLEGE OF PHARMACISTS<br />
VOL. 7, NO. 6 NOVEMBER/DECEMBER 2000<br />
OCP Council 2000-2001<br />
Included in this issue. . .<br />
• Council Member Introductions<br />
• Reporting Adverse Drug Reactions<br />
• Respecting Patient Confidentiality
O N T A R I O C O L L E G E O F P H A R M A C I S T S<br />
<strong>Ontario</strong> <strong>College</strong> <strong>of</strong> <strong>Pharmacists</strong><br />
483 Huron Street<br />
Toronto, ON Canada M5R 2R4<br />
Telephone (416) 962-4861<br />
Facsimile (416) 703-3100<br />
Internet www.ocpharma.com<br />
Sam Hirsch, B.Sc.Phm.<br />
President<br />
Deanna Laws, B.Sc.Phm.<br />
Registrar<br />
Della Croteau, B.S.P., M.C.Ed.<br />
Deputy Registrar/Director <strong>of</strong> Programs<br />
and<br />
Editor, Pharmacy Connection<br />
Alison DeLory, B.A.A., B.P.R.<br />
Associate Editor, Pharmacy Connection<br />
Alice Wlosek<br />
Distribution<br />
ISSN 1198-354X<br />
8 2000 <strong>Ontario</strong> <strong>College</strong> <strong>of</strong> <strong>Pharmacists</strong><br />
Canada Post Agreement #569275<br />
Undelivered copies should be returned to<br />
the <strong>Ontario</strong> <strong>College</strong> <strong>of</strong> <strong>Pharmacists</strong>.<br />
Not to be reproduced in whole or in part<br />
without the permission <strong>of</strong> the Editor.<br />
Subscription Rates<br />
In Canada, $48 + GST for six issues/year.<br />
For international addresses, $60.<br />
Subscription rates do not apply to<br />
pharmacists, students, interns and certified<br />
pharmacy technicians registered with<br />
the <strong>Ontario</strong> <strong>College</strong> <strong>of</strong> <strong>Pharmacists</strong>.<br />
Statutory Committees<br />
Executive ♦ Complaints ♦ Discipline<br />
♦ Fitness to Practice ♦ Patient Relations<br />
♦ Quality Assurance ♦ Registration<br />
♦ Accreditation<br />
Standing Committees<br />
Finance ♦ Pr<strong>of</strong>essional Practice<br />
Special Committees<br />
Structured Practical Training ♦ Task<br />
Force on Primary Health Care Reform<br />
♦ Working Group on Certification<br />
Examinations for Pharmacy Technicians<br />
♦ Standards <strong>of</strong> Practice Working Group<br />
♦ Working Group on Pharmacy Technicians<br />
♦ Communications<br />
Mission Statement<br />
The mission <strong>of</strong> the <strong>Ontario</strong> <strong>College</strong> <strong>of</strong> <strong>Pharmacists</strong> is to regulate the practice<br />
<strong>of</strong> pharmacy, through the participation <strong>of</strong> the public and the pr<strong>of</strong>ession, in<br />
accordance with standards <strong>of</strong> practice which ensure that pharmacists provide<br />
the public with quality pharmaceutical service and care.<br />
Council Members<br />
Council Members for Districts 1-17 are listed below according to District number.<br />
PM indicates a public member appointed by the Lieutenant-Governor-in-Council.<br />
DFP indicates the Dean <strong>of</strong> the Faculty <strong>of</strong> Pharmacy, University <strong>of</strong> Toronto.<br />
1 Marie Ogilvie<br />
2 Barbara Minshall<br />
3 Martin Belitz<br />
4 Sam Hirsch,<br />
President<br />
5 Larry Hallok<br />
6 Alexander Wong<br />
7 Leslie Braden, Vice<br />
President<br />
8 Iris Krawchenko<br />
9 Larry Boggio<br />
10<br />
11<br />
12<br />
13<br />
14<br />
15<br />
16<br />
17<br />
10 Steve Balestrini<br />
11 David Malian<br />
12 Sherry Peister<br />
13 Bill Mann<br />
14 Vacant<br />
15 Gurjit Husson<br />
16 Albert Chaiet<br />
17 Malcolm Ng<br />
PM Joan Boyer<br />
PM Garry Dent<br />
PM Bob Drummond<br />
PM Pasquale Fiorino<br />
PM Dean French<br />
PM Steve Gupta<br />
PM Marlene Hogarth<br />
PM Wally Hunter<br />
PM Stephen Mangos<br />
PM Malcolm Mansfield<br />
PM Barry Solway<br />
DFP Wayne Hindmarsh<br />
Frequently Accessed Extensions/Addresses<br />
Registrar’s Office<br />
ext 243 urajdev@ocpharma.com<br />
Deputy Registrar/Director <strong>of</strong> Programs’ Office ext 241 lseneviratne@ocpharma.com<br />
Director <strong>of</strong> Finance and Administration’s Office ext 263 lbaker@ocpharma.com<br />
Registration Programs<br />
ext 250 jdsouza@ocpharma.com<br />
Pharmacy Practice Programs<br />
ext 236 ltodd@ocpharma.com<br />
Patient Relations Programs/Legal Services ext 272 ehelleur@ocpharma.com<br />
Continuing Education/Pharmacy<br />
Technicians Programs<br />
ext 251 cpowell@ocpharma.com<br />
Communication Programs<br />
ext 294 lverbeek@ocpharma.com<br />
Information Processing<br />
Registration Information surnames A-L: ext 228 vduczek@ocpharma.com<br />
surnames M-Z: ext 232 jmckee@ocpharma.com<br />
Pharmacy Technician Information<br />
ext 231 bchurch@ocpharma.com<br />
Pharmacy Openings/Closings<br />
ext 230 mvasile@ocpharma.com<br />
Pharmacy Sales/Relocation<br />
ext 227 zjiwani@ocpharma.com<br />
Membership<br />
ext 237 rstarr@ocpharma.com<br />
Pharmacy Connection<br />
The objectives <strong>of</strong> Pharmacy Connection are to...<br />
♦ encourage ongoing dialogue with pharmacists by communicating information on<br />
<strong>College</strong> activities and discussing issues <strong>of</strong> interest to members.<br />
♦ promote understanding and appreciation <strong>of</strong> the role <strong>of</strong> the pharmacist among members<br />
<strong>of</strong> our pr<strong>of</strong>ession, allied health pr<strong>of</strong>essions and the public, and provide access to resources<br />
that will facilitate the provision <strong>of</strong> pharmaceutical care.<br />
We welcome original manuscripts for consideration. We publish six times a year, in January,<br />
March, May, July, September and November. Manuscripts should be received no later than<br />
eight weeks prior to publication. If you intend to submit material, or would like a copy <strong>of</strong> the<br />
publishing requirements, please contact the Associate Editor. The <strong>Ontario</strong> <strong>College</strong> <strong>of</strong> <strong>Pharmacists</strong><br />
reserves the right to modify contributions as editorial staff feel is appropriate.<br />
To be published, subject matter should promote the objectives <strong>of</strong> the journal. We also<br />
invite you to share with us any suggestions for topics, or journal criticisms, etc. Letters must<br />
include the name, address and telephone number <strong>of</strong> the author for verification purposes, and<br />
may be reprinted in a Letters to the Editor column.<br />
The opinions expressed in this publication do not necessarily represent the views or<br />
<strong>of</strong>ficial position <strong>of</strong> the <strong>Ontario</strong> <strong>College</strong> <strong>of</strong> <strong>Pharmacists</strong>.
a Message from the Editor<br />
Della Croteau<br />
Deputy Registrar/Director <strong>of</strong> Programs<br />
Having just returned from a fabulous bike trip in France,<br />
it occurs to me that my journey was similar to the one<br />
we face personally and pr<strong>of</strong>essionally in day-to-day life.<br />
Three friends and I cycled from Bordeaux along the<br />
Dordogne River Valley, and then back out to the Atlantic<br />
Della Croteau (far left) and friends atop the Dordogne River Valley, France<br />
coast. Like a Van Gogh painting, the countryside was<br />
dappled with vineyards, old chateaus, fields <strong>of</strong> corn and<br />
tobacco, sunflowers and apple orchards. The old towns<br />
along the Dordogne date back to the 12 th and 13 th Centuries,<br />
and these “Bastides” were built on the highest hills<br />
overlooking the Valley. The challenge for us cyclists was<br />
climbing up these hills. The roads were built using switchbacks,<br />
so <strong>of</strong>ten we peddled for four to five kilometres<br />
uphill, making it to the top <strong>of</strong> one portion <strong>of</strong> the road,<br />
only to turn and head up another portion. Of course, the<br />
view <strong>of</strong> the Dordogne Valley from the top was spectac-<br />
ular, and the exhilarating ride back down to the Valley<br />
made us forget how much work it was to get to the top.<br />
We cycled for 10 days and covered 620 kilometres.<br />
We cycled up too many hills to count during our travels,<br />
each hill making us stronger for the next. By our last day<br />
out we had picked up speed and<br />
covered 66 km in only four hours.<br />
I tell this story because I think<br />
it relates to many <strong>of</strong> our challenges<br />
in life and in our work. The way<br />
to the top is <strong>of</strong>ten slow and difficult.<br />
You conquer one challenge,<br />
only to turn the corner and find<br />
another challenge ahead, but you<br />
keep going because you know the<br />
reward is worth the effort. Sometimes<br />
you stop and take a break,<br />
but you keep pressing on to the<br />
top.<br />
As pharmacists, we are currently<br />
in the midst <strong>of</strong> that slow<br />
climb - mutual recognition <strong>of</strong> pharmacists<br />
across Canada, regulation<br />
<strong>of</strong> technicians and the implementation<br />
<strong>of</strong> pharmaceutical care are<br />
but a few <strong>of</strong> the challenges we face. But we need to<br />
persevere. Sometimes we must pause, and take a trip or<br />
even just a few deep breaths and a moment to think, for<br />
this energizes us to continue the climb. It's these steps<br />
which we take everyday to move towards our goals that<br />
get us to our pr<strong>of</strong>essional best.<br />
We know the view from the top will be worth the<br />
climb.<br />
<strong>PHARMACY</strong> CONNECTION Nov/Dec 2000<br />
1
Contents............................................................................................<br />
OCP Council Members<br />
introductions by district<br />
p. 10<br />
Getting Connected<br />
member survey results<br />
p. 11<br />
Deciding on Discipline<br />
case studies<br />
p. 16<br />
A Message from the Editor............................................................1<br />
Della Croteau<br />
A Message from the President.....................................................3<br />
Sam Hirsch<br />
Letters to the Editor......................................................................4<br />
OCP Council Report....................................................7<br />
OCP Electoral Districts and Council Members...........................10<br />
Committee Appointments 2000-2001........................................12<br />
Getting Connected – Results <strong>of</strong> the Pharmacist/Pharmacy<br />
Technician Survey.......................................................13<br />
Deciding on Discipline.................................................................16<br />
Tina Langlois & Ellen Helleur<br />
Q&A Pharmacy Practice..............................................17<br />
Heather Arnott & Brian Hack<br />
Focus on Error Prevention............................................................18<br />
Ian Stewart<br />
New Drugs/Drug News.............................................................I-IV<br />
Drug Information and Research Centre<br />
New Drugs/Drug News Cumulative Index 2000...........................19<br />
Pharmacy Connection Cumulative Index 2000...........................20<br />
New PEBC Examination – Assessors Needed.................................22<br />
CE for <strong>Pharmacists</strong> and Pharmacy Technicians........................24<br />
Q&A Quality Assurance..............................................26<br />
Della Croteau<br />
Drug Schedule Changes - ASA......................................27<br />
Reporting Adverse Drug Reactions.................................28<br />
Canadian Adverse Drug Reaction Monitoring Program<br />
SPT Changes Affecting Foreign-trained <strong>Pharmacists</strong>...30<br />
Chris Schillemore & Marie Rocchi Dean<br />
Close-up on Complaints – Patient Confidentiality...........32<br />
Carmina Vieira-Conti<br />
<strong>Pharmacists</strong>’ Bulletin Board <strong>of</strong> News and Events.........................34<br />
Pharmacist Required, OCP...........................................35<br />
OCP Manual Inserts......................................................................36<br />
2 <strong>PHARMACY</strong> CONNECTION Nov/Dec 2000
a Message from the President<br />
Sam Hirsch<br />
President<br />
It's a new Council year and I’m in<br />
the fortunate position <strong>of</strong> being the<br />
incoming President <strong>of</strong> the <strong>Ontario</strong><br />
<strong>College</strong> <strong>of</strong> <strong>Pharmacists</strong>. I am honoured<br />
that our Council, pictured on<br />
the cover <strong>of</strong> this issue <strong>of</strong> Pharmacy<br />
Connection, would choose me as<br />
leader. You may remember seeing me<br />
in past Council photos, for indeed I<br />
have served many years on Council,<br />
and more recently on the Executive<br />
Committee. This exposure has allowed<br />
me to meet many <strong>of</strong> you<br />
throughout the province, and my<br />
hope is that we will continue to work<br />
together.<br />
This is the year that we will begin<br />
to implement our strategic plan,<br />
the primary directions aimed at:<br />
(1) improving consistency and quality<br />
<strong>of</strong> pharmaceutical care and service<br />
across <strong>Ontario</strong> through efficient<br />
regulation <strong>of</strong> member delivery <strong>of</strong><br />
standards <strong>of</strong> practice; (2) facilitating<br />
optimal public protection through<br />
enhancing awareness <strong>of</strong> the pr<strong>of</strong>ession<br />
with government, other health<br />
pr<strong>of</strong>essions and stakeholders;<br />
(3) communicating the value and<br />
range <strong>of</strong> pharmaceutical services to<br />
the public; and<br />
(4) embracing technology in the pr<strong>of</strong>ession<br />
and at the <strong>College</strong>.<br />
As point (1) demonstrates,<br />
standards <strong>of</strong> practice will take the<br />
spotlight. We will endeavour to challenge<br />
our members to not only meet<br />
the standards, but in many cases,<br />
exceed expectations. In this way, we<br />
collectively strive to “raise the bar”<br />
<strong>of</strong> the pr<strong>of</strong>ession. An important component<br />
is examining the role <strong>of</strong> the<br />
pharmacy technician. This issue impacts<br />
pharmacists and how services<br />
are delivered to the public, and much<br />
work and research is planned in this<br />
area.<br />
Points (2) and (3) relate to communications,<br />
which will be front and<br />
centre this year. This is being facilitated<br />
by the Communications Manager,<br />
the continued refinement <strong>of</strong> the<br />
<strong>College</strong>’s web site, and the establishment<br />
<strong>of</strong> a Communications Committee<br />
to provide input to Council respecting<br />
communication initiatives.<br />
To address point (4), the <strong>College</strong><br />
is in the process <strong>of</strong> undertaking<br />
a comprehensive review <strong>of</strong> the needs<br />
and expectations <strong>of</strong> members, stakeholders,<br />
management and staff in<br />
relation to technology. Expect the<br />
<strong>College</strong>'s commitment to technology<br />
to become evident at all levels <strong>of</strong><br />
<strong>College</strong> operations. Additionally, a<br />
special working group will be convened<br />
to consider the impact <strong>of</strong> technology<br />
on the pr<strong>of</strong>ession and its regulation.<br />
Meeting these goals will require<br />
the combined efforts <strong>of</strong> the Council,<br />
OCP staff, and you, the members.<br />
There are several newly elected and<br />
appointed members <strong>of</strong> Council, who<br />
are introduced on p. 9. Their new<br />
perspectives, combined with the experience<br />
<strong>of</strong> the returning members,<br />
can carry us far. The OCP administration<br />
is benefiting from a similar<br />
mix <strong>of</strong> staff who have been involved<br />
in <strong>College</strong> affairs for many years, and<br />
newly hired senior managers who<br />
bring fresh ideas and insight. Council<br />
members and staff want to hear<br />
from you, the constituents; contact<br />
information is provided for Council<br />
members on p. 10-11, and for OCP<br />
staff in the masthead.<br />
We have a great pr<strong>of</strong>ession but<br />
it is under-used in most cases. As<br />
stakeholders begin to comprehend<br />
how valuable pharmacists are in<br />
health care, I think we will begin to<br />
feel that our work, education and<br />
service are well worth the effort. I<br />
look forward to meeting many more<br />
<strong>of</strong> you during my tenure as President.<br />
I would like to once again say<br />
that it is important that we work together<br />
as pharmacists and as a <strong>College</strong><br />
to make this OUR year.<br />
<strong>PHARMACY</strong> CONNECTION Nov/Dec 2000<br />
3
Letters<br />
Regulation <strong>of</strong> Pharmacy<br />
Technicians Unnecessary<br />
if pharmacist focuses on cognitive services<br />
Dear Editor,<br />
In regards to the potential regulation<br />
<strong>of</strong> pharmacy technicians, I feel that<br />
the resources <strong>of</strong> the OCP would yield<br />
more benefits in the area <strong>of</strong> employer<br />
and pharmacist education. In<br />
many pharmacies, adequate staff is<br />
not available and the pharmacist finds<br />
him/herself performing non-cognitive<br />
duties. In this case, educating<br />
employers regarding the standards <strong>of</strong><br />
practice and the need to provide adequate<br />
staff would create an environment<br />
more conducive to proper<br />
patient care. It is in the public interest<br />
for employers to shoulder their<br />
share <strong>of</strong> responsibility in providing<br />
sufficient staffing to ensure proper<br />
patient care. At the other end, where<br />
staffing is adequate, the pharmacist<br />
must be educated<br />
that his/her responsibility<br />
is to provide<br />
cognitive services for<br />
patients and not to<br />
focus time on technical<br />
functions. If every technician<br />
focused on ringing in sales, stocking<br />
shelves and counting pills, there<br />
would be no time for them to be doing<br />
anything else, and hence no need<br />
for their regulation. Doctors do just<br />
fine without having their secretaries<br />
regulated by any <strong>College</strong>. Clearly,<br />
member resources would be better<br />
spent and the public better served by<br />
getting pharmacists <strong>of</strong>f the cash registers<br />
and into counselling rooms.<br />
Sincerely,<br />
Brandon Tanebaum, B.Sc.Phm.<br />
Dear Mr Tanebaum,<br />
The proposal to regulate pharmacy<br />
technicians currently under study is<br />
designed to provide for staff support<br />
in the pharmacy when it is deemed<br />
necessary to support the pharmacist<br />
in the delivery <strong>of</strong> pharmaceutical<br />
services according to the standards<br />
established by this <strong>College</strong>. To be effective,<br />
it requires proper use <strong>of</strong><br />
pharmacist staff performing tasks<br />
for which they are the most qualified<br />
and delegating those tasks to<br />
others who are trained and qualified<br />
to perform them. This is the premise<br />
on which we are looking to expand<br />
the scope <strong>of</strong> a pharmacy technician’s<br />
responsibilities. Our Council is concerned<br />
that any expansion <strong>of</strong> the<br />
pharmacy technician’s role be considered<br />
in the context <strong>of</strong> how the<br />
pharmacist will use the time that is<br />
freed up. It should not be in the performance<br />
<strong>of</strong> clerical duties but rather<br />
in use <strong>of</strong> his/her expertise to better<br />
manage patient health care needs.<br />
Bernie Des Roches, Ph.D.<br />
Manager, Pharmacy Technician<br />
Programs<br />
<strong>Pharmacists</strong> have<br />
"nothing to fear" about<br />
herbals<br />
& should educate themselves<br />
Dear Editor,<br />
Regarding the article Herbal & Alternative Products: the dialogue continues (Pharmacy Connection,<br />
Vol 7, No 4, Jul/Aug 2000), I wish to applaud the cautious and conservative approach<br />
espoused by the author; however, that same approach belies a lack <strong>of</strong> knowledge and a denial<br />
factor found in certain health care practitioners.<br />
Canadian pharmacists who carry the most commonly used herbs in<br />
their pharmacies have nothing to fear if they take the time to educate themselves<br />
and have in their possession some <strong>of</strong> the better references, such as<br />
Herbs. Everyday Reference for Health Pr<strong>of</strong>essionals published by the Canadian<br />
<strong>Pharmacists</strong>’ Association or Natural Medicines. Comprehensive<br />
Database, compiled by the editors <strong>of</strong> Pharmacist’s Letter/Prescriber’s Letter.<br />
By doing that, they would realize there are specific herbals which are<br />
appropriate for mild to moderate depression, for benign prostatic hypertrophy; also Ginseng plants<br />
do come in several varieties, one <strong>of</strong> which reportedly lowers blood pressure and is being studied<br />
in a Canadian hospital setting to treat diabetes.<br />
Nghia Truong, Doct. Pharm.<br />
Kemptville, ON<br />
4 <strong>PHARMACY</strong> CONNECTION Nov/Dec 2000
Can I date my "patients"?<br />
sexual abuse prevention plan questioned<br />
Dear Editor,<br />
I have read the article “Document provides guidelines for interaction with patients” on page<br />
12 <strong>of</strong> Pharmacy Connection, Sep/Oct 2000. I am concerned with the sentence,<br />
“This Plan applies to conduct with all patients, irrespective <strong>of</strong> their consent for a pharmacist's<br />
conduct to be otherwise.”<br />
This is troublesome for me. I live in a small town. I assume that there<br />
are two definitions for a patient. The first one is a person for whom I have<br />
filled prescription(s). The second one is a person to whom I have provided<br />
pharmaceutical care. So, if I counsel a person on how to use a cough/cold<br />
medication, I cannot date this person. Odds are, I have counselled most<br />
people in this town on cough/cold products.<br />
I remembered reading in the November/December 1995 issue <strong>of</strong> Pharmacy<br />
Connection an article titled, “Sexual Abuse Prevention Plan and Dating<br />
Guidelines,” which is on page 19-20. This article gave an example <strong>of</strong> a<br />
waiver that allowed a pharmacist to date a patient.<br />
Is this waiver still valid? Should I move to a city in order to protect my license?<br />
Yours truly,<br />
Roman Moretti, B.Sc.Pharm.<br />
(Please see Q & A below for response)<br />
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Q & A<br />
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Patient Relations<br />
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Tina Langlois<br />
B.A., L.L.B., CAE<br />
Manager Legal Services/<br />
Patient Relations Programs<br />
Can I date my "patients" if I<br />
have them sign a waiver?<br />
The Regulated Health Pr<strong>of</strong>essions<br />
Act (RHPA) makes it an act <strong>of</strong> pr<strong>of</strong>essional<br />
misconduct to engage in<br />
sexual contact with patients regardless<br />
<strong>of</strong> consent.<br />
The Patient Relations Committee<br />
(PRC) <strong>of</strong> the <strong>College</strong> defines a<br />
patient as someone for whom you<br />
have a patient pr<strong>of</strong>ile. This definition<br />
<strong>of</strong> "patient" was chosen because<br />
pharmacists cannot be expected<br />
to remember exactly whom<br />
they counselled on nonprescription<br />
products and whether their names<br />
were recorded or not. In the situation<br />
you describe, this could include<br />
a person for whom you have filled<br />
a prescription or for whom you<br />
have provided pharmaceutical care,<br />
depending upon your policies regarding<br />
documentation.<br />
You are correct in stating that<br />
in 1995 the Patient Relations Committee<br />
issued a waiver that attempted<br />
to inform the patient <strong>of</strong> the issues<br />
regarding confidentiality and deal<br />
with the particular concerns <strong>of</strong><br />
practitioners in remote areas who<br />
wished to commence personal relationships<br />
with patients. It should<br />
be noted that even at that time, it<br />
was stated that the waiver did not<br />
make the relationship risk free.<br />
Five years later the issue <strong>of</strong><br />
consent as it relates to these provisions<br />
<strong>of</strong> the RHPA is the subject <strong>of</strong><br />
court action and we are awaiting<br />
the court’s clarification.<br />
The <strong>College</strong> has also asked the<br />
government to clarify this issue as<br />
part <strong>of</strong> its five-year review <strong>of</strong> the<br />
RHPA because <strong>of</strong> the uncertainty<br />
<strong>of</strong> practitioners. Until we have more<br />
answers, there is no real way, short<br />
<strong>of</strong> severing your patient relationship<br />
prior to commencing a personal<br />
one, to absolutely avoid the application<br />
<strong>of</strong> the Act. We will keep<br />
members advised as we are made<br />
aware <strong>of</strong> developments in this area.<br />
<strong>PHARMACY</strong> CONNECTION Nov/Dec 2000<br />
5
<strong>Pharmacists</strong> Not Expected to Think<br />
reader objects that pharmacists can't exercise discretion<br />
Dear Editor,<br />
Although I am no longer actively practising pharmacy, I try to keep abreast <strong>of</strong> changes to and within the pr<strong>of</strong>ession.<br />
I believe that changes in the last few years have improved the pr<strong>of</strong>ession considerably. More emphasis is now<br />
placed on communicating with patients and providing information than before.<br />
Occasionally, I come across vestiges <strong>of</strong> an old spirit which my colleagues and I used to joke was exemplified by<br />
a movie quote "Think? Who told you to think? I don't give you enough information to think!"<br />
A response to a question in the "Pharmacy Practice Q&A" section in the September/October 2000 edition <strong>of</strong><br />
Pharmacy Connection comes dangerously close to the one above.<br />
"Q: If the physician prescribes MS-Contin 90 mg, Take 1 daily, M:30, can I exercise discretion and dispense<br />
MS-Contin 30 mg and MS-Contin 60 mg to satisfy the prescription dosage?"<br />
"A: MS-Contin 90 mg does not exist . . . It is not within the jurisdiction <strong>of</strong> the pharmacist to assume what can<br />
be dispensed."<br />
Undoubtedly, this is the correct legal answer. However, the fact that a pharmacist with a minimum <strong>of</strong> five years<br />
university education can not assume that 30 and 60 make 90 for the sake <strong>of</strong> a patient in pain speaks volumes about<br />
how far the pr<strong>of</strong>ession has to go.<br />
Yours Sincerely,<br />
Wael Haddara, B.Sc.Pharm, MD<br />
London, ON<br />
Prescription is<br />
Ambiguous<br />
pharmacists must seek clarification<br />
There are two problems we encounter with this prescription<br />
(above) as it is written. First, the product<br />
is not manufactured in this strength and, as such,<br />
does not legally exist. Second, one can never assume<br />
anything with respect to the filling <strong>of</strong> a prescription.<br />
The ambiguity created by the prescription<br />
begs for clarification.<br />
Community practice does not take place in a<br />
controlled clinical environment and we, as pharmacists,<br />
are responsible for what we dispense. There<br />
are legal requirements, both provincially and federally,<br />
with respect to filling a prescription. As this is<br />
not a legal prescription, the prescriber must be contacted<br />
and a new written or faxed order obtained.<br />
In this situation, more communication is required<br />
between the pharmacist and physician in the interest<br />
<strong>of</strong> better patient care.<br />
OCP Field Representatives<br />
12345678901234567<br />
12345678901234567<br />
MS-Contin 90 mg<br />
12345678901234567<br />
12345678901234567<br />
12345678901234567<br />
12345678901234567<br />
Take 1 daily<br />
12345678901234567<br />
12345678901234567<br />
12345678901234567<br />
12345678901234567<br />
12345678901234567<br />
12345678901234567<br />
12345678901234567<br />
12345678901234567<br />
CPSO Policy Statement on<br />
Anabolic Steroids<br />
M:30<br />
The <strong>College</strong> <strong>of</strong> Physicians and<br />
Surgeons <strong>of</strong> <strong>Ontario</strong> recently<br />
reviewed literature<br />
on the<br />
side effects <strong>of</strong><br />
anabolic<br />
steroids and<br />
consulted with<br />
experts in the<br />
field. This past<br />
summer, CPSO<br />
released a policy statement<br />
regarding the use <strong>of</strong> anabolic<br />
steroids by athletes. It reads:<br />
“Prescribing, administering or providing<br />
assistance relating to the use <strong>of</strong> substances,<br />
including anabolic steroids, for the purpose <strong>of</strong><br />
enhancing athletic performance, without<br />
medical indication, and/or for the apparent<br />
purpose <strong>of</strong> assisting an athlete to cheat, is<br />
unpr<strong>of</strong>essional.”<br />
6 <strong>PHARMACY</strong> CONNECTION Nov/Dec 2000
OCP COUNCIL<br />
September 2000 Meeting<br />
REPORT<br />
Council Approves 2001 Operating<br />
Budget<br />
Council approved an operating budget for 2001 as well<br />
as adjustments to annual fees for pharmacists, pharmacy<br />
accreditation renewals, and fees for training and initial<br />
registration.<br />
Council considered a report submitted by the Finance<br />
Committee that presented an expense budget for<br />
2001 calling for an increase in spending <strong>of</strong> 11 per cent<br />
over the prior year. The spending is related to activities<br />
necessary to achieve the goals set forth in the recentlyapproved<br />
strategic plan. The new activities include improving<br />
our information technology services and support<br />
systems; expanding the practice advisory and field<br />
services role; moving forward with the regulation <strong>of</strong> technicians;<br />
increasing and improving communications particularly<br />
with the public; and reducing the discipline case<br />
backlog. In order to minimize cost increases for the full<br />
year, some proposed activity will be deferred to later in<br />
year 2001.<br />
The Finance Report presented several options for<br />
addressing the shortfall <strong>of</strong> revenue created by the new<br />
spending. Council debated the option <strong>of</strong> a lesser fee adjustment<br />
to deliver a deficit budget but opted instead to<br />
increase fees equal to the new spending to achieve a<br />
balanced budget. This decision was also based on the<br />
need to maintain the accumulated reserves <strong>of</strong> the <strong>College</strong><br />
as some significant capital spending is likely in<br />
the next couple <strong>of</strong> years for computer systems and<br />
facilities.<br />
The Finance Report also included changes proposed<br />
by the Registration Committee following an internal review<br />
<strong>of</strong> entry to practice activity and associated fees. A<br />
revised fee model was introduced to: 1) align fees with<br />
activity, 2) increase cost recovery, 3) treat all applicants<br />
the same, regardless <strong>of</strong> place <strong>of</strong> graduation, and 4) serve<br />
as a disincentive to frivolous applications. The changes<br />
to the entry to practice fee model will contribute an additional<br />
$200,000 <strong>of</strong> revenue over previous years.<br />
Although a small capital budget was put forward<br />
for furniture and building improvements, approval <strong>of</strong> this<br />
was deferred to December 2000. At this time Council<br />
will consider the recommendations <strong>of</strong> a report from an<br />
external consulting group that is examining the current<br />
and future needs for information technology. Together<br />
they will form the capital budget for 2001, which will be<br />
funded by the reserves.<br />
Council also agreed that a member communiqué be<br />
developed to explain the new initiatives proposed in the<br />
2001 budget, along with the value the initiatives bring to<br />
the members. Accordingly, a letter was sent to members<br />
in the last week <strong>of</strong> September.<br />
Following is a summary <strong>of</strong> the 2001 operating budget:<br />
Revenue<br />
Pharmacist Fees<br />
Pharmacy Fees<br />
Registration Fees<br />
Sundry Fees<br />
Investment Income<br />
Total Revenue<br />
Expenses<br />
Council & Committees<br />
<strong>College</strong> Administration<br />
Property<br />
Niagara Apothecary<br />
Total Expenses<br />
Excess <strong>of</strong> Revenue over Expenses<br />
$3,924,414<br />
1,460,500<br />
370,875<br />
157,500<br />
192,500<br />
$6,105,789<br />
$1,468,500<br />
4,364,225<br />
239,200<br />
31,600<br />
$6,103,525<br />
$2,264<br />
Capital expenditures to be approved at a later date.<br />
<strong>PHARMACY</strong> CONNECTION Nov/Dec 2000<br />
7
Council Election Results<br />
Council has elected its new Executive Committee for<br />
the 2000-2001 year. Members include:<br />
• Sam Hirsch, Council representative for District 4,<br />
President<br />
• Leslie Braden, Council representative for District 7,<br />
Vice President<br />
• Barbara Minshall, Council representative for District<br />
2, member-at-large<br />
• three appointed public members <strong>of</strong> Council, namely<br />
Joan Boyer, Pasquale Fiorino and Barry Solway, and<br />
• Bill Mann, Council representative for District 13, who<br />
will continue to sit on the Executive Committee as<br />
Past President.<br />
For a complete list <strong>of</strong> OCP committees and their members,<br />
please see p. 12.<br />
Structured Practical Training<br />
Council approved proposed changes to the <strong>College</strong>’s<br />
existing policies regarding structured practical training<br />
(SPT) for pharmacist graduates from outside Canada<br />
and the United States as follows:<br />
1. that Structured Practical Training be implemented for<br />
pharmacist graduates from outside Canada and the US<br />
as <strong>of</strong> January 1, 2001<br />
2. that this training and assessment be based on the<br />
NAPRA competencies as is required <strong>of</strong> Canadian and<br />
US applicants<br />
3. that applicants already in traditional internship training<br />
on January 1, 2001 be allowed to complete the traditional<br />
internship training. Applicants in traditional studentship<br />
on January 1, 2001 may complete that portion <strong>of</strong><br />
their training but then must advance to the structured<br />
internship training. For more on these changes, please<br />
see a Q&A article on p. 30-31 <strong>of</strong> this issue.<br />
In addition, Council approved the following proposed<br />
changes in policy respecting the SPT requirements for<br />
pharmacy graduates from outside Canada and the United<br />
States:<br />
1. that the current traditional 48 weeks <strong>of</strong> in-service training<br />
be replaced by 48 weeks <strong>of</strong> Structured Practical<br />
Training, consisting <strong>of</strong>:<br />
i) a minimum <strong>of</strong> 32 weeks SPT studentship<br />
(consisting <strong>of</strong> a minimum <strong>of</strong> 16 weeks <strong>of</strong> academic<br />
modules developed and provided in conjunction<br />
with the Faculty <strong>of</strong> Pharmacy, University<br />
<strong>of</strong> Toronto, and a minimum <strong>of</strong> 16 weeks<br />
practical training) and<br />
Council 2000-2001<br />
ii) a minimum <strong>of</strong> 16 weeks SPT internship<br />
2. that there be flexibility within the 32-week studentship<br />
to <strong>of</strong>fer a variety <strong>of</strong> combinations <strong>of</strong> both academic<br />
and practical training to meet the needs for distance education<br />
or a part-time format, provided that equivalent<br />
outcomes are met<br />
3. that applicants may be exempted from the studentship<br />
portion <strong>of</strong> training when they successfully complete<br />
the PEBC Qualifying Examination (including the<br />
OSCE portion).<br />
To ensure that pharmacy graduates from outside<br />
Canada and the United States meet required competencies<br />
before internship and to support the above policy<br />
changes, Council further approved the following proposed<br />
amendment to the Regulation under the Pharmacy<br />
Act so as to reflect the following additional requirements<br />
for the issuance <strong>of</strong> a certificate <strong>of</strong> registration<br />
as an intern:*<br />
“The applicant must have been granted the<br />
degree <strong>of</strong> Bachelor <strong>of</strong> Science in Pharmacy<br />
by the University <strong>of</strong> Toronto, or by a pharmacy<br />
degree program accredited by CCAPP or<br />
ACPE, or must have obtained a degree in<br />
pharmacy that is required for the holder <strong>of</strong><br />
the degree to become eligible to write and have<br />
successfully passed a licensing examination<br />
based on the ‘Pr<strong>of</strong>essional Competencies for<br />
Canadian <strong>Pharmacists</strong> at Entry to Practice’<br />
and approved by Council. (This is currently<br />
8 <strong>PHARMACY</strong> CONNECTION Nov/Dec 2000
the qualifying examination <strong>of</strong> the Pharmacy<br />
Examining Board <strong>of</strong> Canada [PEBC] with the<br />
OSCE component).”<br />
*This proposal requires approval by the Lieutenant<br />
Governor in Council before being proclaimed in<br />
force.<br />
OCP Jurisprudence Examination<br />
Schedule Changes<br />
In order to facilitate the implementation <strong>of</strong> the recently<br />
signed Mutual Recognition Agreement for Pharmacy in<br />
Canada, Council approved the Registration Committee’s<br />
recommendation that the number <strong>of</strong> sittings <strong>of</strong> the OCP<br />
Jurisprudence Examination being <strong>of</strong>fered annually across<br />
Canada increase from three to four. In addition, the summer<br />
sitting, traditionally held in August, will be moved to<br />
July so that applicants awaiting licensure may receive<br />
their results in a more timely manner.<br />
Scope <strong>of</strong> Practice for <strong>Pharmacists</strong><br />
Council considered the Canadian <strong>Pharmacists</strong>’ Association<br />
discussion paper on prescriptive authority for pharmacists<br />
and the issue <strong>of</strong> cholesterol/glucose screening<br />
in pharmacies. After considerable discussion, Council<br />
has directed the Executive Committee to investigate an<br />
expanded scope <strong>of</strong> practice for pharmacists and utilization<br />
<strong>of</strong> emerging technology, and to report back to Council<br />
at a future meeting.<br />
Emergency Contraception Update<br />
Council received a verbal update from the Registrar respecting<br />
the recent approval <strong>of</strong> funding for an emergency<br />
contraception pilot program in the Toronto area<br />
through Sunnybrook/Women’s <strong>College</strong> Hospital. In the<br />
summer <strong>of</strong> last year, the <strong>College</strong> met with other interested<br />
parties to consider making emergency contraception<br />
available through pharmacies under appropriate conditions<br />
through collaborative agreements with prescribers.<br />
In September 1999, Council considered a model that<br />
currently exists in the State <strong>of</strong> Washington. Considering<br />
that such a program could enhance the pharmacist’s<br />
primary care role and provide the public with an accessible,<br />
knowledgeable health pr<strong>of</strong>essional, Council agreed<br />
in principle to support pharmacists’ participation in such<br />
a pilot project should one be approved for funding in<br />
<strong>Ontario</strong>. Details and particulars respecting the proposed<br />
pilot project will be communicated to you as they become<br />
available.<br />
New Council Members<br />
OCP is grateful to Anne Resnick, Kelly Carfagnini, Liz<br />
Mutton, Gord Murray and Felice Guberman for their<br />
many contributions as Council members. Replacing them,<br />
Council is pleased to welcome:<br />
Alexander Wong, the new Council representative for<br />
District 6. He practices at Meadowvale Pharmacy in Mississauga.<br />
Mr Wong received his pharmacy degree from<br />
Dalhousie University in Halifax. His hobbies include gardening.<br />
Larry Boggio, the new Council representative for District<br />
9. A University <strong>of</strong> Toronto pharmacy graduate, he<br />
owns and practices at Boggio Pharmacy Ltd. in Port<br />
Colborne. In his spare time, Mr Boggio enjoys hockey,<br />
skiing and coaching soccer.<br />
Sherry Peister, the new Council representative for District<br />
12. Ms Peister, a past president <strong>of</strong> the <strong>Ontario</strong> <strong>Pharmacists</strong>’<br />
Association, is also involved with the CPhA<br />
and local pharmacists’ associations. She practices as a<br />
pharmacist associate with Shoppers Drug Mart and holds<br />
a B.Sc.Phm. degree from the University <strong>of</strong> Toronto. In<br />
her spare time, Ms Peister likes spending time with her<br />
children, skiing and golfing.<br />
Albert Chaiet, the new Council representative for District<br />
16. He is the Director <strong>of</strong> Pharmaceutical Services<br />
for the Centre for Addiction and Mental Health in Toronto.<br />
He has bachelor and masters' degrees in pharmacy<br />
from U <strong>of</strong> T, and an MBA from York University. He is<br />
also involved with the OPA, CPhA, and the Association<br />
<strong>of</strong> Pharmacy Managers <strong>of</strong> Toronto Area Hospitals. He<br />
enjoys music, theatre, reading and sports.<br />
Malcolm Mansfield, appointed as a new public member<br />
<strong>of</strong> Council. Mr Mansfield works as a finance account<br />
executive.<br />
For a complete list <strong>of</strong> Council members, including<br />
their photos and contact information, see p. 10-11.<br />
Council Meetings<br />
Council will hold meetings at the <strong>Ontario</strong> <strong>College</strong> <strong>of</strong> <strong>Pharmacists</strong>,<br />
483 Huron St., Toronto, <strong>Ontario</strong> on:<br />
December 11 and 12, 2000<br />
March 26 and 27, 2001<br />
June 18 and 19, 2001<br />
September 10 and 11, 2001.<br />
<strong>PHARMACY</strong> CONNECTION Nov/Dec 2000<br />
9
15<br />
14<br />
OCP Electoral<br />
Districts<br />
1<br />
7<br />
2<br />
13<br />
3<br />
4<br />
5<br />
6<br />
District 1, Marie Ogilvie<br />
R.R. #1, 834 South Gower Dr.<br />
Kemptville, ON K0G 1J0<br />
Tel: (613) 258-5624<br />
Fax: (613) 258-9290<br />
mogilvie@sympatico.ca<br />
District 5, Larry Hallok<br />
28 Humbervale Blvd.<br />
Toronto, ON M8Y 3P2<br />
Tel: (416) 535-1944<br />
Fax: (416) 236-5700<br />
lllh@ionsys.com<br />
11<br />
10<br />
12<br />
8 9<br />
District 12, Sherry Peister<br />
SDM, 450 Erb St. West<br />
Waterloo, ON N2T 1H4<br />
Tel: (519) 886-3530<br />
Fax: (519) 746-8012<br />
District 2, Barbara Minshall<br />
168 Orchard Park Rd.<br />
Lindsay, ON K9V 6A8<br />
Tel: (705) 324-5428<br />
District 6, Alexander Wong<br />
Meadowvale Pharmacy Ltd.<br />
6750 Winston Churchill Blvd.<br />
Mississauga, ON L5N 4C4<br />
Tel: (905) 824-0701<br />
Fax: (905) 824-0702<br />
alexwong_ca@yahoo.com<br />
District 9, Larry Boggio<br />
Boggio Pharmacy Ltd., 222 Catharine St.<br />
Port Colborne, ON L3K 4K8<br />
Tel: (905) 834-3514<br />
Fax: (905) 834-6252<br />
boggio@pharmassist.org<br />
District 13, Bill Mann<br />
Mann's IDA Pharm.<br />
332-10th St.<br />
Hanover, ON N4N 1P3<br />
Tel: (519) 364-2300<br />
Fax: (519) 364-3592<br />
machine@bmts.com<br />
District 14, Vacant<br />
District 3, Martin Belitz<br />
28 Hawleaf Cres.<br />
North York, ON M2H 3H4<br />
Tel: (905) 791-8276 X423<br />
mbelitz_ca@yahoo.com<br />
District 7, Leslie Braden<br />
15 Hopkins Rd.<br />
Barrie, ON L4M 5X8<br />
Tel: (905) 819-3000 X3290<br />
District 10, Steve Balestrini<br />
3-521 Nottinghill Rd.<br />
London, ON N6K 4L4<br />
Tel: (519) 473-4949<br />
Fax: (519) 473-9160<br />
steve@afpwmi.com<br />
District 4, Sam Hirsch<br />
SDM, 1531 Bayview Ave.<br />
Toronto, ON M4G 3B5<br />
Tel: (416) 482-7100 X18<br />
Fax: (416) 489-8750<br />
District 8, Iris Krawchenko<br />
Dell Pharmacy, 517 Upper Sherman Ave.<br />
Hamilton, ON L8V 3L7<br />
Tel: (905) 388-2222<br />
Fax: (905) 385-8662<br />
District 11, David Malian<br />
Greenshield Canada, 285 Giles Blvd.<br />
P.O. Box 1606, Windor, ON N9A 6W1<br />
Tel: 1-800-265-5615<br />
Fax: (519) 255-7929<br />
dmalian@greenshield.ca<br />
District 15, Gurjit Husson<br />
SDM, 1186 Memorial Ave.<br />
Thunder Bay, ON P7B 5K5<br />
Tel: (807) 623-3601<br />
Fax: (807) 623-3725<br />
10 <strong>PHARMACY</strong> CONNECTION Nov/Dec 2000
ONTARIO<br />
Area shown in map, p. 10<br />
Council Members<br />
The map on page 10 is a graphical representation <strong>of</strong> the existing Council district boundaries.<br />
Pages 10 and 11 reflect the members representing each <strong>of</strong> the districts as well as<br />
two hospital representatives (Districts 16 and 17), the Dean <strong>of</strong> the Faculty <strong>of</strong> Pharmacy,<br />
University <strong>of</strong> Toronto, and 11 public members.<br />
District 16, Albert Chaiet<br />
Centre for Addiction & Mental Health<br />
33 Russell St. Toronto, ON M5S 2S1<br />
tel: (416) 535-8501 X6671<br />
fax: (416) 595-6606<br />
albert_chaiet@camh.net<br />
Public Member Garry Dent<br />
15 Mateev<br />
Kapuskasing, ON P5N 3G2<br />
Tel: (705) 335-6964<br />
Fax: (705) 335-3493<br />
grdent@nt.net<br />
Public Member Steve Gupta<br />
174 The Bridle Path<br />
Toronto, ON M3C 2P2<br />
Tel: (905) 940-9409 X23<br />
Fax: (905) 940-9412<br />
Public Member Malcolm Mansfield<br />
1220-Sheppard Ave. East, Ste. 402<br />
Toronto, ON M2K 2S5<br />
Tel: (416) 496-1220 X24<br />
Fax: (416) 496-8666<br />
malcolm@brookcor.com<br />
District 17, Malcolm Ng<br />
150 Strathearn Ave.<br />
Richmond Hill, ON L4B 2L7<br />
Tel: (905) 472-7373 X3943<br />
Fax: (905) 472-7027<br />
Public Member Bob Drummond<br />
3 Avenue Rd.<br />
Parry Sound, ON P2A 2A6<br />
Tel: (705) 746-9898<br />
Public Member Marlene Hogarth<br />
104 High St. South<br />
Thunder Bay, ON P7B 3K4<br />
Tel: (807) 345-9181<br />
Fax: (807) 344-5715<br />
Public Member Barry Solway<br />
41 T<strong>of</strong>ino Crescent<br />
Toronto, ON M3B 1R9<br />
Tel: (416) 510-0073 X214<br />
Fax: (416) 510-0703<br />
Dean Wayne Hindmarsh<br />
Faculty <strong>of</strong> Pharmacy, 19 Russell St.<br />
Toronto, ON M5S 2S2<br />
Tel: (416) 978-2880<br />
Fax: (416) 978-8511<br />
wayne.hindmarsh@utoronto.ca<br />
Public Member Joan Boyer<br />
15 Charlotte St.<br />
Port Colborne, ON L3K 3C7<br />
Tel: (905) 835-1441<br />
Fax: (905) 835-0110<br />
Public Member Pasquale Fiorino<br />
1024 Front Rd. North<br />
Amherstberg, ON N9V 2V9<br />
Tel: (519) 736-2778<br />
Fax: (519) 736-0088<br />
Public Member Dean French<br />
P.O. Box 301, TD Centre<br />
Suite 2200, Commercial Union Tower<br />
Toronto, ON M5K 1K2<br />
Tel: (416) 366-2971 X212<br />
Fax: (416) 366-7489<br />
deanfrench@sympatico.ca<br />
Public Member Wally Hunter<br />
63 Barton St.<br />
Milton, ON L9T 1C8<br />
Tel: (905) 876-1664<br />
wallyhunter@hotmail.com<br />
Public Member Steve Mangos<br />
3087 Kingston Rd.<br />
Toronto, ON M1M 1P1<br />
Tel: (416) 265-6867<br />
Fax: (416) 265-5438<br />
flower@pathcom.com<br />
In Memoriam<br />
It is with great sadness<br />
and regret that the <strong>Ontario</strong><br />
<strong>College</strong> <strong>of</strong> <strong>Pharmacists</strong><br />
must inform members<br />
that on November 6, Bill<br />
Wilson, Council Member<br />
for District 14, passed<br />
away after a short illness.<br />
Bill, who was our friend<br />
and colleague, served as<br />
OCP President from<br />
1998-1999. He owned a<br />
pharmacy with his wife<br />
Elizabeth in Copper Cliff,<br />
near Sudbury. As this<br />
happened very close to<br />
press time, a more detailed<br />
tribute to Bill will be prepared<br />
for the Jan/Feb<br />
2000 issue.<br />
<strong>PHARMACY</strong> CONNECTION Nov/Dec 2000<br />
11
Committee Appointments 2000-2001<br />
Statutory Committees<br />
Executive<br />
President:<br />
S Hirsch (Chair)<br />
V. Pres: L Braden<br />
Past Pres:<br />
B Mann<br />
Council Members:<br />
B Minshall<br />
P Fiorino<br />
J Boyer<br />
B Solway<br />
Quality<br />
Assurance<br />
S Balestrini (Chair)<br />
M Hogarth<br />
S Mangos<br />
B Solway<br />
C Donaldson*<br />
J Mann*<br />
R Farmand*<br />
M Ng<br />
Complaints<br />
I Krawchenko<br />
(Chair)<br />
J Boyer<br />
D Malian<br />
B Solway<br />
D Organ*<br />
Patient Relations<br />
B Minshall (Chair)<br />
J Boyer<br />
M Hogarth<br />
M Ogilvie<br />
B Solway<br />
Accreditation<br />
M Ogilvie (Chair)<br />
R Drummond<br />
J Farnham*<br />
A Wong<br />
Fitness to Practice<br />
L Hallok (Chair)<br />
R Ball*<br />
S Gupta<br />
D Malian<br />
M Mansfield<br />
Registration<br />
M Belitz (Chair)<br />
M Hogarth<br />
W Hindmarsh<br />
G Husson<br />
S Mangos<br />
M Ng<br />
Discipline<br />
P Fiorino (Chair)<br />
Z Austin*<br />
M Belitz<br />
L Boggio<br />
L Braden<br />
A Chaiet<br />
B Chute*<br />
G Dent<br />
S Gupta<br />
M Hogarth<br />
G Husson<br />
S Mangos<br />
B Mann<br />
M Mansfield<br />
G Murray*<br />
T Nieuwh<strong>of</strong>*<br />
A Resnick*<br />
Special Committees/Working Groups/Task Forces<br />
Pharmacy<br />
Technicians<br />
Working Group<br />
S Balestrini (Chair)<br />
H Armstrong*<br />
M Belitz<br />
A Chaiet<br />
E Ells*<br />
W Hindmarsh<br />
Y McRobbie*<br />
B Miller*<br />
E Moore*<br />
M Ogilvie<br />
B Stowe*<br />
A Taddeo*<br />
Working Group<br />
for Certification<br />
Examinations for<br />
Pharmacy<br />
Technicians<br />
A Chaiet (Chair)<br />
C Anderson*<br />
G Husson<br />
J Koehne*<br />
Z Somani*<br />
C Vanderspiegel*<br />
Communications<br />
L Braden (Chair)<br />
S Balestrini<br />
S Hirsch<br />
S Mangos<br />
B Solway<br />
B Phillips*<br />
Standards <strong>of</strong><br />
Practice Working<br />
Group<br />
A Resnick* (Chair)<br />
Z Austin*<br />
L Braden<br />
L Bruni*<br />
A Chaiet<br />
M Colquhoun*<br />
L Hallok<br />
M Monaghan*<br />
Structured<br />
Practical Training<br />
M Monaghan*<br />
(Chair)<br />
L Boggio<br />
D Malian<br />
M Ng<br />
P Reynolds*<br />
L Wilson*<br />
D Miller*<br />
R Farmand*<br />
Task Force on<br />
Primary Care<br />
Reform<br />
D Organ* (Chair)<br />
B Solway<br />
B Drummond<br />
B Wilson<br />
Standing Committees<br />
Pr<strong>of</strong>essional<br />
Practice<br />
B Mann (Chair)<br />
R Drummond<br />
B Greenberg*<br />
G Dent<br />
S Peister<br />
J Penney*<br />
Finance<br />
W Hunter (Chair)<br />
D French<br />
S Balestrini<br />
L Boggio<br />
L Braden<br />
B Solway<br />
* Non-Council<br />
Committee Member<br />
12 <strong>PHARMACY</strong> CONNECTION Nov/Dec 2000
Getting Connected<br />
Results <strong>of</strong> the Pharmacist/Pharmacy<br />
Technician Survey<br />
This year’s annual fee form for pharmacists included a survey to gain feedback on the<br />
extent to which you are ready and looking for alternate means to communicate with and<br />
obtain information from the <strong>College</strong>. Some preliminary results were reported in the July/<br />
August issue <strong>of</strong> Pharmacy Connection. A similar survey was also sent with the fee form for<br />
Certified Pharmacy Technicians. There were questions specific to each group, however the<br />
availability <strong>of</strong> results from both studies prompted us to report on them jointly in this issue <strong>of</strong><br />
Pharmacy Connection.<br />
We were very pleased with the survey response from both pharmacists (78.1 per cent)<br />
and pharmacy technicians (76.5 per cent), providing usable data from 6,758 pharmacists<br />
and 766 certified pharmacy technicians. Not all questions were answered, therefore the<br />
results, in some instances, come from a smaller number than the total population <strong>of</strong><br />
respondents.<br />
internet access<br />
Of the survey respondents, the great majority <strong>of</strong> pharmacists (72 per cent) and pharmacy<br />
technicians (69.6 per cent) have access to the Internet. Of these, 64.5 per cent <strong>of</strong> pharmacists<br />
and 55 per cent <strong>of</strong> pharmacy technicians access it from home. Accessing the Internet<br />
from the work place is reported by a relatively small percentage <strong>of</strong> pharmacists (11.7 per<br />
cent) and pharmacy technicians (20 per cent), while approximately 25 per cent <strong>of</strong> both<br />
groups indicate that they have the choice <strong>of</strong> accessing it either from home or the work<br />
place.<br />
For those who do not currently have access to the Internet, 41.8 per cent <strong>of</strong> pharmacists<br />
and 36 per cent <strong>of</strong> pharmacy technicians anticipate that they will get connected by next<br />
year; 33.2 per cent <strong>of</strong> pharmacists and 38 per cent <strong>of</strong> pharmacy technicians expect to do so<br />
within the next two years. At this time, approximately one-quarter <strong>of</strong> the pharmacist and<br />
pharmacy technician respondents do not feel they will likely get connected.<br />
The Internet is used by 10.9 per cent <strong>of</strong> pharmacists and 6.9 per cent <strong>of</strong> pharmacy technicians<br />
for its e-mail capabilities; 14.6 per cent <strong>of</strong> pharmacists and 17.5 per cent <strong>of</strong> pharmacy<br />
technicians for information research. A high proportion <strong>of</strong> pharmacists (74.5 per cent) and<br />
pharmacy technicians (85.6 per cent) use it for a variety <strong>of</strong> purposes.<br />
<strong>PHARMACY</strong> CONNECTION Nov/Dec 2000<br />
13
www.ocpharma.com<br />
When asked if they had ever visited the <strong>College</strong>’s web site, one-third (32.9 per cent) <strong>of</strong><br />
pharmacists and almost half (48.7 per cent) <strong>of</strong> the pharmacy technician respondents had<br />
done so. Of these:<br />
• 9.3 per cent <strong>of</strong> pharmacists and 4.4 per cent <strong>of</strong> pharmacy technicians visit the site one<br />
to five times a week<br />
• 27.5 per cent <strong>of</strong> pharmacists and 34 per cent <strong>of</strong> pharmacy technicians do so one to five<br />
times per month<br />
• approximately 60 per cent in both groups do so one to five times per year.<br />
This is an indication that we must make greater effort to ensure that current, relevant information<br />
is posted to the web as soon and as <strong>of</strong>ten as possible. Other comments on the survey<br />
support this need. Recent developments and proposed strategies for <strong>College</strong> communications<br />
should make this happen.<br />
sharing & accessing information<br />
We were interested in learning how pharmacists and pharmacy technicians would like to<br />
receive and transmit information to and from the <strong>College</strong> in the future. A slight majority <strong>of</strong><br />
52.9 per cent <strong>of</strong> pharmacists and 50.5 per cent <strong>of</strong> pharmacy technicians would prefer to<br />
receive <strong>College</strong> notices in electronic rather than mail format. For those preferring electronic<br />
communication, 66.5 per cent <strong>of</strong> pharmacists and 74.3 per cent <strong>of</strong> pharmacy technicians<br />
prefer e-mail; the remainder prefer fax transmission.<br />
If the <strong>College</strong> provided the option <strong>of</strong> submitting changes to personal information such as<br />
address changes through electronic means, 45.5 per cent <strong>of</strong> pharmacists and 33.2 per cent<br />
<strong>of</strong> pharmacy technicians would prefer to be able to do that by phone. Use <strong>of</strong> the Internet to<br />
transmit such data is preferred by 54.4 per cent <strong>of</strong> pharmacists and 41.5 per cent <strong>of</strong> pharmacy<br />
technicians; the pharmacy technician respondents were also given the option <strong>of</strong> selecting<br />
fax transmittal, which 25.3 per cent indicated as their preference.<br />
When it comes to transmitting the annual fees form electronically, 55.4 per cent <strong>of</strong> pharmacist<br />
respondents and 40.5 per cent <strong>of</strong> pharmacy technicians would prefer this method rather<br />
than receiving the fees form by mail. When asked whether they would prefer to pay their<br />
fees by cheque, credit or debit card, 53.2 per cent <strong>of</strong> pharmacists and 83.5 per cent <strong>of</strong><br />
pharmacy technicians would prefer to pay by cheque. Pharmacy technicians in particular<br />
show little desire to pay by credit card (10.2 per cent) or debit card (6.3 per cent). As<br />
cheques could not effectively be used with electronic transmission <strong>of</strong> the fees form, there<br />
would have to be a shift in willingness to use credit or debit cards for this to be feasible.<br />
The <strong>College</strong> anticipates that it will soon be in a position to accommodate each pharmacist’s<br />
and pharmacy technician’s preference to receive data by mail, e-mail or fax.<br />
<strong>of</strong> particular interest to pharmacists<br />
Some questions were directed specifically to pharmacists. When asked whether they would<br />
be comfortable using electronic methods for conducting elections to Council, 73.3 per cent<br />
indicated they would. They were also asked to indicate the extent to which some proposed<br />
14 <strong>PHARMACY</strong> CONNECTION Nov/Dec 2000
services would be appealing. Of the 6,676 pharmacists who answered this question:<br />
• 23.6 per cent would like to see the <strong>College</strong> develop news groups<br />
• 39.2 per cent would like to use electronic means to access interactive learning modules<br />
like the Clinical Knowledge Assessment currently available, and for sharing data from<br />
their Learning Portfolios<br />
• 37.2 per cent would like to view instructional videos related to, for example, the Quality<br />
Assurance Program and continuing education programs.<br />
<strong>of</strong> particular interest to pharmacy technicians<br />
Similarly, specific questions were directed to pharmacy technicians. We asked them if they<br />
would like to be able to specify whether they receive communications at their place <strong>of</strong><br />
practice; 90.6 per cent were not in favour, indicative <strong>of</strong> a preference by the majority to<br />
receive such communications at their residence.<br />
When asked whether they would like to have their mailing addresses provided to pharmacy<br />
related groups to use in communicating directly:<br />
• 76.8 per cent <strong>of</strong> the pharmacy technicians would be agreeable, <strong>of</strong> which<br />
• 51.6 per cent would allow the information to be provided to pharmacy associations, and<br />
• 48.4 per cent to organizations and companies providing continuing education programs.<br />
Under the <strong>College</strong>’s plans to provide alternative communications methods, it will be possible<br />
to restrict provision <strong>of</strong> information to outside groups only to pharmacy technicians who<br />
authorize this.<br />
Pharmacy technicians find the journal Pharmacy Connection to be:<br />
• <strong>of</strong> some value (70 per cent)<br />
• great value (22.3 per cent)<br />
• no value (7.7 per cent).<br />
Similarly, our regularly featured Question and Answer column for pharmacy technicians is<br />
<strong>of</strong> great value to 35.1 per cent <strong>of</strong> the readers and some value to 60.7 per cent. We are<br />
encouraged by these results but will strive to improve the value <strong>of</strong> the journal and column<br />
for all pharmacy technicians.<br />
future developments<br />
These surveys have given us a good indication <strong>of</strong> how ready and willing pharmacists and<br />
pharmacy technicians are to move to greater use <strong>of</strong> electronic communications with the<br />
<strong>College</strong>. Several areas where we need to enhance our services were noted and steps are<br />
underway to achieve these improvements. Communication has been identified as a high<br />
priority for the <strong>College</strong> and a Communications Manager is now on staff, supported by a fulltime<br />
web site designer. As well, our information technology area is currently under extensive<br />
review to help us prepare for a major expansion in our use <strong>of</strong> electronic technology.<br />
Watch for great things to come!<br />
<strong>PHARMACY</strong> CONNECTION Nov/Dec 2000<br />
15
Deciding on Discipline<br />
Case 1<br />
Name:<br />
Chu Fang (Julia) Lin<br />
Burlington, On<br />
Hearing Date: Aug. 24, 2000<br />
The Discipline Committee found Ms<br />
Lin guilty <strong>of</strong> pr<strong>of</strong>essional misconduct<br />
in that, as designated manager <strong>of</strong><br />
Millrose Pharmacy, at 4119 Upper<br />
Middle Road, Burlington, <strong>Ontario</strong>:<br />
1. On or about September 29,<br />
1995, she practiced beyond the<br />
scope <strong>of</strong> her pr<strong>of</strong>ession in that she<br />
assessed a lump on a patient and provided<br />
a diagnosis for his condition.<br />
2. On or about April 15, 1996, she<br />
practiced beyond the scope <strong>of</strong> her<br />
Tina Langlois<br />
B.A., L.L.B., CAE<br />
Manager Legal Services/<br />
Patient Relations Programs<br />
&<br />
Ellen Helleur<br />
Secretary,<br />
Patient Relations Programs<br />
pr<strong>of</strong>ession in that she dispensed 15<br />
gm <strong>of</strong> Zovirax ® ointment to a patient<br />
when the prescription called for 4 gm<br />
<strong>of</strong> Zovirax ® cream, without consulting<br />
the prescriber.<br />
3. She dispensed the prescriptions<br />
set out below, in a form other than<br />
prescribed, without first obtaining<br />
proper authority from the prescriber.<br />
Prescribed<br />
500 mL Hydrocortisone 1% powder<br />
in Lubriderm ®<br />
Dispensed<br />
600 mL Hydrocortisone 1% powder<br />
in Lubriderm ®<br />
Prescribed<br />
Axid ® 300 mg tablets; 15<br />
Dispensed<br />
30 Axid ® 150 mg<br />
Prescribed<br />
N/A<br />
Dispensed<br />
300 trihexyphenidyl 2 mg<br />
Prescribed<br />
no quantity specified Lamisil ® Cream<br />
Dispensed<br />
30 g Lamisil ® Cream<br />
Penalty:<br />
1. a three-month suspension <strong>of</strong> the<br />
registrant’s Certificate <strong>of</strong> Registration,<br />
two months to be remitted in<br />
full upon successful completion (by<br />
August 31, 2001) <strong>of</strong> the Pharmaceutical<br />
Jurisprudence course and examination,<br />
to be taken at the registrant’s<br />
expense (the one-month suspension<br />
is to be completed within 90<br />
days);<br />
2. successful completion (by August<br />
31, 2001) <strong>of</strong> a Practice Review,<br />
to be taken at the registrant’s expense;<br />
3. a reprimand to be recorded on<br />
the register.<br />
Case 2<br />
Name:<br />
Herman Szeto<br />
Markham ON<br />
Hearing Date: July 19, 2000<br />
The Discipline Committee found Mr<br />
Szeto guilty <strong>of</strong> pr<strong>of</strong>essional misconduct,<br />
in that:<br />
1. On or about, at least, March 15,<br />
1996; May 31, 1996; May 11, 1996;<br />
and January 19, 1996, he was the<br />
dispensing pharmacist at Shoppers<br />
Drug Mart at 270 The Kingsway, in<br />
the City <strong>of</strong> Etobicoke.<br />
(continued on p. 27)<br />
16 <strong>PHARMACY</strong> CONNECTION Nov/Dec 2000
1. Is it true that a technician<br />
can take a verbal refill order<br />
from a physician?<br />
No. When repeats on a prescription<br />
are exhausted, a new authorization<br />
from the prescriber is required.<br />
Even though the medication<br />
is being reordered, and the patient<br />
has had it before, it is still a new<br />
prescription. DPRA regulation 551<br />
section 56(1) clearly stipulates that<br />
an oral prescription may only be<br />
given to a pharmacist, intern or<br />
pharmacy student working under<br />
the direct supervision <strong>of</strong> a pharmacist.<br />
Therefore, a technician cannot<br />
take a verbal refill order from a<br />
physician.<br />
2. Do I have to manually cross<br />
reference my prescription hard<br />
copies to their original authorization?<br />
Yes, but how you do this depends<br />
upon the s<strong>of</strong>tware in your pharmacy<br />
computer system. Some s<strong>of</strong>tware<br />
systems automatically cross<br />
reference refills to the original authorization<br />
and record this information<br />
on the hard copy. For systems<br />
that do not print this information<br />
on the hard copy, the pharmacist<br />
or technician must manually record<br />
this information on each subsequent<br />
repeat/part-fill. The requirement<br />
to cross reference comes<br />
from DPRA regulation 551 section<br />
61. It applies to regular, controlled<br />
drug, narcotic, and targeted substance<br />
prescriptions.<br />
3. What information must be<br />
on a prescription receipt?<br />
As per Regulation 936 to the Drug<br />
Interchangeability and Dispensing<br />
Fee Act, a person who dispenses a<br />
drug pursuant to a prescription shall<br />
provide a receipt to the person to<br />
whom the drug is supplied at the<br />
same time that the drug is supplied.<br />
&<br />
Q<br />
A<br />
1234567890123456789012<br />
1234567890123456789012<br />
1234567890123456789012<br />
1234567890123456789012<br />
1234567890123456789012<br />
1234567890123456789012<br />
1234567890123456789012<br />
1234567890123456789012<br />
1234567890123456789012<br />
1234567890123456789012<br />
1234567890123456789012<br />
1234567890123456789012<br />
Pharmacy Practice<br />
1234567890123456789012<br />
1234567890123456789012<br />
1234567890123456789012<br />
1234567890123456789012<br />
1234567890123456789012<br />
1234567890123456789012<br />
1234567890123456789012<br />
1234567890123456789012<br />
Heather Arnott<br />
B.Sc.Phm.<br />
Field Representative<br />
&<br />
Brian Hack<br />
B.Sc.<br />
Compliance Officer<br />
The receipt sets out the amount being<br />
charged in respect <strong>of</strong>:<br />
(a) the pr<strong>of</strong>essional dispensing fee,<br />
(b) the cost <strong>of</strong> the drug, and<br />
(c) the total price <strong>of</strong> the prescription.<br />
Please note that the total on the prescription<br />
receipt must include the<br />
co-payment made by the patient. The<br />
receipt must also show the amount<br />
paid by the patient. For example, if a<br />
$2.00 co-payment is required but the<br />
pharmacy chooses not to collect it,<br />
the amount paid would be $0.00, and<br />
this must be reflected on the receipt.<br />
4. My computer system is giving<br />
benzodiazepine prescriptions a narcotic<br />
file number. Am I not to file<br />
these prescriptions with the regular<br />
prescriptions?<br />
It is not necessary to record the sale<br />
<strong>of</strong> these drugs as narcotics. However,<br />
some computer systems are only<br />
able to handle the change in ordering<br />
requirements for benzodiazepines by<br />
coding them as “non-reportable narcotics.”<br />
In these cases, prescriptions<br />
are assigned an N/CD number<br />
and must be filed with the N/CD<br />
prescriptions in order to maintain<br />
the numbering sequence. The method<br />
<strong>of</strong> filing must be consistent within<br />
the pharmacy.<br />
5. Can a physician who has restrictions<br />
for narcotic or controlled<br />
drugs prescribe benzodiazepines?<br />
Yes. Benzodiazepines represent a<br />
new class <strong>of</strong> drugs under the<br />
CDSA. We have contacted Health<br />
Canada and received confirmed that<br />
a physician with restrictions with<br />
respect to prescribing narcotics<br />
and/or controlled drugs can still prescribe<br />
benzodiazepines. A restriction<br />
letter would have to specifically<br />
mention targeted substances.<br />
For further information on the status<br />
<strong>of</strong> benzodiazepines, please refer<br />
to the Q&A article posted on<br />
the OCP web site at<br />
www.ocpharma.com or visit the<br />
NAPRA web site at<br />
www.napra.org, and click on<br />
Health Canada Notices for the<br />
“guidance documents.” You can<br />
also contact the Controlled Substances<br />
Office <strong>of</strong> Health Canada at<br />
tel: (613) 954-1541.<br />
6. Do I still need to get a drug<br />
interaction text if I have s<strong>of</strong>tware<br />
on my computer?<br />
The pharmacy library requires a<br />
current edition <strong>of</strong> a drug interaction<br />
publication, or a comparable<br />
computer program that is updated<br />
on a regular basis. Reference texts<br />
are verified by the Field Representatives<br />
and Compliance Officer at<br />
pharmacy site visits. The inspector<br />
must be able to verify when the<br />
computer or text was last updated,<br />
and that these updates are in fact<br />
the most current.<br />
<strong>PHARMACY</strong> CONNECTION Nov/Dec 2000<br />
17
Drug Schedule Changes<br />
Focus on Error Prevention<br />
Ian Stewart<br />
B.Sc.Phm.<br />
Suggestions to<br />
help pharmacists<br />
identify and<br />
prevent<br />
medication errors<br />
It's estimated that thousands <strong>of</strong><br />
people die each year due to<br />
preventable medical errors. Of<br />
these, medication errors are one <strong>of</strong><br />
the most common causes <strong>of</strong> death.<br />
Rather than blame individuals,<br />
focus should be on preventing<br />
future errors by designing safety<br />
into the system. A better<br />
understanding <strong>of</strong> the many factors<br />
that contribute to the occurrence <strong>of</strong><br />
medication errors must be at the<br />
heart <strong>of</strong> any prevention effort.<br />
Ian Stewart<br />
Excessive workload demands on<br />
pharmacists have raised concerns<br />
about a potential increase in medication<br />
errors. This increase in workplace<br />
pressure and stress may be attributable,<br />
at least in part, to the current<br />
pharmacist shortage and an increase<br />
in the number <strong>of</strong> prescriptions<br />
being written. More prescriptions are<br />
being written largely because new<br />
drugs are being approved and the<br />
population is aging. Though seniors<br />
represent 12 per cent <strong>of</strong> the population,<br />
they consume between 28 per<br />
cent and 40 per cent <strong>of</strong> all prescription<br />
drugs. Since multiple medication<br />
use is common in this age group,<br />
there is an increase in the number <strong>of</strong><br />
potential drug interactions requiring<br />
the pharmacist's intervention, hence<br />
putting more pressure on the pharmacist’s<br />
time.<br />
As we move closer to pharmaceutical<br />
care, there is a clear need to<br />
spend a greater amount <strong>of</strong> time with<br />
each patient to ensure that all potential<br />
drug-related problems are identified.<br />
Third party payors are also demanding<br />
more <strong>of</strong> the pharmacist’s<br />
time, <strong>of</strong>ten with no increased compensation.<br />
Increased patient demand<br />
can also add to a stressful situation.<br />
Such a pressured environment can<br />
adversely affect the pharmacist’s<br />
ability to provide safe pharmaceutical<br />
care, as the following case suggests.<br />
Case: 1<br />
Imipramine was prescribed for a<br />
five-year old boy to treat childhood<br />
enuresis. A pharmacy technician entered<br />
the concentration into the computer<br />
as 50 mg/mL instead <strong>of</strong> 50 mg/<br />
5 mL, along with the prescribed directions<br />
to give two teaspoonfuls at<br />
bedtime. He then mixed the solution<br />
using the incorrect concentration on<br />
the label and placed the prescription<br />
in a holding area to await a pharmacist’s<br />
verification. The high workload<br />
made it impossible for the pharmacist<br />
to check the prescription right<br />
away.<br />
When the child’s mother came<br />
in to pick up the prescription, the<br />
pharmacy technician was unaware<br />
that it had not been checked and gave<br />
it to the mother without telling a<br />
pharmacist. The mother gave the<br />
child two teaspoons <strong>of</strong> the drug at<br />
bedtime, resulting in a dose <strong>of</strong> 500<br />
mg instead <strong>of</strong> the intended 100 mg.<br />
Sadly, the child was found dead the<br />
next morning. An autopsy confirmed<br />
imipramine poisoning.<br />
Ironically, one year earlier, almost<br />
exactly to the day, the pharmacy<br />
owner was interviewed for an<br />
article in which community pharmacists<br />
told <strong>of</strong> being overworked. The<br />
article described the pharmacist’s<br />
frustration with how little attention<br />
is paid to workload difficulties faced<br />
in today’s health care environment.<br />
The owner commented on steps taken<br />
to overcome these barriers, including<br />
the use <strong>of</strong> technology. However,<br />
despite these efforts, this fatal<br />
error occurred.<br />
(continued on p. 36)<br />
18 <strong>PHARMACY</strong> CONNECTION Nov/Dec 2000
New Drugs/Drug News<br />
Cumulative Index 2000<br />
The following abbreviations are used:<br />
January/February is J/F<br />
March/April is M/A<br />
May/June is M/J<br />
July/August is J/A<br />
September/October is S/O<br />
November/December is N/D<br />
Each article is referenced by issue.<br />
A<br />
ACTONEL - new product S/O<br />
ACTOS - new product<br />
N/D<br />
AGGRENOX - new product M/J<br />
Alosetron (LOTRONEX) for Irritable<br />
Bowel Syndrome - review M/J<br />
AMBISOME - new product M/J<br />
ARAVA - new product<br />
M/J<br />
AROMASIN - new product S/O<br />
ASA/NSAID Cross-sensitivity<br />
- update N/D<br />
AVALIDE - new product<br />
M/J<br />
AVANDIA - new product M/J<br />
B<br />
BUSULFEX - new product<br />
C<br />
CORVERT - new product<br />
CRINONE - new product<br />
D<br />
DENTI-CARE CHLORHEXIDINE<br />
GLUCONATE - new product<br />
DIASTAT Rectal Delivery System -<br />
new product<br />
DOSTINEX - new product<br />
DUOFILM GEL for kids - new<br />
product<br />
E<br />
Emergency Contraception - review<br />
ESTALIS - new product<br />
Etanercept and Infliximab for<br />
Rheumatoid Arthritis - review<br />
EXELON - new product<br />
F<br />
FemHRT 1/5 - new product<br />
J/F<br />
N/D<br />
J/F<br />
J/F<br />
J/F<br />
S/O<br />
S/O<br />
J/F<br />
J/A<br />
M/A<br />
J/A<br />
N/D<br />
G, H<br />
HUMULIN N PEN - new product<br />
HYZAAR DS - new product<br />
I<br />
Infliximab (and Etanercept) for<br />
Rheumatoid Arthritis - review<br />
J, K<br />
KOGENATE FS - new product<br />
M/J<br />
J/F<br />
M/A<br />
N/D<br />
L<br />
LEVAQUIN - new product S/O<br />
LOTRONEX (Alosetron) for Irritable<br />
Bowel Syndrome - review M/J<br />
M<br />
Metronidazole Oral Suspension -<br />
FAQ<br />
MIACALCIN Nasal Spray - review<br />
Mirtazapine (REMERON) - review<br />
MONOCOR - new product<br />
J/F<br />
J/F<br />
S/O<br />
S/O<br />
N<br />
Narcotic Analgesic Crossallergenicity<br />
- update<br />
S/O<br />
NSAID/ASA Cross-sensitivity<br />
- update N/D<br />
O<br />
ONE-ALPHA - new product<br />
OXY-IR - new product<br />
P<br />
PanOxyl Clear Acne Cleansing<br />
Gel<br />
PLAN B - new product<br />
PREVEN Emergency Contraceptive<br />
Kit - new product<br />
Progesterone, topical formulations -<br />
review<br />
S/O<br />
M/J<br />
N/D<br />
M/J<br />
J/F<br />
M/A<br />
Q<br />
QVAR - new product<br />
J/A<br />
R<br />
RELENZA - new product<br />
J/F<br />
REMERON (Mirtazapine ) - review S/O<br />
RENAGEL - new product S/O<br />
RILUTEK - new product N/D<br />
RITUXAN - new product M/J<br />
S<br />
STARNOC - new product<br />
STEMGEN - new product<br />
Sulfonamide Allergy and Crossallergenicity<br />
- review<br />
SYNERCID - new product<br />
Synthetic Calcitonin, Salmon<br />
(MIACALCIN Nasal Spray) -<br />
review<br />
T<br />
TAMIFLU - new product<br />
TEMODAL - new product<br />
Triptan (5-HT agonist) Use<br />
Concomitantly with an<br />
SSRI - FAQ<br />
U, V<br />
VARIVAX II - new product<br />
VISUDYNE - new product<br />
W, X<br />
XELODA - new product<br />
Y, Z<br />
ZADITOR - new product<br />
ZANAFLEX - new product<br />
ZENAPAX - new product<br />
ZOMETA - new product<br />
J/A<br />
J/F<br />
J/A<br />
M/A<br />
J/F<br />
M/A<br />
J/F<br />
M/J<br />
S/O<br />
J/A<br />
S/O<br />
S/O<br />
J/F<br />
S/O<br />
N/D<br />
<strong>PHARMACY</strong> CONNECTION Nov/Dec 2000<br />
19
Pharmacy Connection<br />
Cumulative Index 2000<br />
The following abbreviations are used:<br />
January/February is J/F<br />
March/April is M/A<br />
May/June is M/J<br />
July/August is J/A<br />
September/October is S/O<br />
November/December is N/D.<br />
Each article is referenced by issue and page number.<br />
A<br />
Academic Credential Assessment<br />
Service for <strong>Ontario</strong><br />
J/A:7<br />
Annual Membership Renewal 2000<br />
J/F:8, M/A:28<br />
Annual Pharmacy Renewal 2000<br />
M/A:5, M/J:24<br />
Appointment <strong>of</strong> New Registrar M/J:6<br />
B<br />
Before Modern Medicines, New<br />
Book<br />
Benzodiazepine Coding<br />
Benzodiazepine Prescribing<br />
Bridging Program<br />
Bulletin Board<br />
J/F:30<br />
N/D:17<br />
N/D:17<br />
J/F:13<br />
J/F:30, M/A:28, M/J:23,<br />
J/A:28, S/O:27, N/D:34<br />
C<br />
Cancellations<br />
S/O:36<br />
CCCEP Courses<br />
M/A:30<br />
CE Events J/F:20, M/A:16, M/J:27,<br />
J/A:32, S/O:30, N/D:24<br />
CE Resources J/F:14, M/J:29, M/J:36,<br />
J/A:29, J/A:36, N/D:25<br />
Certified Pharmacy Technician J/F:27<br />
Child Abuse, Requirement to Report<br />
M/J:9, J/A:11<br />
Clarification<br />
J/F:30<br />
Class <strong>of</strong> 4T0 and 5T0 Reunion<br />
M/A:29, M/J:24<br />
Class <strong>of</strong> 7T3 Reunion M/J:25, J/A:29<br />
Class <strong>of</strong> 7T5 Reunion J/F:30, M/A:29,<br />
M/J:25, J/A:29<br />
Class <strong>of</strong> 8T0 Reunion M/A:29, M/J:25,<br />
J/A:29<br />
Class <strong>of</strong> 8T5 Reunion M/A:29, M/J:25,<br />
J/A:29, S/O:28<br />
Class <strong>of</strong> 9T5 Reunion<br />
S/O:28<br />
Close-up on Complaints M/A:12,<br />
M/J:10, J/A:27, N/D:32<br />
Committee Appointments N/D:12<br />
Communications Coordinator,<br />
Position Available<br />
J/F:31<br />
Communication Skills for<br />
<strong>Pharmacists</strong> J/F:31, M/A:29<br />
COPA Sponsorship<br />
Coroner’s Alert Re:<br />
Diphenhydramine<br />
Correction<br />
Council Elections<br />
Council Meetings<br />
Council Members, New<br />
CSHP - <strong>Ontario</strong> Branch<br />
J/A:6<br />
M/A:28<br />
J/F:30<br />
S/O:36, N/D:8<br />
J/A:7, N/D:9<br />
N/D:9<br />
J/A:29<br />
D<br />
Deciding on Discipline J/F:22, M/A:34,<br />
M/J:32, J/A:34, S/O:33, N/D:16<br />
DHEA<br />
S/O:17<br />
Diabetes Certification Exam S/O:27<br />
Discipline, How Matters Are<br />
Referred to<br />
M/A:33, S/O:5<br />
Dispensing Errors, Prevention<br />
System<br />
M/J:14<br />
Drug Interaction Texts<br />
N/D:17<br />
Drug Schedules J/F:32, M/A:6, J/A:14,<br />
N/D:27<br />
Dunsdon, Jim, 30 th Anniv. M/A:3<br />
Dunsdon, Jim, Tribute Upon<br />
Retiring<br />
M/J:16<br />
Dunsdon, Jim, OPA Honorary<br />
Life Member<br />
J/A:28<br />
E<br />
Echinacea<br />
M/A:15<br />
Educational Modules, U <strong>of</strong> T M/J:26,<br />
J/A:31, S/O:29<br />
Electronic Transmissions, Member<br />
Notices J/A:13<br />
Emergency Contraceptive Update N/D:9<br />
Emergency Supplies, Narcotics J/F:32<br />
F<br />
Fax-back Prescription Form S/O:11<br />
Five-year Review <strong>of</strong> the RHPA J/F:6<br />
Focus on Error Prevention J/F:19,<br />
M/A:8, M/J:8, S/O:14, N/D:18<br />
Follow-up Calls<br />
J/A:5<br />
G<br />
Geriatric and Longterm Care Ctte.,<br />
10 th Annual Report J/A:7, J/A:30<br />
Getting Connected, Member Survey<br />
Results<br />
N/D:13<br />
H<br />
Have Your Say M/J:35, J/A:22, S/O:35<br />
Health Canada Withdraws Prepulsid<br />
(cisapride)<br />
J/A:28<br />
Herbal and Alternative Products J/A:22<br />
Hockey Tournament J/F:31, M/A:29<br />
Hospital for Sick Children Reports<br />
Formula Changes<br />
M/J:23<br />
Hours <strong>of</strong> Operation, Pharmacy J/A:21<br />
I<br />
Index, Policy Handbook and Reference<br />
Guide, Latest Version M/J:25<br />
Initiating Dialogue on:<br />
Adverse Reactions<br />
M/J:12<br />
Blood Glucose Meters J/F:33<br />
Smoking Cessation<br />
J/A:19<br />
St. John’s Wort Extract S/O:15<br />
Vitamins & Herbal Suppl. M/A:13<br />
Insulin Stability<br />
S/O:6<br />
Interchangeability Rules J/A:21<br />
Internet Guidelines<br />
M/J:20<br />
Internet Pharmacy<br />
M/J:22<br />
Internet Prescriptions<br />
J/F:32<br />
Internet Regulations<br />
J/F:7<br />
Invitation from NAPRA to Intl.<br />
Conference<br />
J/A:28<br />
J<br />
Jurisprudence Exam, OCP<br />
N/D:9<br />
K, L<br />
Labeling Former D1/D2 Drugs S/O:17<br />
Labelling Oral Contraceptives S/O:27<br />
Laws, Deanna, Appointed<br />
Registrar<br />
M/A:3<br />
Letters<br />
J/F:1, M/A:4, M/J:4,<br />
J/A:4, S/O:4, N/D:4<br />
Limited Use<br />
J/A:7<br />
M<br />
Manager, Pharmacy Practice Programs,<br />
Position Available<br />
M/J:11<br />
20 <strong>PHARMACY</strong> CONNECTION Nov/Dec 2000
Melatonin<br />
S/O:17<br />
Message from the Editor J/F:1, M/A:1,<br />
J/A:1, S/O:1, N/D:1<br />
Message from the President M/J:1,<br />
S/O:3, N/D:3<br />
Message from the Registrar J/F:1,<br />
M/J:3, J/A:3<br />
Methadone Maintenance M/A:9<br />
Morning Sickness, New Web Site J/F:30<br />
Mutual Recognition Agreement<br />
J/F:5, M/A:10, M/J:15<br />
N<br />
NAPRA Newsletter, Outlook<br />
J/F:9, J/A:15<br />
National Model, Continuing<br />
Competency Program J/A:7<br />
New Deputy Registrar Appointed<br />
M/J:7<br />
New Drugs/Drug News Index N/D:19<br />
New Version, Pr<strong>of</strong>essional Pr<strong>of</strong>ile &<br />
Learning Portfolio Available J/A:20<br />
O<br />
Obituary, Clare Mitchell M/A:28<br />
Obituary, Noreen Quirk J/A:29<br />
Obituary, Cecil Walters N/D:34<br />
OCP Council Members N/D:11<br />
OCP Council Report<br />
J/F:5, M/J:6, J/A:6, S/O:7, N/D:7<br />
OCP District Meetings<br />
M/J:23, J/A:8, S/O:9<br />
OCP Electoral Districts N/D:10<br />
OCP Manual Inserts J/F:37, M/A:37,<br />
M/J:37, J/A:37, S/O:37, N/D:36<br />
OCP Past Presidents Get Together<br />
M/A:29<br />
OCP Strategic Plan 2000 S/O:7<br />
On-line Learning<br />
M/A:32<br />
OPA Proposal: Pr<strong>of</strong>essional Liability<br />
M/J:7, J/A:6<br />
Operating Budget Approved N/D:7<br />
Orientation to Licensing Process<br />
J/F:30, M/J:24, N/D:35<br />
Outlook, NAPRA Newsletter J/F:9,<br />
J/A:15<br />
P<br />
Palliative Care Information Centre<br />
N/D:34<br />
Patient Confidentiality M/J:14, N/D:32<br />
PEBC, New Certification Exam S/O:32<br />
N/D:22<br />
Pharmacist Required<br />
N/D:35<br />
Pharmacist Status Confirmation<br />
M/A:28<br />
<strong>Pharmacists</strong>’ Access to Diagnosis M/J:7<br />
<strong>Pharmacists</strong>' Scope <strong>of</strong> Practice N/D:9<br />
PharmAction Program N/D:34<br />
Pharmacy Connection Index N/D:20<br />
Pharmacy Education Now Available<br />
in Modules<br />
J/F:13<br />
Pharmacy Technicians<br />
J/A:6<br />
Pharmacy Technician Updates M/A:18,<br />
M/J:19, S/O:19<br />
Pharm.D. Program at U <strong>of</strong> T S/O:28<br />
Practice Revew<br />
N/D:26<br />
Practice Review, Surviving M/J:35<br />
Prepulsid (cisapride) Withdrawn J/A:28<br />
Prescriptions, Directions J/F:32<br />
Prescription Cross-Referencing N/D:17<br />
Prescription Drug Sales to the US J/A:21<br />
Prescription Part-fills<br />
S/O:17<br />
Prescription Receipts<br />
N/D:17<br />
Prescription Refills<br />
N/D:17<br />
Prescription Transfers Between<br />
Provinces<br />
S/O:17<br />
Pr<strong>of</strong>essional Misconduct M/J:5<br />
Q<br />
Q&A Patient Relations M/A:33,<br />
M/J:5, S/O:5<br />
Q&A Pharmacy Practice J/F:32,<br />
M/A:6, M/J:14, J/A:21, S/O:17, N/D:17<br />
Q&A Pharmacy Technicians J/F:27,<br />
J/A:26<br />
Q&A Quality Assurance N/D:26<br />
QA Clinical Knowledge Assessment,<br />
Five Sample Cases<br />
J/F:15<br />
QA Program Candidate Selections<br />
M/A:29<br />
Quality Assurance Evaluation J/F:7,<br />
M/J:6<br />
R<br />
Reference Book on Botanical<br />
Products Reviewed<br />
J/A:24<br />
Reference Book on Herbs Reviewed<br />
J/A:25<br />
Regional CE Coordinators J/F:31,<br />
M/J:25, M/J:30<br />
Reporting Adverse Drug Reactions<br />
N/D:28<br />
Residencies, Two Specialty M/A:24<br />
RHPA, Five-Year Review J/F:6<br />
S<br />
SAM-e<br />
S/O:17<br />
Screening Tests<br />
M/A:6<br />
Sexual Abuse Prevention Plan S/O:12<br />
Staff Announcements M/A:3, M/A:28,<br />
M/J:7, M/J:23, J/A:29, S/O:27, N/D:34<br />
Standards <strong>of</strong> Practice Working Group<br />
Report Approved<br />
J/F:6<br />
Standards <strong>of</strong> Practice, Revised M/A:19<br />
Statement <strong>of</strong> Operations Approved<br />
M/J:6<br />
Stewart, Douglas, Memorial Award<br />
N/D:35<br />
Strategic Planning Retreat M/J:6<br />
Structured In-service Training J/F:5<br />
Structured Practical Training N/D:8,<br />
N/D:30<br />
Structured Practical Training<br />
Preceptors, Call J/F:26, M/A:36<br />
Structured Practical Training<br />
Newsgroups<br />
M/J:23<br />
Structured Practical Training<br />
Workshops M/J:23, N/D:35<br />
Survey<br />
J/F:31<br />
Suspensions<br />
J/A:35<br />
T<br />
Thank You Preceptors<br />
U<br />
University <strong>of</strong> Sask. Reunion<br />
S/O:20<br />
N/D:34<br />
V, W<br />
Working Group, Pharmacy Techs J/F:3<br />
WSIB Access Line<br />
N/D:34<br />
X, Y, Z<br />
Y2K Readiness<br />
Orientation<br />
to Licensing<br />
Process<br />
J/F:7<br />
If you know a<br />
pharmacy graduate who is interested<br />
in becoming licensed in <strong>Ontario</strong>,<br />
please encourage them to<br />
attend an orientation session at<br />
OCP. There is no charge to attend.<br />
Staff will be available to provide<br />
information and answer questions<br />
related to licensure. The next sessions<br />
are scheduled for:<br />
Dec. 19, 2000 – 1 p.m. to 4 p.m.<br />
April 3, 2001 – 1 p.m. to 4 p.m.<br />
June 26, 2001 – 1 p.m. to 4 p.m.<br />
Sept. 20, 2001 – 1 p.m. to 4 p.m.<br />
Please call (416) 962-4861, ext.<br />
228 (Veronica Duczek) or ext. 232<br />
(Jackie McKee) to enroll.<br />
Participants will also have an<br />
opportunity at the orientation to<br />
make an appointment with a staff<br />
member to ask any questions that<br />
weren’t answered in the seminar.<br />
<strong>PHARMACY</strong> CONNECTION Nov/Dec 2000<br />
21
New PEBC Certification<br />
Examination Begins in 2001<br />
Pharmacist Assessors Needed<br />
As reported in the Sep/Oct 2000 issue <strong>of</strong> Pharmacy<br />
Connection (p. 32), beginning in the Spring <strong>of</strong> 2001 the<br />
Pharmacy Examining Board <strong>of</strong> Canada (PEBC) will implement<br />
a new practice-based examination component.<br />
This will complement the written examination for certification.<br />
The two components are known as the PEBC<br />
Qualifying Examination - Parts I and II. The new exam<br />
component (Part II) will be similar in format to assessments<br />
now in use in several Canadian pharmacy faculties<br />
and in the <strong>Ontario</strong> <strong>College</strong> <strong>of</strong> <strong>Pharmacists</strong>’ Quality<br />
Assurance Program. It will be conducted each Spring in<br />
eight locations and again in the Fall in three <strong>of</strong> these<br />
sites, one <strong>of</strong> which will be a bilingual site. The first administration<br />
will be on Sunday, May 27, 2001. More information<br />
will be provided in the coming months and<br />
also posted on the PEBC web site (www.pebc.ca).<br />
The new component is based on an assessment<br />
model commonly known as the Objective Structured<br />
Clinical Examination (OSCE). It is designed to assess<br />
communications/interpersonal skills, the application <strong>of</strong><br />
knowledge to simulations <strong>of</strong> commonly encountered patient<br />
scenarios, and other aspects <strong>of</strong> pr<strong>of</strong>essional competence<br />
that do not lend well to written examinations.<br />
The competencies to be assessed through both the written<br />
and practice-based exams are those adopted (or adapted)<br />
by all member provinces <strong>of</strong> the National Association<br />
<strong>of</strong> Pharmacy Regulatory Authorities (NAPRA).<br />
PEBC invites pharmacists who are involved in providing<br />
or directly supervising patient care services (including<br />
dispensing, clinical and drug information services)<br />
to participate as assessors in the new examination. It<br />
is particularly important that practising pharmacists be<br />
involved in assessing candidates for licensure, in accordance<br />
with the needs <strong>of</strong> the public and the standards <strong>of</strong><br />
the pr<strong>of</strong>ession. Those who have been assessors in licensing<br />
and quality assurance programs would attest<br />
that involvement is both personally and pr<strong>of</strong>essionally<br />
rewarding.<br />
This is a milestone for our pr<strong>of</strong>ession, one that we,<br />
along with other provinces, have been working towards.<br />
It is a means for many pharmacists to become involved<br />
in a national program and we hope that you will respond<br />
to the invitation.<br />
PEBC Qualifying Examination - Part II (OSCE)<br />
Guidelines for the Selection <strong>of</strong> Assessors<br />
Objectives are to:<br />
• ensure that assessors have current practice experience<br />
• ensure that assessors are well-trained to perform<br />
assessments<br />
• avoid perceived or unconscious conflict <strong>of</strong> interest<br />
(from the point <strong>of</strong> view <strong>of</strong> foreign candidates, students<br />
who are borderline, etc.)<br />
• protect the security <strong>of</strong> the examination from unconscious<br />
or “good intentional” use <strong>of</strong> exam materials in any<br />
manner other than for the PEBC Qualifying Examination.<br />
Assessors must:<br />
• be a “member in good standing” <strong>of</strong> one or more<br />
provincial regulatory authorities<br />
• be fully licensed in a Canadian jurisdiction for at least<br />
the last three years and not disciplined by any pr<strong>of</strong>essional<br />
body during the last three years<br />
• currently practice in a patient care environment, providing<br />
or supervising patient care services on a regular<br />
basis, either full- or part-time. Such services may include:<br />
dispensing, patient teaching, responding to patients’<br />
requests, consulting with other health pr<strong>of</strong>essionals regarding<br />
patients’ needs (e.g., drug information)<br />
• be willing to sign and comply with the assessor confidentiality,<br />
security, conflict <strong>of</strong> interest and code <strong>of</strong> conduct<br />
agreements<br />
• be willing to participate on the basis <strong>of</strong> the <strong>of</strong>fered<br />
honorarium, without additional remuneration for travel<br />
and accommodation<br />
• have no limitations that would impair the ability to<br />
accurately observe, record and assess candidates’ performance<br />
over a 10- to 12-hour period.<br />
22 <strong>PHARMACY</strong> CONNECTION Nov/Dec 2000
Practice-site (structured practical training, internship and<br />
clerkship) preceptors would normally qualify as assessors.<br />
<strong>Pharmacists</strong> are not eligible due to potential or perceived<br />
conflict <strong>of</strong> interest or bias if they are:<br />
• involved in the development <strong>of</strong> the curriculum for<br />
or training/assessment <strong>of</strong> practical/pr<strong>of</strong>essional skills<br />
<strong>of</strong> groups <strong>of</strong> students in the third to final year <strong>of</strong> the<br />
undergraduate program<br />
• graduate students in the same faculty<br />
• involved in the development, review, administration<br />
or dissemination <strong>of</strong> practice exams, cases or preparatory<br />
courses or materials (designed to specifically prepare<br />
candidates for the examination) during a three-year period<br />
from the time <strong>of</strong> participation in the PEBC Qualifying<br />
Examination - Part II.<br />
PEBC Assessor Interest<br />
Assessors are trained on the morning <strong>of</strong> the examination, so it is not necessary to have experience<br />
as an assessor. The most important qualification is your current practice experience (either performing<br />
or directly supervising patient care activities such as dispensing, clinical and drug information<br />
services). The examination day will be approximately 10 to 12 hours long. An honorarium <strong>of</strong> $225<br />
is <strong>of</strong>fered to assessors; however, other expenses are not reimbursed.<br />
If you are interested in participating as an assessor, please indicate by responding to the following<br />
questions and mailing or faxing this page to the PEBC <strong>of</strong>fice. Your early response is greatly<br />
appreciated. (This first response is not considered a commitment on your part, but a means for PEBC<br />
to contact you early in 2001.)<br />
! I am interested in participating as an assessor for the<br />
PEBC Qualifying Examination -Part II (OSCE).<br />
! I meet the qualifications listed.<br />
! I am currently involved in additional pr<strong>of</strong>essional activities<br />
(in addition to my regular work), as follows:<br />
_________________________________________________________________________<br />
_________________________________________________________________________<br />
_________________________________________________________________________<br />
Name (print):<br />
_______________________________________________________<br />
Address:<br />
_______________________________________________________<br />
Workplace & Address: _______________________________________________________<br />
_______________________________________________________<br />
OCP Registration#: _________________________ Year Registered:______________<br />
Tel #:<br />
_______________________________________________________<br />
Fax #:<br />
_______________________________________________________<br />
E-mail:<br />
_______________________________________________________<br />
Signature:<br />
_______________________________________________________<br />
Send to:<br />
Pharmacy Examining Board <strong>of</strong> Canada<br />
123 Edward St. Suite 603<br />
Toronto, ON M5G 1E2 fax : (416) 599-9244<br />
<strong>PHARMACY</strong> CONNECTION Nov/Dec 2000<br />
23
CE<br />
for <strong>Pharmacists</strong> and Pharmacy Technicians<br />
Planners and organizers <strong>of</strong> CE programs, both for pharmacists and pharmacy technicians,<br />
are urged to alert the <strong>College</strong> about their plans as early as possible. To arrange for publicizing<br />
programs in Pharmacy Connection and/or the <strong>College</strong>’s web site, contact Celia Powell at tel: (416) 962-4861,<br />
ext. 251; fax: (416) 962-1619; e-mail: cpowell@ocpharma.com.<br />
Information on many CE events for pharmacists and pharmacy technicians does not reach us in time for<br />
publication in Pharmacy Connection. You are invited to contact Ms Powell or look in the <strong>College</strong>’s web site:<br />
www.ocpharma.com for a listing <strong>of</strong> these events.<br />
A number <strong>of</strong> the programs listed below are suitable for pharmacy technician participation.<br />
CE Events - <strong>Ontario</strong><br />
Nov. 24: Toronto<br />
Living with Respiratory Disease in the<br />
Community, <strong>Ontario</strong> Respiratory Care<br />
Society, Greater Toronto Region, Ramada<br />
Plaza Hotel<br />
For information:<br />
tel: (416) 864-9911<br />
fax: (416) 864-9916<br />
e-mail: orcs@on.lung.ca<br />
Nov. 25: Ottawa<br />
Methadone Treatment Workshop, Centre<br />
for Addiction and Mental Health, Royal<br />
Ottawa Hospital<br />
For information:<br />
tel: (416) 595-6020 or<br />
Peter Williams<br />
tel: (613) 569-6024<br />
e-mail: pwilliam@passport.ca<br />
Nov. 29-30: Mississauga<br />
Marketing & Selling Pr<strong>of</strong>essional Services,<br />
<strong>Ontario</strong> <strong>Pharmacists</strong>’ Association,<br />
Sheraton Four Points Hotel, Mississauga<br />
For information:<br />
Terry Cunningham<br />
tel: (416) 441-0788, ext. 4266<br />
fax: (416) 441-0791<br />
e-mail: tcunnigham@ontpharmacists.on.ca<br />
Nov. 30: Cornwall (suitable for pharmacy<br />
technicians)<br />
Guide Your Patients to a Smoke Free<br />
Future, <strong>Ontario</strong> <strong>Pharmacists</strong>’ Association,<br />
<strong>Ontario</strong> Dental Association and <strong>Ontario</strong><br />
Medical Association<br />
For information:<br />
Nancy LaPlante:<br />
tel: (416) 922-3900 or<br />
1-800-387-1393, ext. 358<br />
fax: (416) 922-9005<br />
e-mail: nlaplante@oda.on.ca<br />
Dec. 2: Toronto<br />
Saturday at the University, Continuing<br />
Education, Faculty <strong>of</strong> Medicine, University<br />
<strong>of</strong> Toronto<br />
For information:<br />
tel: (416) 978-2719<br />
fax: (416) 971-2200<br />
e-mail:<br />
kristin.parsonson@utoronto.ca<br />
web: www.cme.utoronto.ca<br />
Jan. 22-23, 2001: Toronto<br />
CWDA Executive Conference 2001 –<br />
Symbiotic Partnering: Uniting Our<br />
Strengths in the Pharmacy Supply<br />
Chain Conference, Canadian Wholesale<br />
Drug Association, Wyndham Bristol Place<br />
Hotel<br />
For information:<br />
tel: (416) 222-3922<br />
web: cwda.com<br />
Jan. 25-27, 2001: Toronto<br />
Better Breathing 2001, <strong>Ontario</strong> Respiratory<br />
Care Society, Sheraton Centre Hotel<br />
For information:<br />
tel: (416) 864-9911<br />
fax: (416) 864-9916<br />
e-mail: orcs@on.lung.ca<br />
Feb. 3-7, 2001: Toronto<br />
Pr<strong>of</strong>essional Practice Conference, Canadian<br />
Society <strong>of</strong> Hospital <strong>Pharmacists</strong>,<br />
Westin Harbour Castle Hotel<br />
For information:<br />
tel: (613) 736-9733, ext. 29<br />
fax: (613) 736-5660<br />
e-mail: ssmith@cshp.ca<br />
Mar. 3, 2001: Ottawa<br />
Update/Mise-a-Jour 2001, Ottawa Valley<br />
Regional Drug Information Service<br />
(OVRDIS), Ottawa Congress Centre<br />
For information:<br />
Linda Ahmad<br />
tel: (613) 737-8344<br />
Mar. 23-24, 2001: Toronto<br />
Stop and Make a Difference: Teaching<br />
Tools for COPD Education, Michener<br />
Institute for Applied Health Sciences<br />
For information:<br />
tel: 1-800-387-9066<br />
CE Events - Canada<br />
Nov. 24-25: Saskatoon, SK<br />
Practical Management <strong>of</strong> Common<br />
Medical Problems: Infectious Diseases,<br />
CME Office, University <strong>of</strong> Saskatchewan,<br />
Saskatoon Inn<br />
For information:<br />
tel: (306) 966-7787<br />
fax: (306) 966-7673<br />
web: www.usask.ca/cme/<br />
Dec. 2-3: Edmonton, AB<br />
Psychiatric Update for Physicians<br />
For information:<br />
tel: (604) 682-6042<br />
fax: (604) 662-7627<br />
web: www.psychupdate.com<br />
CE Events - International<br />
Nov. 23-24: Amsterdam, The Netherlands<br />
3 rd International Conference on Priorities<br />
in Health Care, Royal Dutch Medical<br />
Association<br />
For information:<br />
fax: 31 30 28 23 326<br />
e-mail: priorities@knmg.nl<br />
24 <strong>PHARMACY</strong> CONNECTION Nov/Dec 2000
Nov. 25-Dec. 3: Barbados<br />
International Conference for Coroners<br />
& Pathologists, <strong>Ontario</strong> Coroners’ Association<br />
For information:<br />
tel: (905) 278-6832<br />
fax: (905) 274-3098<br />
e-mail: kflynn@netrover.com<br />
Nov. 26-Dec. 3: Mexican Riviera Cruise<br />
Pediatrics for Family Physicians and<br />
Primary Care Physicians, Sea Courses<br />
For information:<br />
tel: (604) 684-7327 or 1-888-647-7327<br />
web: www.seacourses.com<br />
Nov. 29-Dec. 2: Miami Beach, FL<br />
Riding the Credentialing Wave, National<br />
Organization for Competency Assurance,<br />
Fontainebleau Hilton Resort & Towers<br />
For information:<br />
tel: (202) 857-1165 or (202) 367-1165<br />
fax: (202) 223-4579<br />
Jan. 24-27, 2001: San Francisco, CA<br />
26 th Annual Conference, Alliance for<br />
CME San Francisco Marriott<br />
For information:<br />
tel: (205) 824-1355<br />
fax: (205) 824-1357<br />
e-mail: acme@acme-assn.org<br />
web: www.acme-assn.org<br />
Mar. 11-18, 2001: Western Caribbean<br />
Cruise<br />
1 st Annual Patient Care Primary Care<br />
CME Cruise, Sea Courses Cruises<br />
For information:<br />
tel: (604) 684-7327 or 1-888-647-7327<br />
fax: (604) 684-7337<br />
e-mail: cruises@seacourses.com<br />
web: www.seacourses.com<br />
ACPE-Approved Vacation Seminars<br />
Dec. 14-16: Las Vegas, NV<br />
Selected Topics in Health Care - Series<br />
XII, MGM Grand<br />
Mar. 20-21, 2001:<br />
Panama Canal Cruise<br />
For information:<br />
tel: (561) 488-5860 or 1-800-940-5860<br />
fax: (561) 488-9399<br />
web: www.universitylearning.com<br />
or www.pharmacyseminars.com<br />
CE Resources<br />
The Handbook <strong>of</strong> Basic Pharmacokinetics . . .<br />
Including Clinical Applications, 5th edition<br />
This text contains excellent information on pharmacokinetics. It<br />
can be a very useful tool for Canadian hospital and academic<br />
institutions, with very limited use in community pharmacy practice.<br />
The text provides comprehensive coverage <strong>of</strong> the topic.<br />
Our reviewer found the text to be a “good learning tool in<br />
undergraduate pharmacy schools – but will be more useful in postgraduate<br />
environments; more theoretical than practical application.<br />
The information is very detailed with complex calculations.”<br />
This text, provided by the American Pharmaceutical Association,<br />
may be purchased at the cost <strong>of</strong> $75.95 plus GST and shipping,<br />
from:<br />
University <strong>of</strong> Toronto Bookstore<br />
214 <strong>College</strong> Street<br />
Toronto, ON M5T 3A1<br />
tel: (416) 978-7911 or 1-800-387-4420; fax: (416) 978-7242<br />
Pharmacy Certified Technician Training Manual<br />
“Some chapters in the text such as calculations, pharmacology and<br />
terminology are generic enough to be useful for Canadian readers.<br />
The other chapters dealing with policy, procedure, education<br />
and training are very US-oriented,” said one reviewer.<br />
Because <strong>of</strong> the manner in which each chapter is outlined and<br />
<strong>of</strong> the way that the terminology is addressed, anyone with any<br />
level <strong>of</strong> pharmacy background will find this text beneficial. The<br />
flow chart concept <strong>of</strong> each chapter allows for ease <strong>of</strong> learning by<br />
focusing on how the elements compliment each other. The selfassessment<br />
questions at the end <strong>of</strong> each chapter reinforce these<br />
concepts, leading a reviewer to say, “I believe that this manual is<br />
by far one <strong>of</strong> the best I have had the opportunity to review.”<br />
The text is recommended for Canadian pharmacy technicians<br />
in both the hospital and community pharmacy practice setting.<br />
Our reviewers agreed that, overall, each chapter covers the<br />
material in a brief but to-the-point manner, saying “The questions<br />
after each chapter were excellent!”<br />
This text may be purchased at the cost <strong>of</strong> $30 (US) plus shipping,<br />
from:<br />
American Pharmaceutical Association<br />
Education Department<br />
2215 Constitution Avenue, SW<br />
Washington, DC 20037-2985<br />
fax: (202) 783-2351<br />
<strong>PHARMACY</strong> CONNECTION Nov/Dec 2000<br />
25
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1. Why do I have to come to the<br />
<strong>College</strong> for my Practice Review?<br />
Why don’t you come to my practice<br />
and observe me in my own<br />
environment?<br />
The Practice Review assesses each<br />
candidate’s ability to gather patient<br />
information, provide counselling<br />
and follow-up, communicate effectively<br />
with patients and demonstrate<br />
clinical knowledge with the aid <strong>of</strong><br />
common resources. To provide a<br />
fair and objective assessment, we<br />
have to ensure that all members are<br />
assessed as equitably as possible in<br />
a standardized format. A consistent<br />
assessment would be impossible<br />
in the workplace, where there<br />
are too many variables that could<br />
not be controlled, such as levels <strong>of</strong><br />
staff support, pace, number, and<br />
difficulty <strong>of</strong> cases.<br />
In addition, current legislation<br />
would require patient consent before<br />
any interaction(s) could be observed<br />
by an assessor, which could<br />
impact the effectiveness <strong>of</strong> any assessment.<br />
Most significantly, candidates<br />
tell us that when they come to the<br />
<strong>College</strong> (sometimes for the first<br />
time since registering with OCP),<br />
they enjoy the opportunity <strong>of</strong> sharing<br />
ideas for their learning portfolios<br />
with their peers. We believe this<br />
promotes a positive learning opportunity<br />
with colleagues.<br />
2. If I don’t meet the standards<br />
for the Practice Review, what will<br />
happen to me?<br />
Most pharmacists (approximately<br />
90 per cent) meet and exceed the<br />
standards for the Practice Review.<br />
For those few falling below the<br />
standards, the QA Committee looks<br />
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Quality Assurance<br />
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Della Croteau<br />
B.S.P., M.C.Ed.<br />
Deputy Registrar/Director<br />
<strong>of</strong> Programs<br />
at the results to determine the appropriate<br />
level <strong>of</strong> remediation and which<br />
programs would best assist the candidate<br />
in improving his/her knowledge<br />
or skills. Candidates are usually<br />
asked to consider their results and<br />
develop an action plan to address<br />
their learning needs. They may be<br />
invited to meet with a small panel <strong>of</strong><br />
the QA Committee to assist them in<br />
determining what courses or activities<br />
would be most useful in facilitating<br />
remediation. Those candidates<br />
falling below the standards in clinical<br />
knowledge or communication<br />
skills, or two <strong>of</strong> the four categories<br />
tested, are usually asked to return for<br />
a reassessment at the end <strong>of</strong> an<br />
agreed-upon remediation period.<br />
Each candidate, regardless <strong>of</strong><br />
whether or not they met the standard,<br />
receives a booklet <strong>of</strong> personalized<br />
results which can help them<br />
plan their future continuing education<br />
initiatives. The <strong>College</strong>’s QA<br />
program is set up to be educational<br />
rather than punitive, and every effort<br />
is made to direct members to<br />
educational resources that will assist<br />
them in continuing to successfully<br />
meet the standards set by their<br />
peers.<br />
3. Who sets the standards for<br />
the Practice Review?<br />
The standards, which are really acceptable<br />
levels <strong>of</strong> practice, are set<br />
by representative groups <strong>of</strong> pharmacists<br />
from across the province.<br />
One group meets to deliberate on<br />
the standards for the standardized<br />
patient interviews and another<br />
group meets to deliberate on the<br />
standards for the clinical knowledge<br />
portion.<br />
Each group has members <strong>of</strong><br />
different gender and ages, from<br />
various locations and practice settings,<br />
that represent different pharmacists<br />
practising around the province.<br />
The groups review each question<br />
and case, and determine<br />
through a consensus process what<br />
a reasonable level <strong>of</strong> knowledge,<br />
skills and performance would be<br />
for <strong>Ontario</strong> pharmacists. The pr<strong>of</strong>essional<br />
judgement <strong>of</strong> practising<br />
pharmacists determines the standards,<br />
not an arbitrary passing<br />
score.<br />
4. Is the Practice Review used<br />
for any other purpose?<br />
Yes, you may have noticed through<br />
reading Deciding on Discipline that<br />
26 <strong>PHARMACY</strong> CONNECTION Nov/Dec 2000
in certain discipline cases, members<br />
have been given an opportunity to<br />
lessen their penalty by agreeing to<br />
complete the Practice Review and<br />
any necessary remediation. The<br />
Complaints Committee can also refer<br />
members to the Practice Review.<br />
The <strong>Ontario</strong> <strong>College</strong> <strong>of</strong> <strong>Pharmacists</strong><br />
believes that ensuring the<br />
knowledge and skills <strong>of</strong> its members<br />
is important for protection <strong>of</strong> the<br />
public. Participation in a competency-based<br />
assessment with accompanying<br />
remediation may prove<br />
more useful in assisting members<br />
in practice and protecting the public<br />
than fines or suspensions.<br />
Deciding on Discipline<br />
from p. 16<br />
Drug Schedule Changes - ASA<br />
October 2000<br />
2. On or about January 19, 1996,<br />
he dispensed or permitted the dispensing<br />
<strong>of</strong> 240 tablets <strong>of</strong> triazolam<br />
0.25 mg to a patient. On or about<br />
May 11, 1996, he dispensed or permitted<br />
the dispensing <strong>of</strong> a prescription<br />
for 120 tablets <strong>of</strong> triazolam 0.25<br />
mg to the same patient. He dispensed<br />
these quantities <strong>of</strong> medication to this<br />
patient in excess <strong>of</strong> the maximum<br />
daily dose for triazolam.<br />
3. On or about May 31, 1996, he<br />
failed to meet the standards <strong>of</strong> practice<br />
<strong>of</strong> the pr<strong>of</strong>ession by dispensing<br />
or permitting the dispensing <strong>of</strong> Novochlorpromazine<br />
® 10 mg, when the<br />
prescription called for Novochlorpromazine<br />
® 100 mg.<br />
4. On or about May 11, 1996, he<br />
failed to meet the standards <strong>of</strong> practice<br />
<strong>of</strong> the pr<strong>of</strong>ession by dispensing,<br />
or permitting the dispensing <strong>of</strong> lithium<br />
carbonate 300 mg to a patient,<br />
accompanied by directions to administer<br />
one capsule at bedtime, when<br />
the prescription dictated the administration<br />
<strong>of</strong> a dosage <strong>of</strong> one capsule,<br />
three times a day.<br />
5. On or about January 19, 1996<br />
and March 15, 1996, he failed to<br />
meet the standards <strong>of</strong> practice <strong>of</strong> the<br />
pr<strong>of</strong>ession as follows:<br />
1. by dispensing or permitting<br />
the dispensing <strong>of</strong> Depakene ® 50<br />
mg in liquid form, when the prescription<br />
did not specify a form;<br />
2. by dispensing<br />
or<br />
permitting the dispensing <strong>of</strong> lithium<br />
citrate 300 mg per 5 mL in<br />
liquid form, when the form was<br />
not prescribed, without first verifying<br />
the form with the physician;<br />
3. and by dispensing or permitting<br />
the dispensing <strong>of</strong> Chlorpromazine<br />
20 mg per mL in liquid<br />
form, when the form was not<br />
prescribed, without first verifying<br />
the form with the physician.<br />
Penalty:<br />
1. a reprimand to be recorded on<br />
the register;<br />
2. a $2,000 fine payable within 60<br />
days;<br />
3. a one-month suspension <strong>of</strong> Mr<br />
Szeto’s Certificate <strong>of</strong> Registration, to<br />
be remitted upon successful completion<br />
<strong>of</strong> a peer review <strong>of</strong> the <strong>College</strong>’s<br />
Quality Assurance Program, at his<br />
own expense, within the next 12<br />
months.<br />
Dear Member,<br />
Re: Drug Schedule Changes:<br />
The National Association <strong>of</strong> Pharmacy<br />
Regulatory Authorities<br />
(NAPRA) received a recommendation<br />
from the National Drug<br />
Scheduling Advisory Committee<br />
concerning the scheduling <strong>of</strong> “Acetylsalicylic<br />
acid and its salts” as<br />
follows:<br />
1. Package size restrictions have<br />
been eliminated.<br />
Note: Package size restrictions remain<br />
in effect for children's ASA.<br />
2. Schedule III entry has been<br />
amended to ASA “in products intended<br />
for oral, adult use in<br />
strengths <strong>of</strong> 81 mg per dosage unit<br />
and 650 mg or greater per dosage<br />
unit, and in rectal preparations<br />
containing more than 150 mg”.<br />
Note: the Schedule II status <strong>of</strong> Children’s<br />
ASA products is not affected.<br />
3. ASA products in strengths <strong>of</strong><br />
325 mg per dosage unit and 500<br />
mg per dosage unit have been<br />
moved to unscheduled status.<br />
Yours truly,<br />
D. L. Laws, B.Sc.Phm<br />
Registrar<br />
S. Hirsch, B.Sc.Phm<br />
President<br />
<strong>PHARMACY</strong> CONNECTION Nov/Dec 2000<br />
27
Reporting Adverse Drug Reactions<br />
Canadian Adverse Drug Reaction Monitoring Program<br />
Guidelines for the Voluntary Reporting <strong>of</strong><br />
Adverse Drug Reactions by Health<br />
Pr<strong>of</strong>essionals<br />
Health Canada<br />
Therapeutic Products Programme<br />
What do I report?<br />
An adverse drug reaction (ADR) is a noxious and unintended response to a drug which<br />
occurs with use or testing for the diagnosis, treatment or prevention <strong>of</strong> a disease or the<br />
modification <strong>of</strong> an organic function. This includes any undesirable patient effect suspected<br />
to be associated with drug use. ADRs as a result <strong>of</strong> prescription, nonprescription,<br />
biological (including blood products), complementary medicines (including herbals)<br />
and radiopharmaceutical drug products are monitored. Drug abuse, drug overdoses,<br />
drug interactions and unusual lack <strong>of</strong> therapeutic efficacy are also considered to be<br />
reportable as ADRs.<br />
ADR reports are, for the most part, only suspected associations. A temporal or possible<br />
association is sufficient for a report to be made. Reporting an ADR does not imply a<br />
causal link.<br />
ADRs that should be reported include all suspected adverse drug reactions which are:<br />
• unexpected, regardless <strong>of</strong> their severity, i.e. not consistent with product<br />
information or labelling; or<br />
• serious, whether expected or not; or<br />
• reactions to recently marketed drugs (on the market for less than five<br />
years) regardless <strong>of</strong> their nature or severity.<br />
What is a serious reaction?<br />
The Canadian Regulations pertaining to reporting ADRs for marketed drug products<br />
define a serious adverse drug reaction as “a noxious and unintended response to a drug,<br />
which occurs at any dose and requires in-patient hospitalization or prolongation <strong>of</strong><br />
existing hospitalization, causes congenital malformation, results in persistent or significant<br />
disability or incapacity, is life-threatening or results in death.” ADRs that require<br />
significant medical intervention to prevent one <strong>of</strong> the other outcomes listed above are<br />
considered to be serious.<br />
How do I make a report?<br />
To report a suspected ADR for drug products marketed in Canada, Health Pr<strong>of</strong>essionals<br />
should complete a copy <strong>of</strong> the ADR Reporting Form (Report <strong>of</strong> suspected adverse<br />
28 <strong>PHARMACY</strong> CONNECTION Nov/Dec 2000
eaction due to drug products marketed in Canada [Vaccines excluded] HC 4016 [12-98]).<br />
This form may be obtained from your regional centre (see address below), and is included<br />
in the Compendium <strong>of</strong> Pharmaceuticals and Specialities (CPS).<br />
To report an ADR for a vaccine, health pr<strong>of</strong>essionals should complete a copy <strong>of</strong> the<br />
Vaccine-Associated Adverse Event Form. This form is also included in the CPS.<br />
Fill in the sections that apply to the report as completely as possible, using a separate<br />
form for each patient. Additional pages may be attached if additional space is required.<br />
The success <strong>of</strong> the program depends on the quality and accuracy <strong>of</strong> the information<br />
sent in by the reporter.<br />
Is ADR information considered confidential?<br />
Any information related to the reporter and patient identifiers is kept strictly confidential.<br />
How do I deal with follow-up information for an ADR that has<br />
already been reported?<br />
Any follow-up information for an ADR that has already been reported can be sent on<br />
another ADR form, or it can be communicated by telephone, fax or e-mail. So that this<br />
information can be matched with the original report, indicate that it is follow-up information,<br />
the date <strong>of</strong> the original report and the report case number if known. It is very<br />
important that follow-up reports are identified and linked to the original report.<br />
What about reporting ADRs to the manufacturer?<br />
Health pr<strong>of</strong>essionals may also report ADRs to the manufacturer. Indicate on your ADR<br />
report sent to Health Canada if a case was also reported to the manufacturer.<br />
Where do I send the report or obtain more information?<br />
Adverse reactions for drug products that are marketed in Canada are monitored by the<br />
Canadian Adverse Drug Reaction Monitoring Program (CADRMP). Send these ADR<br />
reports to the <strong>Ontario</strong> Regional ADR Centre. Adverse reactions to vaccines are monitored<br />
by the Laboratory Centre for Disease Control. Send these reports to the address<br />
listed on the Vaccine-Associated Adverse Event Form.<br />
For more information on the ADR monitoring program, additional copies <strong>of</strong> ADR reporting<br />
forms or to report an ADR, physicians, pharmacists and other health pr<strong>of</strong>essionals<br />
are invited to contact:<br />
<strong>Ontario</strong> Regional ADR Centre<br />
LonDIS Drug Information Centre<br />
London Health Sciences Centre<br />
339 Windermere Road<br />
London ON N6A 5A5<br />
Tel: 519-663-8801<br />
Fax: 519-663-2968<br />
E-mail: adr@lhsc.on.ca<br />
You can also find information on the Health Canada, Therapeutic Products Programme<br />
Web site: www.hc-sc.gc.ca/hpb-dgps/therapeut<br />
<strong>PHARMACY</strong> CONNECTION Nov/Dec 2000<br />
29
Structured Practical Training<br />
Changes affecting<br />
foreign-trained pharmacists<br />
Chris Schillemore<br />
B.Sc.Phm.<br />
Manager, Registration Programs<br />
&<br />
Marie Rocchi Dean<br />
B.Sc.Phm.<br />
Education Coordinator, Faculty <strong>of</strong> Pharmacy, U <strong>of</strong> T<br />
The document “Pr<strong>of</strong>essional Competencies<br />
for Canadian <strong>Pharmacists</strong><br />
at Entry to Practice,” developed by<br />
NAPRA members and finalized in<br />
1997, has been adopted in Canada<br />
by provincial pharmacy regulators<br />
(with the exception <strong>of</strong> Quebec, Yukon<br />
and Northwest Territories) as the<br />
basis for setting training outcomes.<br />
As a standard for pharmacy practice<br />
across Canada, the competency document<br />
will facilitate the movement<br />
<strong>of</strong> pharmacists between provinces.<br />
As a result <strong>of</strong> the Mutual Recognition<br />
Agreement (MRA) which<br />
takes effect July 1, 2001, the <strong>College</strong><br />
is required to provide Structured<br />
Practical Training (SPT) for all licensure<br />
candidates. The <strong>College</strong> has<br />
already implemented SPT for Canadian<br />
and US graduates, and will implement<br />
SPT for foreign-trained<br />
pharmacists starting January 1,<br />
2001. This change in the training requirements<br />
will have implications for<br />
pharmacist preceptors with foreigntrained<br />
students as <strong>of</strong> January 1,<br />
2001. We have tried to anticipate<br />
some <strong>of</strong> the questions that might<br />
arise from this change.<br />
Q<br />
What if I am a preceptor to a<br />
foreign-trained pharmacist<br />
intern on January 1, 2001?<br />
If an intern is registered in the traditional<br />
program on January 1, 2001,<br />
he/she will be allowed to complete<br />
the traditional training program.<br />
Q<br />
What if I currently am a preceptor<br />
to a foreign-trained<br />
pharmacist student?<br />
The student will be allowed to complete<br />
their traditional studentship program.<br />
However, he/she will be required<br />
to proceed to the SPT internship<br />
program.<br />
Q<br />
What will this mean for me<br />
as a preceptor to a foreigntrained<br />
pharmacist moving<br />
from the traditional program<br />
to a structured practical training<br />
internship?<br />
Under the SPT model, preceptors<br />
must attend a one-day preceptor<br />
workshop. Therefore, if you wish to<br />
continue to be a preceptor once this<br />
candidate begins internship in the<br />
SPT program and you have not attended<br />
a workshop in 2000, you need<br />
to attend a workshop. If you are not<br />
a trained preceptor, the student cannot<br />
enter SPT studentship or internship<br />
with you until you have attended<br />
a workshop. The <strong>College</strong> will hold<br />
workshops regularly to meet this requirement.<br />
Q<br />
Why do preceptors need to be<br />
trained for the SPT program?<br />
The SPT program has more structured<br />
accountability, activities and<br />
objectives than the traditional pro-<br />
30 <strong>PHARMACY</strong> CONNECTION Nov/Dec 2000
gram. Although a manual with questions<br />
and activities is provided, the<br />
workshop provides an excellent and<br />
necessary forum to review the activities,<br />
time investment and skills<br />
required <strong>of</strong> the preceptor. Regular<br />
feedback for the SPT student/intern<br />
is also required and assessment<br />
forms must be submitted to OCP.<br />
Q<br />
Why did OCP implement an<br />
SPT program for foreigntrained<br />
pharmacists?<br />
As signatories to the MRA which<br />
takes effect July 1, 2001, all provincial<br />
regulatory bodies are required to<br />
have a structured practical training<br />
program in place.<br />
The program will result in candidates<br />
being better trained to meet<br />
the competencies required <strong>of</strong> all pharmacists<br />
at entry to practice.<br />
Q<br />
How will foreign-trained pharmacists<br />
be assessed?<br />
Preceptors will provide regular assessments<br />
in the structured practical<br />
training program.<br />
As well, a significant change is<br />
being made to the Pharmacy Examining<br />
Board <strong>of</strong> Canada (PEBC) qualifying<br />
examination beginning with the<br />
Spring 2001 sitting. All candidates<br />
will be required to undergo an OSCE<br />
(objective structured clinical examination)<br />
in addition to the written portion<br />
<strong>of</strong> the examination. This assessment<br />
requires the candidate to interact<br />
with simulated patients and is a<br />
practical evaluation <strong>of</strong> communication<br />
skills, problem solving and the<br />
application <strong>of</strong> therapeutics to practice.<br />
This process will be similar to<br />
the standardized patient interviews<br />
now used in OCP’s Quality Assurance<br />
Program.<br />
Q<br />
What other differences will I<br />
notice in the SPT program?<br />
In the past, foreign-trained pharmacists<br />
completed a minimum <strong>of</strong> 48<br />
weeks <strong>of</strong> traditional training (as a<br />
student and intern) at the pharmacy<br />
site, which could have been in a continuous<br />
fashion. In the SPT system,<br />
the candidate first completes an eightweek<br />
academic program at the Faculty<br />
<strong>of</strong> Pharmacy, then does a minimum<br />
<strong>of</strong> 16 weeks <strong>of</strong> structured practical<br />
studentship training at a pharmacy<br />
site. Upon successful completion,<br />
the student will then return to<br />
the Faculty <strong>of</strong> Pharmacy for the second<br />
academic session consisting <strong>of</strong><br />
eight weeks. After completing this<br />
part <strong>of</strong> the program, the student may<br />
return to the pharmacy site to do 16<br />
weeks <strong>of</strong> SPT internship.<br />
More details <strong>of</strong> the academic<br />
program will appear in a future edition<br />
<strong>of</strong> Pharmacy Connection. If you<br />
have any immediate questions about<br />
the academic program, you may contact<br />
Marie Dean at the Faculty <strong>of</strong><br />
Pharmacy at tel: (416) 946-5586 or<br />
e-mail: marie.dean@utoronto.ca.<br />
For further information about the<br />
SPT program or workshops, phone<br />
(416) 962-4861 and ask for Barbara<br />
Church at ext. 297 or Jessie D’Souza<br />
at ext. 250. You can e-mail Barbara<br />
at bchurch@ocpharma.com and Jessie<br />
at jdsouza@ocpharma.com.<br />
For questions related to registration<br />
as a student or intern, please<br />
contact Veronica Duczek at ext. 228<br />
or Jackie McKee at ext. 232.<br />
The following diagram outlines<br />
the licensing process for foreigntrained<br />
pharmacists.<br />
Pathway to Licensure for International<br />
Pharmacy Graduates<br />
SPT Studentship<br />
minimum 16 weeks<br />
Jurisprudence<br />
PEBC Qualifying<br />
Exam<br />
Fluency Requirement plus PEBC<br />
Evaluating Exam<br />
Admissions:<br />
Portfolio;<br />
Resume;<br />
Canadian Pharmacy Guided<br />
Question Discovery<br />
Canadian Pharmacy Skills I<br />
8 weeks<br />
Canadian Pharmacy Skills II<br />
8 weeks<br />
SPT Internship<br />
minimum 16 weeks<br />
Registration as a Pharmacist<br />
Distance Modules<br />
During SPT<br />
Communications<br />
for Pharmacy<br />
Practice<br />
(determined by<br />
communication<br />
assessment)<br />
Shaded boxes indicate parts <strong>of</strong> the program provided by the Faculty <strong>of</strong> Pharmacy<br />
*Note: Candidates who successfully complete PEBC with OSCE can proceed directly to SPT Internship<br />
<strong>PHARMACY</strong> CONNECTION Nov/Dec 2000<br />
31
Close-up on Complaints<br />
Case Summary<br />
Carmina Vieira-Conti<br />
Complaints Officer, Patient Relations Programs<br />
As the Complaints Committee is seeing an increasing number <strong>of</strong> complaints<br />
that deal with patient confidentiality, this decision is being published in<br />
Pharmacy Connection. Moving forward, the Complaints Committee expects a<br />
high level <strong>of</strong> compliance and intends to take sterner action against members<br />
who breach Principle Three <strong>of</strong> the Code <strong>of</strong> Ethics.<br />
The Complainant’s<br />
Allegations<br />
The patient said that without<br />
her consent, her pharmacist<br />
gave her husband a<br />
list <strong>of</strong> her prescription medications.<br />
This occurred on<br />
or about November 3,<br />
1999. She and her husband<br />
separated on October 28,<br />
1999, and are getting divorced.<br />
The information<br />
was therefore released<br />
while the couple were separated.<br />
The patient provided<br />
the <strong>College</strong> with a copy<br />
<strong>of</strong> the patient pr<strong>of</strong>ile/prescription<br />
report that her<br />
pharmacist signed and gave<br />
to her husband. The patient<br />
said she only became aware<br />
this had occurred when she<br />
received an affidavit, signed<br />
by her husband, as part <strong>of</strong><br />
their divorce proceedings.<br />
The Pharmacist’s<br />
Response<br />
In his response, the pharmacist<br />
said it is his view<br />
that consent can be verbal<br />
or written, expressed or<br />
even implied. He said he<br />
provides reports (such as<br />
patient pr<strong>of</strong>ile/prescription<br />
reports) to patients or to<br />
their representatives, with<br />
the knowledge and consent<br />
<strong>of</strong> the patient. The pharmacist<br />
said that these reports<br />
are only issued for valid<br />
reasons that could include<br />
income tax purposes, because<br />
a patient is changing<br />
doctors, or because they<br />
are required by insurers.<br />
He said certain patients provide<br />
him with initial consent,<br />
together with general guidance,<br />
which ultimately becomes<br />
normal and accepted<br />
practice for future dealings.<br />
Such practice is then<br />
kept in place until the patient<br />
retracts the arrangement.<br />
If a patient regularly<br />
sends his/her spouse to collect<br />
or pay for prescriptions,<br />
the pharmacist said<br />
he comes to know and trust<br />
the spouse. If there are any<br />
changes to the patient’s circumstances<br />
causing the<br />
patient to want to change<br />
the arrangement, the pharmacist<br />
said that the patient<br />
must notify the pharmacy<br />
accordingly.<br />
As he had not received notification<br />
to do otherwise,<br />
the pharmacist said his store<br />
acted in good faith on Nov.<br />
3, 1999 in fulfilling the request<br />
for information. The<br />
pharmacy is a fast-paced<br />
environment, he said,<br />
where a sound service culture<br />
is fundamental to the<br />
success <strong>of</strong> his business. He<br />
said that pharmacists are<br />
not perfect and that mistakes<br />
do occur; however,<br />
he said every conceivable<br />
effort is made to uphold the<br />
spirit <strong>of</strong> the Code <strong>of</strong> Ethics<br />
and safeguard the confidentiality<br />
<strong>of</strong> patients.<br />
The pharmacist referred to<br />
the patient’s statement, “I<br />
was not called by the pharmacist.”<br />
The pharmacist<br />
felt that this was misleading<br />
as consent can be given<br />
in different ways. He<br />
said he tries to be as empathetic<br />
as possible, as those<br />
who come into the pharmacy<br />
are usually unwell, and<br />
require quick and efficient<br />
service to “<strong>of</strong>fset or mitigate”<br />
their pain and suffering.<br />
He said patients don’t<br />
appreciate delays or hassles<br />
from the pharmacy staff;<br />
however, he believes that he<br />
and his colleagues at the<br />
pharmacy do obtain or assume<br />
appropriate consent.<br />
With respect to his signing<br />
the patient pr<strong>of</strong>ile/prescription<br />
report in question, the<br />
pharmacist said this is done<br />
to “authenticate” that the<br />
report is correct. Had he<br />
known that the report in<br />
question was going to be<br />
used for any questionable<br />
purpose, he would not have<br />
provided it without a writ-<br />
32 <strong>PHARMACY</strong> CONNECTION Nov/Dec 2000
ten request from the patient.<br />
He said that if any person<br />
representing the patient intends<br />
to mislead, misrepresent<br />
or not operate within<br />
any ethical boundaries, it<br />
should then be the sole responsibility<br />
<strong>of</strong> the patient’s<br />
representative to show accountability<br />
to the patient,<br />
particularly if there appears<br />
to be a breach <strong>of</strong> trust.<br />
The pharmacist said that the<br />
report was not made for the<br />
patient’s ex-husband, but<br />
for the patient herself.<br />
Therefore, it was given to<br />
him in a sealed, clearlymarked<br />
envelope. The<br />
pharmacist maintains that<br />
this report would never<br />
have been given with the<br />
intent for it to be misused<br />
by anyone, including the<br />
patient herself. The pharmacist<br />
said he and his staff<br />
always try to act in the best<br />
interest <strong>of</strong> the patient. The<br />
patient’s prescriptions were<br />
covered by her husband’s<br />
insurance plan. The pharmacist<br />
felt it was logical to<br />
conclude that as these prescriptions<br />
had been dispensed<br />
over a period <strong>of</strong><br />
time, that the patient’s exhusband<br />
was aware <strong>of</strong> his<br />
wife’s medication use, not<br />
only as the person whose<br />
plan paid for her prescriptions,<br />
but also in his role as<br />
a husband who was not<br />
“estranged” until recently.<br />
In his mind, it was clear to<br />
the pharmacist that the patient’s<br />
husband was recognized<br />
as a representative for<br />
his wife at her pharmacy.<br />
The Committee’s<br />
Decision<br />
The Committee found the<br />
pharmacist’s actions unacceptable.<br />
The pharmacist<br />
should have called the patient<br />
before releasing the<br />
information and should not<br />
have assumed that consent<br />
was implied. Regardless <strong>of</strong><br />
marital relationship, a pharmacist<br />
must respect the privacy<br />
<strong>of</strong> each individual patient.<br />
It was the Committee’s<br />
view that pharmacists<br />
must make their staff aware<br />
<strong>of</strong> the absolute requirements<br />
to preserve the confidentiality<br />
<strong>of</strong> their patients.<br />
Due to the seriousness <strong>of</strong><br />
this matter, the Committee<br />
issued a written caution to<br />
the pharmacist as it felt that<br />
he did not uphold the prin-<br />
ciple in the <strong>College</strong>’s Code<br />
<strong>of</strong> Ethics that relates to<br />
confidentiality.<br />
All pharmacists have an<br />
obligation to act in the best<br />
interest <strong>of</strong> the patient, observe<br />
the law, uphold the<br />
dignity and honour <strong>of</strong> the<br />
pr<strong>of</strong>ession, and practice in<br />
accordance with ethical<br />
principles. <strong>Pharmacists</strong> are<br />
also reminded <strong>of</strong> Principle<br />
Three <strong>of</strong> the <strong>College</strong>’s Code<br />
<strong>of</strong> Ethics (stated below).<br />
<strong>Pharmacists</strong> must protect<br />
their patients by serving<br />
them in a private and confidential<br />
manner. <strong>Pharmacists</strong><br />
do not divulge information<br />
that identifies the<br />
patient, except in instances<br />
in which there is a compelling<br />
need, in the pharmacist’s<br />
pr<strong>of</strong>essional judgement,<br />
to share information<br />
in order to protect the patient<br />
or another person from<br />
harm, or when authorized<br />
by the patient or required<br />
by law.<br />
When dealing with spousal<br />
requests for information,<br />
pharmacists should be cautious,<br />
as this information is<br />
sometimes being requested<br />
without the patient’s knowledge.<br />
<strong>Pharmacists</strong> must obtain<br />
permission from the patient<br />
whose information is<br />
being released. While nothing<br />
requires pharmacists to<br />
get written permission,<br />
pharmacists must document<br />
their conversations<br />
with patients when verbal<br />
authorization is received<br />
and/or denied.<br />
Code <strong>of</strong> Ethics<br />
3<br />
“The pharmacist preserves the<br />
confidentiality <strong>of</strong> information about<br />
principle<br />
individual patients acquired in the course <strong>of</strong><br />
his or her pr<strong>of</strong>essional practice, and does<br />
not divulge this information except<br />
where authorized by the patient<br />
or required by law.”<br />
<strong>PHARMACY</strong> CONNECTION Nov/Dec 2000<br />
33
<strong>Pharmacists</strong>’<br />
B U L L E T I N<br />
<strong>of</strong> news and events<br />
B O A R D<br />
WSIB Provides Access Line<br />
for Health Pr<strong>of</strong>essionals<br />
Dear Health Pr<strong>of</strong>essional,<br />
Need the name and phone number <strong>of</strong> the<br />
Workplace Safety & Insurance Board<br />
(WSIB) adjudicator? Require information<br />
on how to register? Questions about your account<br />
and don’t know who to call?<br />
Keeping the lines <strong>of</strong> communication open is important<br />
to us as we work together with you to provide quality<br />
care for injured and ill workers. That’s why we’ve<br />
set up an Access Line for health pr<strong>of</strong>essionals.<br />
You can call 1-800-569-7919 or (416) 344-4526<br />
between 9:00 a.m. and 4:00 p.m., Monday to Friday, to<br />
get help finding the right individual in the WSIB who can<br />
answer your questions and address your concerns. It is<br />
not intended for the person staffing the line to resolve<br />
the issue directly. If you happen to get voice mail, leave<br />
a message and we’ll get back to you within one business<br />
day. We hope you find the new service helpful.<br />
Donna Bain, Executive Director, Health Services<br />
Workplace Safety & Insurance Board<br />
Staff Announcements<br />
Dayton Pereira has recently joined the <strong>College</strong> as web<br />
developer. Mr Pereira previously managed a computertraining<br />
centre where he developed courseware, and held<br />
individual and corporate training seminars on Internet<br />
technologies and various computer applications. He has<br />
a Bachelors Degree in Chemical Engineering from the<br />
University <strong>of</strong> Toronto. He can be reached at (416) 962-<br />
4861 ext. 291, e-mail: dpereira@ocpharma.com.<br />
Cremilde Mathews recently celebrated<br />
her silver anniversary with the<br />
<strong>College</strong>. In her 25 years <strong>of</strong> dedicated<br />
service, Ms Mathews has contributed<br />
to many <strong>College</strong> initiatives and is now<br />
the Coordinator, Information Processing.<br />
A staff reception was held in her<br />
honour on Oct. 5, 2000.<br />
University <strong>of</strong> Saskatchewan, BSP<br />
Reunion - Class <strong>of</strong> 1991<br />
In September, the organizing committee mailed out information<br />
letters about a <strong>College</strong> <strong>of</strong> Pharmacy Class Reunion<br />
that will be held June 29 - July 1, 2001. If you<br />
have not received a letter, contact Andrea (Finstad) Shoobert<br />
at tel: (306) 522-1610 or afinstad@sk.sympatico.ca<br />
or Susan (Mah) Yee at tel: (306) 789-4467 or<br />
gsyee@sk.sympatico.ca. Hope to see you in 2001!<br />
Obituary, Cecil E. Walters<br />
Cecil E. Walters, a pharmacist since 1951, passed away<br />
recently at age 83. He served overseas in World War II<br />
and worked as a pharmacist for the Armed Forces. In<br />
1982 he retired from community pharmacy and the position<br />
<strong>of</strong> Emergency Health Officer with the Ministry <strong>of</strong><br />
Health, and returned to his hometown <strong>of</strong> Midland. Mr<br />
Walters is survived by his wife, Jean, five children, 11<br />
grandchildren and two great-grandchildren.<br />
Palliative Care Information Centre<br />
The Palliative Care Information<br />
Centre, a program <strong>of</strong> the<br />
Ministry <strong>of</strong> Health, provides<br />
information on a wide range<br />
<strong>of</strong> palliative/hospice care<br />
services and resources available<br />
in Toronto. This includes<br />
palliative care units and programs, hospice programs,<br />
community-based services, pain and symptom management,<br />
bereavement support services and palliative care<br />
education. It is available to people living with life-threatening<br />
illnesses, families and friends, caregivers and volunteers,<br />
and health care pr<strong>of</strong>essionals. Information is<br />
provided primarily on a one-to-one basis, respecting dignity<br />
and confidentiality. Contact tel: (416) 480-4844, fax:<br />
(416) 480-5210, www.palliativecareinfo.com.<br />
34 <strong>PHARMACY</strong> CONNECTION Nov/Dec 2000
SPT Workshops<br />
Additional preceptor workshops are scheduled to take<br />
place at the <strong>College</strong>, 483<br />
Huron St., Toronto, on:<br />
January 24. 2001<br />
February 21, 2001<br />
Please contact Barb<br />
Church, tel: (416) 962-<br />
4861, ext. 297, to register.<br />
SPT<br />
Workshops<br />
The Douglas Stewart Memorial Award<br />
The Faculty <strong>of</strong> Pharmacy at the University <strong>of</strong> Toronto<br />
has established the “Douglas Stewart Memorial Award”<br />
to honour this pr<strong>of</strong>essor who passed away May 5, 2000.<br />
Mr Stewart was a faculty member from 1963-84.<br />
He was also the Director <strong>of</strong> Pharmacy at the Toronto<br />
General Hospital (TGH). In 1967 he established a hospital<br />
pharmacy residency program at TGH and initiated a<br />
clinical pharmacy service.<br />
At the Faculty, Mr Stewart was instrumental in the<br />
development <strong>of</strong> the first undergraduate clinical pharmacy<br />
course in Canada and impacted many careers through<br />
the Hospital Pharmacy Administration course. As well,<br />
he played a key role in getting the hospital pharmacy<br />
residency program accredited.<br />
The “Douglas Stewart Memorial Award” will be allocated<br />
to a fourth year U <strong>of</strong> T Pharmacy student who is<br />
pursuing a hospital pharmacy residency. The value <strong>of</strong><br />
the Award will be based on the annual interest accrued<br />
on the endowment.<br />
Donations will be gratefully received by the Faculty.<br />
Please make cheques payable to: Douglas Stewart Memorial<br />
Fund, and forward to the attention <strong>of</strong> Heather<br />
Ditzend, Faculty <strong>of</strong> Pharmacy, University <strong>of</strong> Toronto,<br />
19 Russell Street, Toronto, ON M5S 2S2.<br />
PharmAction Program Expands Into<br />
Doctors’ Offices<br />
PharmAction, now in its fifth year <strong>of</strong> operation, is an<br />
effective and popular patient information program distributed<br />
in 3,500 pharmacies across Canada.<br />
The program’s success has prompted such positive<br />
response from physicians that it is now being distributed<br />
in over 1,000 doctors’ <strong>of</strong>fices, known as MedAction.<br />
For the first time, exactly the same information is<br />
available in Canadian pharmacies and doctors’ <strong>of</strong>fices.<br />
PharmAction provides patients with the facts they<br />
need to know about a wide variety <strong>of</strong> topics, including<br />
acne, antibiotics, asthma, COPD, cholesterol, congestive<br />
heart failure, diabetes, gastric problems, hypertension,<br />
migraine, pregnancy, and your pharmacist. Its<br />
unique, interactive format helps patients focus on the<br />
key questions they should be asking. It also helps them<br />
understand such important treatment issues as efficacy<br />
and barriers to treatment, and existing or potential problems<br />
such as side effects and allergies.<br />
Covering such topics as the goals and expectations<br />
<strong>of</strong> pharmacological and non-pharmacological treatment,<br />
and the proper use <strong>of</strong> medication, PharmAction provides<br />
patients with relevant information developed in cooperation<br />
with medical societies and public health associations.<br />
For more information, call 1-800-363-5634.<br />
Pharmacist Required<br />
The <strong>Ontario</strong> <strong>College</strong> <strong>of</strong> <strong>Pharmacists</strong> has recently made significant changes<br />
to the Structured Practical Training Program that provide an opening for a<br />
self-directed, energetic, creative pharmacist. This 15-month contract <strong>of</strong>fers a<br />
unique opportunity to work with a team to expand and enhance this educational<br />
program.<br />
The <strong>College</strong> is seeking a pharmacist experienced in a variety <strong>of</strong> practice<br />
settings with a demonstrated ability to deal effectively with people <strong>of</strong> varied cultural backgrounds<br />
in individual and group situations. The individual will: participate in the development and delivery <strong>of</strong><br />
workshops; enhance training manuals and assessment tools; and coach preceptors, students and<br />
interns through ongoing evaluation and assessment activities.<br />
Excellent interpersonal, written and verbal communication skills, and a flair for setting and<br />
prioritizing competing demands is essential.<br />
If you are interested in becoming a member <strong>of</strong> this energetic, pr<strong>of</strong>essional group, please<br />
forward your resume with salary expectations by January 1, 2001 to Lisa Baker, HR Administrator,<br />
<strong>Ontario</strong> <strong>College</strong> <strong>of</strong> <strong>Pharmacists</strong>, 483 Huron Street, Toronto, ON M5R 2R4, fax: (416) 703-3114, e-<br />
mail: lbaker@ocpharma.com.<br />
<strong>PHARMACY</strong> CONNECTION Nov/Dec 2000<br />
35
OCP Manual Inserts<br />
As you know, each issue <strong>of</strong> Pharmacy<br />
Connection includes an up-todate<br />
summary <strong>of</strong> all current OCP<br />
Manual items (p. 37). We also list<br />
how these items can be downloaded<br />
from our Web site, purchased from<br />
the <strong>College</strong>, or bought from the federal<br />
and provincial printers.<br />
These methods have not been<br />
completely helpful, as some members<br />
have told us they find it difficult<br />
to navigate the Web site’s many layers.<br />
In some cases, members, frustrated<br />
with the steps involved, have<br />
opted to purchase a new OCP Manual<br />
just to have a complete set <strong>of</strong> upto-date<br />
references.<br />
Consequently, <strong>College</strong> staff has<br />
begun to consider new ways to make<br />
it easier for members to access and<br />
download the vast amounts <strong>of</strong> information<br />
on the site. As part <strong>of</strong> this<br />
effort, we have a Communications<br />
Manager and a Web Site Coordinator,<br />
both <strong>of</strong> whom will be exploring<br />
ways to improve the image, functionality<br />
and interaction <strong>of</strong> the site.<br />
Connie Campbell<br />
C.A.M., C.A.E.<br />
Director <strong>of</strong> Finance and<br />
Administration<br />
During the Web site review and<br />
redesign, we will also be soliciting<br />
your advice for ways in which the<br />
site can better meet members’ varying<br />
levels <strong>of</strong> computer experience<br />
and pr<strong>of</strong>essional need. We are confident<br />
that, with your input and advice,<br />
we will be able to improve the<br />
site’s effectiveness. If you have any<br />
comments, please forward them to<br />
the Communications Manager Layne<br />
Verbeek at tel: (416) 962-4861, ext.<br />
294 or e-mail: lverbeek@ocpharma.com.<br />
In the meantime, individual copies,<br />
or complete sets <strong>of</strong> the legislation<br />
(with binder and tabs), can be<br />
ordered from the <strong>College</strong>. The OCP<br />
Manual, sold with the OCP Policy<br />
Handbook, complete with index and<br />
copies <strong>of</strong> reference articles, is $85<br />
($90.95 with GST). Sold separately,<br />
the OCP Manual is $64.20 (GST<br />
included) and the OCP Policy Handbook<br />
is $32.10 (GST included).<br />
Please note that copies <strong>of</strong> certain<br />
legislative updates can also be requested<br />
from Publications <strong>Ontario</strong> or<br />
the Publishers Group <strong>of</strong> Federal Publications<br />
[see square brackets p. 37].<br />
All contents <strong>of</strong> the OCP Manual<br />
can also be viewed and/or printed<br />
directly from our Web site<br />
www.ocpharma.com.<br />
Focus on Error Prevention from p. 18<br />
Recommendations:<br />
• Always check the original<br />
prescription and the hard copy<br />
to detect input errors.<br />
• Create a culture <strong>of</strong> medication<br />
safety in your pharmacy,<br />
which must be communicated<br />
to all new staff. Discuss minimum<br />
standards such as patient<br />
counselling on all new prescriptions<br />
and <strong>of</strong>fering to counsel on<br />
repeat prescriptions.<br />
123<br />
123<br />
123<br />
• Re-examine the staffing<br />
schedule to ensure the hours<br />
worked and workload does<br />
not compromise patient<br />
safety.<br />
12<br />
12<br />
12<br />
• Avoid interruptions<br />
and other distractions.<br />
• Consider investing in<br />
technology that can identify<br />
potential medication errors<br />
while increasing efficiency.<br />
Please continue to send re-<br />
ports <strong>of</strong> medication errors in confidence<br />
to:<br />
Ian Stewart<br />
P.O. Box 40620<br />
5230 Dundas St. W.<br />
Etobickoke, <strong>Ontario</strong><br />
M9B 6K8<br />
Reference:<br />
1. Institute for Safe Medication<br />
Practices Medication Safety Alert,<br />
Volume 5, August 23, 2000.<br />
36 <strong>PHARMACY</strong> CONNECTION Nov/Dec 2000
OCP Manual Inserts<br />
as <strong>of</strong> November 1, 2000<br />
Drug and Pharmacies<br />
Regulation Act (DPRA) &<br />
Regulations<br />
Drug Schedules<br />
Regulated Health Pr<strong>of</strong>essions<br />
Act (RHPA)<br />
Pharmacy Act (PA) &<br />
Regulations<br />
Standards <strong>of</strong> Practice<br />
• Version – Office Consolidation August 27, 1999 [Publications <strong>Ontario</strong>]<br />
• Summary <strong>of</strong> Laws Governing Prescription Drug Ordering, Records,<br />
Prescription Requirements and Refills, August 1999 [OCP]<br />
• Canada's National Drug Scheduling System [OCP] – Oct. 31, 2000*<br />
• Version – Office Consolidation June 30, 1999 [Publications <strong>Ontario</strong>]<br />
• Version – Office Consolidation May 28, 1999 [Publications <strong>Ontario</strong>]<br />
• <strong>Ontario</strong> Regulation 548/99 Amending O. Reg. 202/94, Nov. 29, 1999<br />
• <strong>Ontario</strong> Regulation 550/99 Revoking O. Reg 620/93, Nov. 29, 1999<br />
• Reference Page to Policy Handbook [OCP]<br />
• Guidelines for the Practice <strong>of</strong> Pharmacy, June 1989 [OCP]<br />
Drug Interchangeability and<br />
Dispensing Fee Act (DIDFA) &<br />
Regulations<br />
• Version – Office Consolidation Dec. 4, 1998 [Publications <strong>Ontario</strong>]<br />
• <strong>Ontario</strong> Regulation 73/99 Amending Reg. 935 <strong>of</strong> R.R.O. 1990,<br />
Feb. 25, 1999 [OCP]<br />
• <strong>Ontario</strong> Regulation 496/00 Amending Reg. 935 <strong>of</strong> RRO 1990,<br />
Aug. 28, 2000*<br />
<strong>Ontario</strong> Drug Benefit Act<br />
(ODBA) & Regulations<br />
Food and Drugs Act (FDA) &<br />
Regulations<br />
Controlled Drugs and<br />
Substances Act (CDSA)<br />
Narcotic Control Regulations<br />
OCP By-Laws<br />
• Version – Office Consolidation May 12, 2000 [Publications <strong>Ontario</strong>]<br />
• Amendment –<strong>Ontario</strong> Regulation 495/00 Amending Reg. 201/96,<br />
Aug. 28, 2000*<br />
• Updated NAPRA Version as <strong>of</strong> Oct. 25, 2000*<br />
• Amendment – Paragraph C.01.004 (1) (b), Sept. 1, 2000<br />
• Updated NAPRA Version as <strong>of</strong> Dec. 1, 1999<br />
• Amendments – Schedules III and IV, Sept. 1, 2000<br />
• Amendment – Benzodiazepines and Other Targeted Substances<br />
Regulations, Sept. 1, 2000<br />
• Updated NAPRA Version as <strong>of</strong> Dec. 1, 1999<br />
• OCP General Operating By-Law, May 1996 [OCP]<br />
• OCP By-Law, Procedure for Elections to Council, May 1996 [OCP]<br />
• By-Laws approved by Council 1999 (Red Tape Reduction Act)<br />
Reference<br />
Publications <strong>Ontario</strong>:<br />
tel: (416) 326-5300/1-800-668-9938<br />
• Code <strong>of</strong> Ethics, May 1996 [OCP]<br />
• Handling Dispensing Errors, Pharmacy Connection, Mar/Apr 1995 [OCP]<br />
• Revenue Canada Customs and Excise Circular ED 207.1 [OCP]<br />
• Revenue Canada Customs and Excise Circular ED 207.2 [OCP]<br />
• District Excise Duty Offices, Oct. 10/96 [OCP]<br />
• Guidelines for <strong>Pharmacists</strong> on The Role <strong>of</strong> the Pharmacy Technician [OCP]<br />
* items added to the Manual since the list was last published in Pharmacy Connection are printed in bold<br />
Publishers Group <strong>of</strong> Federal Publications:<br />
Ottawa: 1-888-4FEDPUB (1-888-433-3782)<br />
Toronto: tel: (416) 860-1611<br />
fax: (416) 860-1608<br />
e-mail: fedpubs@fedpubs.com<br />
<strong>PHARMACY</strong> CONNECTION Nov/Dec 2000<br />
37
OCP Vice President, Leslie Braden &<br />
President Sam Hirsch<br />
Canada Post Insignia