Medication Management (Adapting a Prescription)

PPP-58: Medication Management (Adapting a Prescription)


Medication Management is an umbrella term that encompasses all professional activities that a pharmacist undertakes, as the medication experts, to optimize safe and effective drug therapy outcomes for patients.  Pharmacists’ involvement in medication management activities will continue to expand as the needs of patients and the demands of the healthcare system continue to increase.

This point was reinforced throughout the February 2008 Throne Speech where the provincial government acknowledged the challenges of sustaining the current healthcare system and called on all healthcare professionals to practice to the full extent of their scope as a means of helping to alleviate pressure from the system.  This led to the introduction of – Bill 25 – The Health Professions (Regulatory Reform) Amendment Act, 2008, which, specific to the pharmacy profession, formalizes a pharmacist’s authority to ‘renew existing prescriptions’.

Professional Practice Policy #58 (PPP-58)

The College of Pharmacists of BC’s Professional Practice Policy #58 entitled “Protocol for Medication Management – Adapting a Prescription, approved by College council in September 2007, provides the framework to guide pharmacists in the safe and effective adaptation, including renewals, of existing prescriptions.  PPP-58 is applicable to pharmacists in all practice settings including; community, long-term, hospital and other institutional pharmacy settings.

This policy, which provides the opportunity for pharmacists to maximize their full educational and professional competencies, also provides structure to, and refines the process of, exercising professional judgment in clinical practice.  This becomes increasingly important as pharmacists evolve their role as medication experts and assume accountability for their drug therapy decisions.

It is not mandatory that a pharmacist adapt a prescription and the decision to adapt a prescription or not is at the discretion of the individual pharmacist.  Should a pharmacist choose to adapt a prescription however, the intent must be to optimize therapeutic outcome of treatment and the adaptation must be done in accordance with PPP-58 and within the limits of the pharmacist’s own competencies.

The evolutionary change in pharmacy practice, through the implementation of PPP-58, is that it gives pharmacists independent authority and accountability for the adaptation of a prescription.  In doing this, the pharmacist is making the decision, based on their professional judgment, that the prescription is the ‘right’ drug therapy for their patient.

Although this additional authority comes with added responsibility it allows pharmacists to demonstrate their value, as medication experts, in an evolving patient-centered, clinical care environment.