News

Happy Holidays
December 14, 2010

Best wishes from ACP staff to you for a happy, healthy holiday season and New Year.

Note: The ACP office will be closed between 1 p.m., Fri., Dec. 24, 2010 and 8 a.m., Tue., Jan. 4, 2011.

Originally published in the December 14, 2010, issue of The Link
Order your free health journals now
December 14, 2010

Help your patients have a healthier 2011. Give them a free health journal, on us!

ACP’s 30-page booklets help patients track symptoms, moods, and health issues and note their questions and concerns.

Email acpinfo@pharmacists.ab.ca or call 1-877-227-3838 to order your copies.

ACP will cover the costs of the journals and shipping. First come, first served while quantities last.

Originally published in the December 14, 2010, issue of The Link

Does your pharmacy need a compounding and repackaging license?
December 14, 2010

If your pharmacy provides compounding and repackaging services to other pharmacies, then your pharmacy requires a compounding and repackaging license. 

Section 5(3) under the Pharmacy and Drug Act provides: 

5(3) A compounding and repackaging pharmacy licence authorizes the provision of compounding and repackaging pharmacy services from a compounding and repackaging pharmacy that is the subject of the licence, but does not authorize the dispensing or selling of a drug to or for a patient unless the licensee also holds a community pharmacy licence.

If you have a compounding and repackaging license, then you must have a compounding and repackaging contract with each pharmacy for which you provide services. 

It has come to ACP’s attention that there may be pharmacies in Alberta who hold a compounding and repackaging license, but are not using the compounding and repackaging agreement approved by ACP council. 

A compounding and repackaging pharmacy must meet the requirements under the Pharmacy and Drug Act in relation to written agreements for compounding and repackaging services. Section 19 of the Pharmacy and Drug Regulation provides:

Contracts, compounding and repackaging pharmacies

19. A licensee of a compounding and repackaging pharmacy must 

(a) ensure that the compounding and repackaging pharmacy only provides pharmacy services to other pharmacies under the terms of written contracts that

(i) include the terms required by the council, and 
(ii) are in the form required by the registrar, and

(b) provide copies of those contracts to the registrar on request. 

Please click on the following link https://pharmacists.ab.ca/nRegistrationLicensure/Forms.aspx 
to find the Compounding and Repackaging Pharmacy Agreement that contains the terms required by council and is in a form that is acceptable to the registrar. You will note that both the licensee and owner must sign this agreement. This reflects the central role of the licensee in the control of the operations of a licensed pharmacy and the duty of the owner to respect that role. 

It is important for you to note that the content of this agreement, as approved by council, has been designed to ensure due attention to the Alberta regulatory scheme governing licensed pharmacies and the practice of pharmacy. The form is approved by the registrar so that contracts may, if necessary, be readily reviewed by the registrar to ensure compliance with council requirements. 

The agreement is focused on public safety and professional issues, not commercial Issues

The required content of this agreement is not designed to consider or protect your financial and commercial interests. The agreement contemplates that you will negotiate and agree upon all financial and commercial aspects of your contract. There is provision for inclusion of matters within the agreement that need to be agreed to by the parties, such as length of the term (Article 4.1) and length of period for remedying defaults (Article 5.5). Please note that the term cannot be less than 6 months. Also, please note that if the term of the agreement is longer than 3 years, there must be a review of the agreement on its third anniversary. 

You will note that Schedules A, B, D and E are blank. The parties will need to agree upon other commercial or general terms to be included after the parties negotiate the commercial aspects of their agreement. These may include, but are not limited to, matters such as the fee or price for the compounding and repackaging of drugs, terms of payment, security for payment, times for delivery, as well as general provisions that will better define or protect the rights or interests of the parties such as insurance and indemnity, provisions for arbitration and service of notices. 

You should seek your own legal counsel to assure yourself that: 

(a) you include all additional terms that you may require to protect your financial or commercial interests; and 

(b) the final form of your contract meets your needs, while ensuring that the requirements of council are included. 

Separate considerations for pharmacies that hold Health Canada establishment licences or narcotics dealers licences

This compounding and repackaging agreement is designed to meet the requirements of the Pharmacy and Drug Regulations in relation to compounding and repackaging pharmacies. Pharmacies that hold establishment licences or narcotics dealers licences, in addition to compounding and repackaging licences, may be able to modify Article 2.4 or Article 2.5, as the case may be, to reflect authority granted to them under those licences. Any such proposed changes should be referred to the registrar, with a copy of the applicable licence(s), so that the form of the change may be considered. 

Unique considerations for compounding and repackaging pharmacies that enter into agreements with institution pharmacies

The college recognizes that compounding and repackaging pharmacies may provide compounding and repackaging services to institution pharmacies. Under the terms of the Pharmacy and Drug Act, institution pharmacies that provide services only to the patients of the associated hospital, nursing home, institution, facility or centre, and do not bill third parties, are not required to be licensed. Some types of institution pharmacies, such as hospital pharmacies, may also be able to dispense drugs in response to standing orders. Hospital pharmacies may also be subject to different requirements in relation to controlling narcotics.

Accordingly, recognizing the special nature of institution pharmacies, the college is willing to consider proposed amendments to the agreement to accommodate: 

(a) the need to have someone other than a licensee sign the agreement on behalf of the institution pharmacy, while still ensuing proper pharmacist oversight in the context of the services sought and provided under the agreement; 

(b) the potential for the use of standing orders in appropriate cases; and 

(c) the potential that Article 2.5 may be amended, in appropriate cases, to recognize proper hospital processes in relation to narcotics. 

Before any changes are made to the form of the agreement to accommodate institution pharmacies, they must be approved by the registrar. If there are changes to the required content, council approval will be required.

Please submit any proposed changes in writing with your supporting rationale at least 30 days before the proposed effective date of your agreement.

Originally published in the December 14, 2010, issue of The Link

Dukoral schedule reminder
December 14, 2010

The Public Health Agency of Canada updated its travel notice for the Dominican Republic and Haiti on Dec. 9. It advised Canadians planning to travel to those locations to consider a cholera vaccine beforehand. 

With this in mind, please remember that Dukoral is only Schedule 2 when used for prophylaxis against travelers’ diarrhea due to enterotoxigenic Escherichia coli (ETEC). If patients want it as a vaccine against cholera it is a Schedule 1 product and requires a prescription. Read NDSAC's rationale for this difference.

Also remember that counselling about travel should always include more than just immunization information, e.g., safe water, mosquito netting, sunscreen. For resources, look to the Public Health Agency of Canada’s Travel Health and Information for Travel Medicine Professionals web pages.

Originally published in the December 14, 2010, issue of The Link

For which drugs do vets need to use TPP forms?
December 14, 2010

Since May 1, 2010, Alberta veterinarians have been required to adhere to all requirements of the Triplicate Prescription Program. Like physicians and dentists, veterinarians must use a triplicate prescription pad when writing prescriptions for all drugs on the current TPP medication list.

There are proposed changes regarding the addition of specific medications prescribed by veterinarians, dispensed by veterinary clinics, and dispensed by pharmacists. The proposed changes are not officially part of the TPP program yet. However, the Alberta Veterinary Medical Association (ABVMA) has made these proposed changes mandatory for all veterinarians at this time.

The list of additional medications that are mandatory for vets, but not currently on the TPP list are: 

  • All barbiturate preparations (Phenobarbital, etc.) 
  • All codeine containing preparations 
  • Benzodiazepines 
  • Tramadol 
  • Anabolic steroids

How should pharmacists handle a prescription for a drug that is not on the current TPP medication list but is prescribed using a triplicate prescription pad?

Pharmacists are required to treat TPPs from veterinarians as they would those from any other TPP prescriber, and to apply the same TPP rules to drugs that the veterinarians have been directed by the ABVMA to prescribe using the triplicate prescription pad. This includes all drugs on the approved TPP medication list as well as drugs that are not currently on the TPP medication list but are on the ABVMA additional list. 

According to the existing TPP rules, pharmacists may dispense a drug that is prescribed using a triplicate prescription pad even if it is not currently on the TPP medication list after assessing the prescription according to the Standards for Pharmacist Practice. There may be safety reasons that influence a prescriber’s decision to use a triplicate prescription pad to write a prescription for a drug that is not on the current TPP medication list. 

If a veterinarian fails to follow the prescribing directions provided by ABVMA for drugs not on the current TPP medication list, the ABVMA is responsible for enforcing their requests with their members until the proposed drugs specific to the ABVMA additional list are approved by the TPP Steering Committee.

Originally published in the December 14, 2010, issue of The Link

Practice Skills: Monitoring drug therapy using laboratory values
December 14, 2010

This Practice Development course focuses on helping you to integrate laboratory values in the management of your patients’ medication. It runs from mid-February to mid-May 2011 and includes a one day workshop (February 26, 2011), online modules (activities, presentations, and discussions), and a four-part assignment.

Registration deadline: February 1, 2011

For more information, visit the Practice Development Practice Skills webpage.

Originally published in the December 14, 2010, issue of The Link

Resident prescribing rules
December 14, 2010

Postgraduate medical trainees (residents) are:

not required to record the name and registration number of the preceptor on prescriptions. 
permitted to write prescriptions for Triplicate Prescription medications.

Residents must register with the Triplicate Prescription Program to get their own TPP pads.

More information is available on the CPSA website.

Originally published in the December 14, 2010, issue of The Link

Targin on TPP list
December 14, 2010

Targin® (oral oxycodone/naloxone prolonged-release tablet) is a TPP drug.

While not specifically listed, it is automatically included because of the oxycodone. Any product containing a drug that is listed on TPP will be on TPP unless specifically exempted by the TPP steering committee. As another example, compounds with ketamine as an ingredient are included in TPP. 

Originally published in the December 14, 2010, issue of The Link

Regional meetings valuable
December 14, 2010

Thanks to everyone who participated at the recent town hall meetings in Calgary, Lethbridge, Red Deer,  [meeting] and Edmonton. We appreciate you taking the time to help us learn more about what your issues, concerns and hopes are. 

Congratulations to Brian Abernethy of Calgary, the winner of our draw for one free registration to this May’s centennial conference at Jasper Park Lodge!

What did we hear?

Time, money, technician regulation, and expanding scopes were common discussion themes among all groups. However, opinions on the role of these factors in practice varied widely by group. 

Participants did a quick SWOT analysis of pharmacy practice as it stands today. Following is a summary of the common findings. 

Strengths: 

  • Established, positive relationships with patients 
  • Knowledgeable practitioners 
  • Great accessibility 
  • High trust and reputation
  • Practitioners want to offer good care 

Weaknesses: 

  • Access to electronic health records is cumbersome 
  • Software doesn’t support good documentation or team-based care 
  • Lack of remuneration for cognitive services 
  • Pharmacists have trained patients that care will be immediate and free
  • Pharmacy is often seen as a passive profession, accepting of less than ideal situations 

Opportunities: 

  • Patients have needs that aren’t being met elsewhere that can be met by pharmacists 
  • Patients are becoming more receptive to the idea of making appointments
  • Patients can be empowered to undertake some of their own follow up 
  • Regulated technicians can free pharmacists to spend more time with patients 
  • Technology evolving to improve workflow and patient care 
  • Have a lot of data that can be used, just needs to be collated
  • Pharmacists are being invited to participate with practitioners from other disciplines 

Threats: 

  • It may be some time before there are enough regulated technicians to impact pharmacy workflow 
  • Expectations of corporate owners may be at odds with desired pharmacy practice model 
  • Even with funding, pharmacist uptake of expanded scope may be low (as has been the case in other locations)
  • Inability to access documentation and data to make fully informed care decisions 
  • Few individual pharmacists or technicians feel empowered enough to try and change current systems

Originally published in the December 14, 2010, issue of The Link

 

ACP council will meet on Dec. 9
November 30, 2010

The agenda for council’s Dec. 9th meeting is now available.

Please notify Leslie Ainslie, ACP Executive Assistant, if you plan to attend.

Originally published in the November 30, 2010, issue of The Link
Ever traded a chicken for penicillin?
November 30, 2010

We are getting ready to launch our centennial celebrations and need some pharmacy “human interest” stories to pique the public’s curiousity. We hear rumours about the “good old days” when bartering for services occurred in remote settings, but can’t track down the details for such tales.

If you have the details on this type of story, or any other adventurous anecdotes, mesmerizing moments or transfixing trivia, please submit them to ACP Communications Leader Karen Mills at karen.mills@pharmacists.ab.ca or 780-990-0321.

Originally published in the November 30, 2010, issue of The Link
Interested in international pharmacy?
November 30, 2010

The International Pharmaceutical Students’ Federation (IPSF) and the Canadian Association of Pharmacy Students and Interns (CAPSI) invite you to host an international pharmacy student as part of their exchange program.

Most exchanges are one month, and IPSF recommends that students work for 4-8 hours/day for 4 days/week.

Students are unpaid volunteers and are responsible for the costs of transportation and accommodation, so there is no cost to hosts.

Deadline to apply as a host: Feb. 15, 2011

CAPSI and IPSF have provided the following two information letters that will give you all the details about the exchange program.

Program overview 

Student Exchange Program backgrounder

Originally published in the November 30, 2010, issue of The Link
 
H1N1 communication and you: How did it work?
November 30, 2010

The H1N1 pandemic revealed many communication challenges. The Canadian Institute of Health Research (CIHR) is now conducting research in hopes of improving processes for the future.

They would like you to fill out a short (10 minute) survey regarding the H1N1 pandemic. The questions ask about what kind of information you received from different public health agencies, how useful you thought this information was, and how you applied it to your own personal situation.

The survey is located online at http://www.surveymonkey.com/s/H1N1inCanada.

The H1N1 outbreak, in the spring season of 2009, provided an opportunity for public health agencies to test their pandemic plans in a crisis situation. This outbreak differed to some degree from expectations, in terms of virulence, the population at risk, and how the public itself reacted to the outbreak. As a result, the flexibility and effectiveness of these plans were themselves tested.

We want to assess the effectiveness of these pandemic plans, with a specific focus on the risk communication strategies used by the various public health agencies in Canada. In other words, we want to see how the health agencies communicated the risk to you as a public health care professional working on the ‘front lines’, dealing with members of the public at every stage of the outbreak. By virtue of your job, we feel that you played a dual role in pandemic H1N1 as being both ‘receivers’ and ‘providers’ of information.

If you do not have regular access to the internet, or if there are other circumstances preventing you from filling out this online survey, you may request a paper or electronic PDF copy of the survey. Please email us at RISC_MD@UManitoba.ca with your contact details and survey preference type, or you may write to us at:

Research in Science Communications
P224-770 Bannatyne Avenue
Winnipeg, MB  R3E 0W3

We very much appreciate you taking the time to fill out this survey. The results will be used to help improve the quality of risk communication at all levels of organization, from national plans down to regional/local plans.

With Kindest Regards,

Dr. Michelle Driedger, of the University of Manitoba
Dr. Cynthia Jardine, of the University of Alberta
Dr. Jennifer Keelan, of the University of Toronto

Originally published in the November 30, 2010, issue of The Link

Botox and saline – patients require both
November 30, 2010

Physicians administering Botox injections for migraines and myofascia pain syndrome in private offices have alerted ACP that pharmacies filling the Botox prescription are not also providing saline for reconstitution even though it too is included on the prescription.

Both elements are necessary for patients’ treatment. If you can not provide the saline, please let the patient know immediately so that they can seek other sources and their treatment is not delayed.

Originally published in the November 30, 2010, issue of The Link
New needle, new syringe – every time!
November 30, 2010

Always:

  • Follow aseptic practices during the preparation and administration of injected medications. 
  • Use medications packaged as single-use vials for only one patient.

Never:

  • Administer medications from the same syringe to more than one patient, even if the needle is changed. 
  • Enter a vial with a used syringe or needle.

Originally published in the November 30, 2010, issue of The Link

 

Methadone maintenance course – Dec. 4
November 30, 2010

8 a.m. to 4 p.m. 
Sat., Dec. 04, 2010
Libin Theatre, Health Sciences Centre, U of C 

This introductory workshop will provide practical information in using methadone for opioid dependence and managing these patients in clinical practice. There are still a few spots left. To register, go to http://medicine.ucalgary.ca/files/med/Methadone_10.pdf

Originally published in the November 30, 2010, issue of The Link

Help your patients enjoy a healthier 2011
November 30, 2010

Give them a free health journal, on us!

We often hear from pharmacists how much easier their job would be if patients could provide more details about their symptoms and when health events occurred.

In response, ACP has designed a pocket-size patient health journal. These 30-page booklets help patients track symptoms, moods, and health issues and note their questions and concerns.

To request copies, contact the ACP office at acpinfo@pharmacists.ab.ca or 1-877-227-3838. ACP will cover the costs of the journals and shipping. First come, first served while quantities last.

Originally published in the November 30, 2010, issue of The Link
Regional meetings coming to Red Deer and Edmonton
November 30, 2010

Following excellent discussions in Calgary and Lethbridge last week, we are really looking forward to hearing your views at the next two town hall sessions. 

Dec. 7, 2010 – Red Deer, Red Deer Lodge (4311-49 Avenue)
Dec. 8, 2010 – Edmonton, Sandman Hotel (17635 Stony Plain Road)

Meetings will be held from 7 to 9:30 p.m.  There is no fee. Please notify Leslie Ainslie, ACP Executive Assistant, if you plan to attend.

Originally published in the November 30, 2010, issue of The Link

ACP employment opportunity
November 30, 2010

ACP is looking for a full-time, permanent Pharmacy Practice Consultant.  For position and application details, see the full job posting.

Reporting to the Professional Practice Director, the Pharmacy Practice Consultant, a full-time permanent employee, is responsible for:

  • conducting inspections according to the Health Professions Act (HPA) and the Pharmacy and Drug Act (PDA);
  • assessing pharmacy operations and systems;
  • educating licensees, pharmacy directors, pharmacy staff and proprietors through consultations to ensure safe, effective and responsible pharmacy practice; and
  • developing and implementing educational programs and tools to promote quality assurance and quality improvement initiatives.

The position will require travel and the ability to work extended hours when required to meet assessment travel requirements. 

For position and application details, see the full job posting.

Originally published in the November 30, 2010, issue of The Link