Transforming and Supporting Patient Care - Health Professions ...

176Chapter 7 – Professions of Chiropody and PodiatryProponents’ RationaleThe current regulation lists individual drugs that may be prescribed bychiropodists and podiatrists. Proponents told HPRAC that the requirementto list each substance or drug available to podiatrists and chiropodists wasa cause of a delay of many years in obtaining Lieutenant Governor inCouncil approval of the drug regulation. Adopting categories or classeswould avoid lengthy delays in obtaining approval or amendment toregulations. These delays have meant that chiropodists and podiatristshave been unable to use the latest and most effective drugs and substances,and patients may not receive the most appropriate medication or the bestcare. Categories or classes would allow chiropodists and podiatrists to haveaccess to the latest and most effective proven drugs and substances in theirtreatment regimens.The CCO said that problems also occur when patients exhibit multipleallergies or sensitivities that mean first-line drugs are contraindicated.There are also issues of cross reactivity that require flexibility in theprescription of drugs. 34What HPRAC FoundHPRAC notes that the current regulatory approvals process is beingaddressed with its recommendation for a new drug approvals frameworkfor Ontario, which includes the regulation of therapeutic classes of drugsand a separate transparent process for identifying specific agents and theterms, limitations and conditions that would apply to a class of drugdesignated in the regulation.4. Additions to CCO’s Drug RegulationsThe CCO is requesting that six additional classes of drugs be added to itsdrug regulation, which came into force on September 26, 2008, includingmedical gases (oxygen and nitrous oxide), emergency medications,viscosupplementation agents, oral antifungals, gout therapy cytoprotectiveagents and corticosteroids.Administration of Oxygen and Nitrous Oxide by InhalationChiropodists and podiatrists are seeking to administer oxygen and nitrousoxide for pain management and in emergency situations. Nitrous oxide andoxygen are important components of the chiropodists’ and podiatrists’emergency kit, and are important for pain management. With propertraining it is appropriate for chiropodists and podiatrists to be able toadminister these substances.HPRAC recommends that the profession be authorized to administersubstances by inhalation in limited circumstances.34CCO, OPMA, OSC. Submission to HPRAC: Review of Non-Physician Prescribing: 12.HPRAC Critical Links January 2009