Transforming and Supporting Patient Care - Health Professions ...

351Chapter 14 – Profession of PharmacyHPRAC’s ConclusionsOn balance, HPRAC is confident that any additional risks can be addressedby the detailed standards, with terms, limitations and conditions that wouldbe developed by the OCP through an enabling regulatory framework,including the role of interprofessional collaboration, mandatedcommunication with the original prescriber, and post-registrationeducation.HPRAC therefore recommends that pharmacists be authorized to undertakemedication therapy management activities as an essential part of theirscope of practice.Lists or Classes of DrugsPharmacists have requested that drug regulations under the Pharmacy Act,1991 should include open prescribing authority rather than therapeuticclasses of drugs. HPRAC is of the view that regulations authorizingtherapeutic classes of drugs provide pharmacists with enough latitude topractice to their full scope of practice. HPRAC is not convinced that theexistence of classes will become onerous or restrict the pharmacist’s abilityto adapt, modify or extend prescriptions. If the recommended new drugapprovals process is put in place, approval of new classes of drugs shouldproceed more expeditiously. The process of approvals of specific agentswithin classes, outside of the regulation-making process, should be moreefficient as well.Medication for Emergency SituationsThe proponents have requested that medications for use in emergencysituations be authorized to the profession of pharmacy. The provision ofemergency “crash cart” kits for a number of professions is based on therisks some health professionals face in a clinical practice setting whereclinical procedures are carried out in an office or clinic. HPRAC is notconvinced that this kit is necessary for pharmacists, as they are notperforming in-office or in-clinic procedures. Emergency situations in apharmacy setting would be relatively rare; therefore, HPRAC has concludedthat the emergency provisions under section 29 of the Regulated HealthProfessions Act, 1991 are adequate to meet these needs.Travel ProphylaxisIn the scope of practice review, the OPA proposed that pharmacists beauthorized to initiate therapy for travel prophylaxis subject to additionaltraining (including prescribing Schedule I drugs such as mefloquine,chloroquine, atovaquone/proguanil, relevant vaccines, acetazolamide,antibiotics in case of traveller’s diarrhea). The OCP did not include thisrequest in its submission. Authorizing pharmacists to initiate therapy fortravel prophylaxis subject to additional training concerns two specificcontrolled acts: prescribing a drug, and administering a substance byinjection.HPRAC Critical Links January 2009