Under PPP-58, pharmacists can utilize their professional judgement to adapt (renew) a prescription, for whatever period of time they feel is appropriate for non controlled substances, as long as the duration does not exceed the expiry of the prescription. When adapting, the pharmacist must ensure they have sufficient knowledge, understanding and client-specific information to determine if the adaptation and subsequent continuation of therapy is in the best interest of the client.
Documentation establishes accountability and responsibility for performing prescription adaptations. It is an important component in demonstrating how the pharmacist exercised their professional judgement through documentation of their rationale and case-specific details that support the pharmacist’s decision to adapt.
Some tips for documentation include:
In BC, the obligation to obtain informed consent to healthcare from an adult client, the criteria for consent, and how to obtain consent, is set out in the Health Care (Consent) and Care Facility (Admission) Act.
That Act states that every adult client has the right to give, refuse or withdraw consent to treatment. Providing treatment by adapting a prescription in accordance with PPP-58 requires the pharmacist to obtain consent from the particular client.
Documentation and notification of adaptations must meet the requirements listed in part 3(f) and (g) of PPP-58. A pharmacist can choose to use their own templates but must ensure that all the required information is documented and retained as part of the client’s record.
All prescriptions (new and existing) are valid for up to TWO years from the prescribing date, with exception of prescriptions for benzodiazepines and other targeted substances, which are valid for a period of up to ONE year from the prescribing date (unless validity up to two years is permitted by a section 56 exemption to the Controlled Drugs and Substances Act).
A pharmacist must use their professional judgement to determine if they have ‘sufficient information’ specific to the client each time they consider adapting a prescription.
In doing this, a pharmacist must ensure they review all relevant information that is available to them. This would include, but is not limited to, a review of the client’s local and PharmaNet record, any client specific information conveyed by the prescriber and any information obtained directly from the client or their representative.
A pharmacist must use their professional judgement to determine if they have the ‘appropriate knowledge and understanding of the condition and the drug being dispensed’ each time they consider adapting a prescription, as each situation can be unique.