Transforming and Supporting Patient Care - Health Professions ...

58Chapter 3 - A New Drug Approvals Framework For OntarioHPRAC’s ReviewHPRAC recently completed a scope of practice review for nursepractitioners. 9 In its New Directions report, HPRAC reviewed the use oftherapeutic pharmaceutical agents in the profession of optometry. 10 As partof the Minister’s request for advice on interprofessional collaboration,HPRAC reviewed the scopes of practice of the professions of pharmacy,physiotherapy, dietetics and midwifery. 11 Scope of practice reviews for theprofessions of medical laboratory technology and medical radiationtechnology are included in this Critical Links report.In the course of those reviews, HPRAC indicated that, where relevant,it would consider specific issues concerning the prescribing and use ofdrugs by non-physician health professionals in greater detail in itsexamination of the Minister’s request for advice on this subject. For eachof these professions, HPRAC conducted extensive examinations of theeducation, quality assurance and continuing competence. Literature andjurisdictional reviews were prepared for each of the health professions,as well as a limited jurisprudence review. Interviews and meetings witheducators, members of the profession, other health professions, health carefacilities and institutions and community-based agencies were held tocapture concerns and comments. Proponents’ submissions were posted onHPRAC’s website, and responses to the submissions were invited fromthose with an interest in the subject.HPRAC’s conclusions on the administration of drugs and substances inthe professions of medical laboratory technology and medical radiationtechnology are addressed as part of the scope of practice reviews for theseprofessions and included as chapters five and six of this report.How HPRAC Conducted the ReviewIn conducting this review, HPRAC undertook a literature review toinvestigate current information about the rationale, history and backgroundof non-physician prescribing and drug administration. The literature reviewfocused on identifying key documents in the scholarly and grey literature aswell as publicly available reports and websites on the subject. HPRAC alsoexamined non-physician prescribing in other jurisdictions to identifyemerging trends.A jurisprudence review was also conducted. It included a review ofCanadian case law concerning the prescribing and administration of drugsand substances by non-physician regulated health professionals.9HPRAC, Report to the Minister of Health and Long-Term Care on the Review of the Scope of Practicefor Registered Nurses in the Extended Class (Nurse Practitioners), March 2008.10New Directions Health Professions Regulatory Advisory Council: April 2006115-126.11HPRAC, An Interim Report to the Minister of Health and Long-Term Care on Mechanisms to Facilitateand Support Interprofessional Collaboration among Health Colleges and Regulated HealthProfessionals: Phase II, Part 1. September 2008.HPRAC Critical Links January 2009