Ministry of Health Announces Expansion of Pharmacy Services in British Columbia
On Thursday, September 29th, 2022, British Columbia’s Minister of Health, the Honourable Adrian Dix announced the expansion of pharmacy services available in BC in order to improve healthcare access for British Columbians who have been affected by the shortage of primary care providers.
With BC’s health system continuing to experience significant strain in the context of dual public health emergencies, and close to one million British Columbians unattached to a family doctor, expanding the range of services available at community pharmacies will help to increase British Columbians’ access to critical medications and improve patient health outcomes.
The changes announced on Thursday permit pharmacists in BC to administer a wider range of drugs by injection and intranasal route. They also enable pharmacists to adapt existing prescriptions for a wider range of drugs and conditions.
Additionally, to assist with this expansion of pharmacy services, the College is working towards extending the expiry date for all prescriptions from one year to up to two years. These changes are expected to come into effect on October 14, 2022.
Minister Dix also announced that work with the College is now underway to provide BC pharmacists with the authority to prescribe medications for minor ailments and contraception, with implementation planned for Spring of 2023.
The College recognizes that Indigenous clients in BC are disproportionately affected by issues related to healthcare access. As such, we will continue to evaluate and assess the impact of these changes on Indigenous clients and to ensure that they are helping to address some of the challenges being faced by their communities.
Removal of Restrictions on Drug Administration by Injection and Intranasal Route
Working in collaboration with the Ministry of Health, the College Board held an emergency meeting, at which it approved amendments to the Drug Administration by Injection and Intranasal Route Standards, Limits and Conditions allowing pharmacists to administer most Schedule I, IA and II drugs, which includes controlled drugs by injection and intranasal route, with the exception of cosmetic drugs and substances and allergy serums.
These changes are expected to come into force on October 14, 2022.
Pharmacists may only administer a drug if it has been prescribed by a practitioner, unless it is being administered for the purpose of immunization, or to treat certain medical emergencies including:
- Anaphylaxis arising from administering a drug or substance, or
- Administering naloxone to a person suspected of suffering from an opioid overdose
Pharmacists must have a valid Drug Administration Certification in order to administer drugs by injection and intranasal route.
At this time, additional training for pharmacists beyond the College’s Drug Administration Certification is not required.
The current training requirements for Drug Administration Certification already provide pharmacists with the necessary knowledge, skills and abilities needed to administer drugs beyond vaccines. Pharmacists may only administer a drug within the scope of their education, training and competence. The College encourages pharmacists who self-identify any learning needs to seek out additional training.
HPA Bylaws Schedule F
Part 4 – Certified Practice – Drug Administration by Injection and Intranasal Route
Removal of Restrictions on Adapting Prescriptions
Also in collaboration with the Ministry of Health ,The College Board approved amendments to Professional Practice Policy 58: Medication Management (PPP-58), removing most restrictions on the drugs and conditions that pharmacists can adapt prescriptions for.
These changes are expected to come into force on October 14, 2022.
PPP-58 provides the framework to guide pharmacists in the safe and effective adaptation of existing prescriptions through the following professional activities:
- Change: changing the dose, formulation, or regimen of a prescription to enhance patient outcomes;
- Renew: renewing a prescription for continuity of care; and
- Substitution: making a therapeutic drug substitution within the same therapeutic class for a prescription to best suit the needs of the patient.
Professional Practice Policy – 58: Medication Management (Adapting a Prescription)
(Updated August 2022)
These changes allow pharmacists to use their professional judgement to renew a current, valid prescription for clients who have stable, on-going medical conditions with the exception of cancer chemotherapy prescriptions.
Renewals of narcotics, controlled drugs or targeted substances will also be allowed, as permitted by Health Canada’s section 56 exemption, however they may only be renewed for the same duration as originally prescribed. Additionally, amending the dose/formulation or making a therapeutic substitution for these substances will continue to be restricted.
Extending the Prescription Validity Period
In order to further improve access to medications for patients in British Columbia, the College Board also approved amendments to the Pharmacy Operations and Drug Scheduling Act Bylaws and the Health Professions Act Bylaws to extend the period of time a prescription is valid from one year to up to two years. These changes would enable pharmacists to use their professional judgment to provide renewals of stable medications up to two years past the original prescribing date if appropriate.
These changes were posted for public comment on the College's website until October 05, 2022.
Extending the prescription validity period will help to enhance continuity of care for those patients who cannot practically access a primary care provider for a prescription renewal.
Pharmacists will continue to be able to renew or adapt valid prescriptions for an appropriate time, so long as they do not exceed the expiry date on the original prescription.
Providing an Emergency Supply of Medications for Continuity of Care as Needed
In order to provide continuity of care for clients, pharmacists may use their professional judgment to provide an emergency supply of medication to clients without a valid prescription.
This includes prescriptions for narcotics and other controlled drug substances.
Professional Practice Policy 31 Emergency Supply for Continuity of Care (PPP-31) allows pharmacists to provide an emergency supply of medications to patients for an extended period of time to ensure that no patient goes without the medications they need.
PPP-31 provides pharmacists with the latitude to make decisions on the appropriate amount of medication to provide a patient based on that patient’s best interests, individual circumstances and access to a prescriber.