PRP Annual Report 2019/2020: What We Learned Part 1

PRP Annual Report 2019/2020: What We Learned

Findings from the Pharmacy Professionals Review – Part 1: Pharmacists

The Practice Review Program (PRP) conducts a comprehensive review of pharmacy and pharmacy professional (pharmacists and pharmacy technicians) practice, to ensure compliance with College standards. Practice reviews play an important role in identifying areas of non-compliance and ensuring consistent delivery of pharmacy services across BC.

Read the 2019/2020 PRP Annual Report

This is the first in a series of articles discussing the top areas of non-compliance noted during both Pharmacy Professionals’ Reviews and Pharmacy Reviews, as outlined in the 2019/2020 PRP Annual Report. These insights are intended to support pharmacy professionals as they reflect on their practice and identify opportunities for improvement.

Top Areas of Non-Compliance for Pharmacists During the 2019/2020 Fiscal Year

During the 2019/2020 fiscal year, 666 community pharmacists and 241 hospital pharmacists were reviewed. During practice reviews, pharmacy professionals are observed performing regular pharmacy duties and evaluated based on four focus areas critical to safe and effective pharmacy practice and specific to their scope of practice. Pharmacists in both practice settings are evaluated on the following focus areas: patient identification verification, profile check, counselling, and documentation.

Compliance Officers found missing required counselling points, and failure to provide required prescription counselling were the top areas of non-compliance among both hospital and community pharmacists.

In providing quality care, pharmacists’ responsibility extends beyond simply providing the right patient with the right drug. The pharmacist must ensure that the patient knows about the medication they are taking and understands how to take it appropriately to optimize therapy and promote adherence.

COMMUNITY PHARMACY STANDARDS OF PRACTICE

Health Professions Act Bylaws Schedule F Part 1 s.12(1):

12. (1) Subject to subsection (2), a full pharmacist must consult with the patient or patient’s representative at the time of dispensing a new or refill prescription in person or, where not practical to do so, by telephone.

HOSPITAL PHARMACY STANDARDS OF PRACTICE

Health Professions Act Bylaws Schedule F Part 2 s.8:

(8) A full pharmacist, or a limited or student pharmacist under the direct supervision of a full pharmacist, must provide drug consultation to an outpatient or the outpatient’s representative, or to an inpatient on request.

Counselling in Community Pharmacy

The College would like to remind community pharmacists that the Health Professions Act Bylaws Schedule F, Part 1: Community Pharmacy Standards of Practice requires prescription counselling to be provided to the patient or the patient’s representative in person or, where not practical to do so, by telephone. It is important to emphasize that every prescription, both new and refill, requires counselling by the pharmacist. Simply asking if the patient has any questions is not sufficient.

It is vital that pharmacists understand the role they play in helping to manage a patient’s health. One of the key functions of a pharmacist is to provide drug education and monitoring through patient counselling. The provision of patient counselling is critical to ensure that the patient receives and understands important information related to their drug therapy at the time of dispensing.

TAble 1 Counselling Points Required for new and refill prescriptions in community pharmacy practice
Counselling for NEW prescriptions must include: Confirmation of the identity of the patient Name and strength of drug Purpose of the drug Directions for use of the drug including the frequency, duration and route of therapy Potential drug therapy problems, including any avoidance measures, and action recommended if they occur Storage requirements Prescription refill information How to monitor the response to therapy Expected therapeutic outcomes Action to be taken in the event of a missed dose When to seek medical attention Issues the pharmacist considers relevant to the specific drug or patient	Counselling for REFILL prescriptions must include: Confirmation of the identity of the patient Name and strength of drug Purpose of the drug Directions for use of the drug including frequency and duration Whether the patient has experienced a drug therapy problem

TAble 1

Counselling Points Required for new and refill prescriptions in community pharmacy practice

Counselling for NEW prescriptions must include:

Confirmation of the identity of the patient
Name and strength of drug
Purpose of the drug
Directions for use of the drug including the frequency, duration and route of therapy
Potential drug therapy problems, including any avoidance measures, and action recommended if they occur
Storage requirements
Prescription refill information
How to monitor the response to therapy
Expected therapeutic outcomes
Action to be taken in the event of a missed dose
When to seek medical attention
Issues the pharmacist considers relevant to the specific drug or patient

Counselling for REFILL prescriptions must include:

Confirmation of the identity of the patient
Name and strength of drug
Purpose of the drug
Directions for use of the drug including frequency and duration
Whether the patient has experienced a drug therapy problem

Counselling in Hospital Pharmacy

Unlike community pharmacy practice where pharmacists are required to counsel on every new and refill medication dispensed, hospital pharmacists are required to provide counselling on all outpatient prescriptions but only inpatient medications upon request. The counselling requirements for hospital pharmacists dispensing to outpatients are the same as those for community pharmacists dispensing to community patients and pharmacists are required to counsel the points as listed in table 1 above.

When inpatient consultations are requested, patient counselling in hospital practice must include the following information

table 2 counselling points required for hospital inpatients (when requested)
Confirmation of the identity of the patient Name and strength of drug Purpose of the drug Directions for use of the drug including the frequency, duration and route of therapy Common adverse effects, drug and food interactions and therapeutic contraindications that may be encountered, including their avoidance, and the actions required if they occur Storage requirements Prescription refill information How to monitor the response to therapy Expected therapeutic outcomes Action to be taken in the event of a missed dose When to seek medical attention Other information unique to the specific drug or patient

table 2

counselling points required for hospital inpatients (when requested)

Confirmation of the identity of the patient
Name and strength of drug
Purpose of the drug
Directions for use of the drug including the frequency, duration and route of therapy
Common adverse effects, drug and food interactions and therapeutic contraindications that may be encountered, including their avoidance, and the actions required if they occur
Storage requirements
Prescription refill information
How to monitor the response to therapy
Expected therapeutic outcomes
Action to be taken in the event of a missed dose
When to seek medical attention
Other information unique to the specific drug or patient

For additional practice insights from the 2019/2020 review cycle, please read the Full Report.

Practice Review Program Annual Report 2019-2020 (PDF)

Additional Resources

Practice Review Program, PRP Insights

SRD

PRP Annual Report 2019/2020: What We Learned Part 1 Apr. 29, 2021 Practice Review Program, PRP Insights