One of the requirements for an adaptation involves notifying the original prescriber. If the original prescriber cannot be notified, an adaptation would not be appropriate.
Useful links:
There are no restrictions based on drug schedule or indication for an emergency supply. However, pharmacists must only provide it if they have the appropriate knowledge, sufficient information, and informed consent from the patient.
Useful links:
Yes, but only if permitted under a section 56 exemption to the Controlled Drugs and Substances Act. The pharmacist may use their professional judgement to determine if they have the appropriate knowledge and if it is in the patient’s best interest to do so. If they are comfortable with their assessment, they can make the decision to provide an adapted renewal of a narcotic, controlled drug or targeted substance for a duration up to, but not exceeding, the duration originally prescribed.
No. Authorization does not mean obligation. The decision to adapt a prescription or not is at the discretion of the individual pharmacist. Whenever a pharmacist chooses to adapt a prescription however, the adaptation must be done in accordance with PPP-58 and within the limits of the pharmacist’s own competencies.
Yes. Just like we honour notations like this from prescribers today regarding generic substitution pharmacists are expected to honour hand-written “Do Not Renew &/or Adapt” instructions on prescriptions. The College of Physician and Surgeons (CPSBC) have agreed that pre-printed prescription pads are not acceptable and if a physician electronically produces their prescription they must sign or initial beside the notation.
The pharmacist takes responsibility for the adapted prescription as well as the authorized refills. The pharmacist could choose to provide an initial adaptation of the prescription but reduce or eliminate the authorized refills. If they did this they would need to provide the rationale for their decision in their documentation and inform the patient that they will need to return to their physician earlier than intended (note: a pharmacist cannot add refills that were not initially authorized by the prescriber).
An “original” prescription is an authorization from a practitioner to dispense a specified drug for use by a designated individual. Pharmacists may adapt an original prescription, including the first and subsequent refills of that prescription, in accordance with PPP-58. The adaptation does not need to be the beginning of a new drug therapy.
For the purposes of PPP-58, an original prescription may include a transferred prescription.