College of Pharmacists of BC's November Board Meeting
Topics include Chair and Vice-Chair elections, Toxic Drug Crisis Action: OAT Multidisciplinary Model, amendments to Professional Practice Policy - 66 Opioid Agonist Treatment and more.
The College Board welcomed Mikolaj Piekarski as its new representative for District 7 – Community Hospitals. Mikolaj took his Oath of Office and was officially appointed to the Board during its November meeting.
Board Chair and Vice-Chair Election Results
Chair: Steven Hopp, District 4, was elected Board Chair
Vice-Chair Andrea Silver, District 3, was elected Board Vice-Chair
Toxic Drug Crisis Action: OAT Multidisciplinary Model
Susan Bouma, Executive Director of Clinical Services and Evaluation at the Pharmaceutical, Laboratory and Blood Services Division of the Ministry of Health, and Sonia Drummond, Pharmacist, Clinical Lead, Substance Use, Clinical Services and Evaluation Branch Pharmaceutical, Laboratory & Blood Services Division, BC Ministry of Health presented to the Board information regarding the Integrated Interdisciplinary Model of Opioid Agonist Treatment Provision (IIMOAT) and Transactional Medication Update (TMU) on PharmaNet.
The British Columbia Centre on Substance Use’s (BCCSU) 2017 Guideline for the Clinical Management of Opioid Use Disorder provides a standard model of OAT service delivery with specific requirements for pharmacists. This guideline provides an important template for OAT provision in many community settings in British Columbia.
However, flexible interdisciplinary models have recently emerged in response to the need to overcome barriers for individuals who are unable to regularly attend a pharmacy to receive their OAT doses or for whom doing so adds unreasonable obstacles. Flexible OAT models are intended to improve patient engagement and reduce barriers to OAT access through team-based care, by allowing for options in addition to direct pharmacy dispensing/witnessing.
Amendments to Professional Practice Policy-66 Opioid Agonist Treatment
The Board approved amendments to Professional Practice Policy 66 – Opioid Agonist Treatment to allow pharmacists in community pharmacies to provide opioid agonist treatment to community health facilities, subject to the publication of the Interdisciplinary Model of OAT guidance document outlined earlier in this meeting. The changes to PPP-66 Opioid Agonist Treatment will not be in effect until the guideline is published by the BCCSU.
Over the past year and a half, the College has supported the Ministry of Health and BCCSU in the development of an interdisciplinary OAT model for community health facility settings. This model, called the ‘Integrated Interdisciplinary Model of OAT’, has not yet been published but will provide a framework for interdisciplinary OAT provision in a community health facility setting, and will provide guidance for pharmacists, nursing professionals, and prescribers involved in the model.
This new interdisciplinary OAT model for community health facilities is made possible by two recent section 56 exemptions:
- Subsection 56(1) Class Exemption for the Person in Charge of a Hospital and/or a Pharmacist who Supplies Controlled Substances to a Community Health Facility
- Subsection 56(1) Class Exemption for Nurses providing Health Care at a Community Health Facility
While the College is not responsible for development and implementation of clinical practice guidelines, the College supports the provincial OAT program through development of policies for OAT dispensing that align with provincial guidelines to ensure safe, standardized access to OAT.
Once in effect, the amendments to PPP-66 Opioid Agonist Treatment will allow for two streams of OAT service delivery that pharmacists can support in the community setting – the current pharmacy-based model, and the interdisciplinary OAT model. The amendments will allow pharmacists in community pharmacies to provide patient specific OAT and clinic stock of OAT drugs to community health facilities, in accordance with the Section 56 exemptions. This means that a pharmacist will not be required to be present to release the dose of OAT to a patient and can instead provide the dose to the community health facility where another authorized health professional will be responsible for storing and administering the medication.
Additionally, these amendments also include the following recommendations:
- That pharmacy professionals be familiar with the information included in the Ministry of Health and BCCSU’s most recent version of the interdisciplinary OAT model;
- That pharmacy professionals document in the patient record when a dose of OAT has been delivered to a community health facility;
- That a secure and confidential method of transporting OAT drugs is used, including considering the use of tamper-proof boxes or seals
Additional requirements for transportation and delivery of controlled substances are included in the section 56 exemptions.
When pharmacists are providing OAT to community health facilities, they will be exempt from the requirements in the PPP-66 Policy Guides. Lastly, pharmacy managers will be required to ensure that written policies and procedures are in place to ensure the requirements of the section 56 exemption are met when providing OAT to community health facilities.
Amendments to CPBC Board Meeting Guidelines
The Board approved revisions to the CPBC Board Meeting Guidelines by redefining the types of Board meetings, based on the Board Meeting Guidelines of the British Columbia College of Nurses and Midwives.
Currently, the Guidelines lists “Regular Meetings”, “In-Camera Meetings”, and “Committee of the Whole Meetings” as the three main types of meetings. At its June 2022 meeting, the Board discussed referencing the types of meetings as “Open Meetings” and “Closed Meetings” instead, similarly to the Board Meeting Guidelines of other large health regulatory Colleges.
Further to this, Board meetings will no longer be recorded and posted online.