Board Highlights - June 15, 2018

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Board Highlights - June 15, 2018

Highlights from this meeting include amendments to the Drug Schedules Regulation; the implementation of Professional Practice Policy-67 for Injectable Opioid Agonist Treatment; and the approval of a pharmacy manager education program. There were also guest presentations from PharmaNet Revisions for Information Management Enhancements (PRIME) and Stop Overdose BC.

You can re-watch all the Board meeting presentations through the College’s Periscope Channel.

Auditors Report 

The Board approved the audited financial statements for fiscal year 2017/2018.

Primary Care Initiative

Peter Zed, Associate Dean of Practice Innovation at UBC’s Faculty of Pharmaceutical Sciences, presented to the Board on the addition of 50 new clinical pharmacists as part of the new primary-care network teams around the province.

These positions are being added as part of the BC Government’s new primary health-care strategy to deliver team-based care to all British Columbians. The new team-based approach is intended to deliver faster and improved access to health care for British Columbians all over the province, putting patients in closer contact with the specific type of care they need. 

In addition to the new pharmacist positions, the BC Government will also be recruiting 200 general practitioners and 200 nurse practitioners to work on primary care teams across the province. 

“Pharmacists play an important role in managing patient’s care and ensuring their medications are used to the best effect. This innovative model, which integrates pharmacists into the primary health-care team, is fantastic news for British Columbians. Patients will benefit from the advanced skills and expertise that pharmacists bring.” 

- Michael Coughtrie, Dean, UBC Faculty of Pharmaceutical Sciences 

Having clinical pharmacists working closely with doctors and nurse practitioners, ensures optimal patient care by ensuring primary-care teams are able to concentrate services around a patients’ specific health-care needs. 

Amendments to the Drug Schedules Regulation

The Board approved amendments to the Drug Schedules Regulation (DSR) under the Pharmacy Operations and Drug Scheduling Act (PODSA) to improve its alignment with the National Drug Schedules as well as the Prescription Drug List made under the Food and Drugs Act (FDA) and the Schedules to the Controlled Drugs and Substances Act (Canada).

Subject to the Food and Drugs Act, Health Canada determines whether a drug must be sold by prescription only, or can be sold over the counter (non-prescription status). Provincial regulatory authorities can further restrict the conditions of sale of non-prescription products, however, these conditions cannot be less stringent than those put forth by the FDA. 

Typically, for those drugs determined by Health Canada to be non-prescription, most provincial pharmacy colleges adopt the recommendations of NAPRA without review or additional consideration. In BC, the Board makes a recommendation to the provincial government that considers the NAPRA recommendation, but may not follow it. Nevertheless, most amendments to BC’s DSR are based on recommendations from NAPRA. 

Beginning in 2017, College staff, together with an external pharmacist consultant, reviewed the DSR, identifying a number of misalignments with NAPRA’s National Drug Schedules. Based on the review, there were no compelling reasons to deviate from NAPRA’s National Drug Schedules. As a result, the amendments to Schedule II and III drugs on the DSR align with NAPRA’s National Drug Schedules. 

Although Schedule I drugs were not the focus of the review, several amendments to Schedule I drugs are being proposed, all of which align with NAPRA’s National Drug Schedules and federal legislation. 

The amendments require filing with the Ministry of Health and need to be deposited with the Registrar of Regulations. The College will notify registrants once the amendments come into effect. 

Policy on Injectable Opioid Agonist Treatment 

The Board approved the implementation of Professional Practice Policy 67 for Injectable Opioid Agonist Treatment, as well as an accompanying Policy Guide for Injectable Hydromorphone Maintenance Treatment, effective September 1, 2018. 

The College currently has requirements in place for buprenorphine/naloxone, methadone and slow release oral morphine when used for opioid agonist treatment. However, with the release of the Guidance for Injectable Opioid Agonist Treatment for Opioid Use Disorder from the BC Centre on Substance Use (BCCSU) in 2017, which provides guidelines for prescribing injectable opioid agonist treatment (iOAT) drugs, a gap in policy existed in which there are no specific requirements regarding dispensing (iOAT) drugs. To address this, the College has developed requirements for the safe dispensing of injectable hydromorphone for iOAT to complement the existing OAT requirements, with a focus on injectable hydromorphone

The BCCSU developed the new provincial guidelines for iOAT for Opioid Use Disorder to provide treatment options to individuals who have not benefited from oral opioid agonist treatments (buprenorphine/naloxone, methadone and slow release oral morphine). These individuals face significant risks, including fatal overdose due in large part to the proliferation of fentanyl and other synthetic analogues into the illicit drug supply. The guidelines provide recommendations on how injectable opioid agonists can be used.

PPP-67 sets out requirements regarding pharmacist supervision of injectable hydromorphone maintenance treatment within community pharmacies.  Under this model, patients will self-administer injectable hydromorphone within their community pharmacy up to 3 times per day. Given the public safety risk associated with injectable hydromorphone being dispensed in the absence of specific requirements for safe dispensing of this drug, the College felt it important to develop requirements and guidance as soon as possible.

BC Community Pharmacy Manager Training Program

The Board approved the implementation of Professional Practice Policy 69 Pharmacy Education Training, effective September 1, 2018. The BC Community Pharmacy Manager Training Program, provided by the BC Pharmacy Association, is an online course that includes information relevant to pharmacy management (e.g. employment law, etc.) and a knowledge assessment. The program will be available at the beginning of July 2018.

Pharmacy Managers have distinct and extensive responsibilities under the Pharmacy Operations and Drug Scheduling Act (PODSA) and its bylaws, however, it has come to the College’s attention through the inquiry and discipline process that some pharmacy managers do not seem to understand all of their legislated obligations. 

The goal of an approved education program would be to improve the overall operation of pharmacies, help pharmacy managers avoid future complaints against them, ensure safe pharmacy practices for the public and help pharmacy managers better understand the full extent of their role. 

Stop Overdose BC Campaign 

People Who Use Drugs are Real People: Tackling Stigma through Social Marketing

Regan Hansen, Director of the Partnerships and Engagement Branch at the Ministry of Mental Health outlined for the Board, the implementation and evaluation of the Province of BC’s multi-channel social marketing campaign – StopOverdoseBC.ca – aimed at disrupting common stereotypes of people who use drugs. 

The campaign focused on ways to empower influencers – those close to those at risk – and ways to encourage them to have courageous conversations. 

The campaign is beginning to shift perceptions of who is at risk, with fewer people viewing the overdose crisis as “someone else’s problem.” Those who have seen the campaign posters are more likely to be concerned about the crisis impacting their personal network of family and friends, and to see people who use drugs in a more constructive and empathetic manner.  

The presentation also outlined key partnerships including the Vancouver Canucks, BC Lions and Overwaitea Food Group and the collective impact strategic partnerships can have on reaching critical target audiences. 

Learn how to save a life with Naloxone 

Gillian Vrooman, the College’s Director of Communications and Engagement, presented to the Board the ongoing work surrounding the College’s naloxone campaign to help build awareness on how to use naloxone to save a life. 

The opioid crisis continues to be an important priority for the College and other public health organizations across the province. BC’s opioid overdose crisis has continued its unprecedented escalation over the past three years. There were a total of 1,448 illicit-drug overdose deaths in 2017, compared with 991 in 2016 and 522 in 2015.

Naloxone Resources 
In 2016, the College partnered with the BC Centre of Disease Control and the BC Ministry of Health to develop naloxone resources that would be valuable for the public and health professionals. The College also sought input from patient advocacy groups such as the Vancouver Area Network of Drug Users and the BC Association of Persons on Methadone to help develop the naloxone resources.

The College established a dedicated landing page for this content at bcpharmacists.org/naloxone and has continued to update and add to the resources since it first launched.

The College would like to thank everyone who has helped provide input into the College’s naloxone resources, including the Ministry of Health, BC Centre for Disease Control, First Nations Health Authority, Provincial Naloxone Task Group, Regional Harm Reduction Coordinators, Vancouver Area Network of Drug Users and BC Association of Persons on Methadone and other patient groups. 

In addition to these resources, the College developed and implemented a Naloxone Campaign which focuses on building awareness of the opioid overdose crisis, how to recognize and respond to an opioid overdose, and the resources and information available at bcpharmacists.org/naloxone. 

Since the naloxone resources were first made available in 2016, the naloxone page has received over 94,000 page views. Facebook ads sharing naloxone information also reached over 670,000 people in BC, and over 3,000 have viewed the College’s naloxone webinar. 

PharmaNet Revisions for Information Management Enhancements (Prime) Presentation 

Heidi Giesbrecht, Nelson Lah and John Wightman provided with Board with an update of PharmaNet’s PRIME project. 

In June 2015, the Ministry of Health enacted the Information Management Regulation under the Pharmaceutical Services Act. This regulation introduced new requirements for how access to PharmaNet is granted and managed. 

The College recommends that registrants and other healthcare professionals familiarize themselves with the new requirements and how they affect access to PharmaNet within their practices. 

To implement the changes legislated by the Information Management Regulation and required by government policy and standards, the Ministry of Health launched the PharmaNet Revisions for Information Management Enhancement (PRIME) Project.

The project seeks to deliver a Registration and Enrolment Management solution that will ensure that all PharmaNet access is secure, transparent and accountable.

The purpose of PRIME is to design and implement a solution for PharmaNet user management that 

  • Provides access to PharmaNet information for patient care 
  • Satisfies the requirements of the Information Management Regulation, government policy and best practice, 
  • Standardizes processes across the province, and 
  • Ensures that all access is transparent and accountable

The PRIME project team looks forward to working with the College to help ensure that registrants are as educated as possible on privacy and security and how they affect individual practices. 

Pharmaceutical Services Division/Ministry Update Presentation 

Mitch Moneo, Assistant Deputy Minister of Health provided the Board with an update on the activities of the Pharmaceutical Services Division.

PDAP Mobile Launch

Earlier this year, the College created a Professional Development and Assessment Program (PDAP) Mobile Application to provide pharmacists and pharmacy technicians with an accessible and convenient application where they can create, edit and submit their CE-Plus requirements to the College on a mobile device. 

The PDAP Mobile App is now available through both Google’s Play Store and Apple’s Apple Store.  Frank Lucarelli, Board member and chair of the Quality Assurance Committee, spoke about the College’s plans to share the new tool with registrants. 

Stay tuned for more information coming soon.

Launch of New College Strategic Plan Site 

Gillian Vrooman, the College’s Director of Communications and Engagement, presented information to the Board regarding the launch of a new website for the College’s current 2017/18 – 2019/20 Strategic Plan.

Currently, the College’s Strategic Plan is published as a PDF and linked to off the College’s website. 

The new site, to be launched in June 2018, will provide registrants and the public with new way to engage with the College’s strategic plan, including how to track our progress on individual strategic goals and objectives.

This site is intended to enhance the accessibility and transparency of the College’s strategic plan, and its progress against it. 

Stay tuned for the new strategic plan site launch!

College 2017/2018 Annual Report 

Gillian Vrooman, the College’s Director of Communications and Engagement unveiled the College’s 2017/2018 Annual Report Website. 

The site is designed to enhance the accessibility and transparency of the College’s Annual Report, making it easy for the public, registrants and other stakeholders to discover information about the College’s activities over the past fiscal year. 

The Annual Report is a required accountability report that provides highlights and statistics from the past fiscal year, as well as the College’s audited financials. 

The 2017/2018 Annual Report will be released by the end of June 2018. 

Committee Updates 

The following College Committees provided updates on their activities since the previous Board meeting.

  • Governance Committee 
  • Hospital Pharmacy Advisory Committee 
  • Inquiry Committee 
  • Practice Review Committee 
  • Audit and Finance Committee 
  • Quality Assurance Committee 
  • Community Pharmacy Advisory Committee 
  • Jurisprudence Examination Subcommittee 
  • Discipline Committee 
  • Legislation Review Committee 
  • Registration Committee 
  • Application Committee 
  • Ethics Advisory Committee 
  • Residential Care Advisory Committee 
  • Drug Administration Committee