Prescriptive Authority for Pharmacists
The laws in Saskatchewan have been changed to allow pharmacists to issue prescriptions under certain circumstances where they are trained to do so. Some of your questions regarding this are answered below.
You can ask your pharmacist directly any questions you may have.
What does prescriptive authority for pharmacists mean?
It means changes to provincial laws to recognize pharmacists as prescribers of drugs.
Under a combination of federal and provincial laws, most drugs are only available by prescription. That is because it takes a trained professional to make the decision that these drugs are appropriate for you. When that decision occurs, that professional can issue a prescription for you when the law permits.
The federal law over regular prescription drugs recognizes pharmacists as prescribers when the same occurs under provincial laws. The laws in Saskatchewan have been changed to allow pharmacists to issue prescriptions under certain circumstances where they are trained to do so.
Can my pharmacist prescribe me any kind of drug?
No, your pharmacist cannot prescribe Controlled Substances.
They include narcotics and other mood-modifying drugs. Pharmacists cannot prescribe drugs that can cause addiction or dependency and abuse.
Does this mean that I no longer need a doctor for my medications?
The pharmacist as a prescriber of drugs is NOT intended to replace your doctor or other health care provider. On the contrary, the new laws depend upon a close working relationship between you, your doctor and your pharmacist.
Pharmacists are not trained like doctors to diagnose the more serious ailments for which you cannot look after yourself and need a medical diagnosis. But, they are trained to recognize what might be the best medication for you for that diagnosis made by your doctor. That is why we are not intending to replace your doctor, but are intending to work more closely with him or her.
For some less serious ailments for which you can look after yourself, your pharmacist may be able to help you with more effective prescription drugs. This is explained further below under minor ailments.
Is my doctor informed?
Yes, your pharmacist notifies your doctor after s/he has prescribed your medication.
In addition, any prescribed medications are recorded on the Saskatchewan pharmaceutical drug registry called Pharmaceutical Information Program (PIP) for other providers to see.
If I don't have a doctor, can my pharmacist prescribe for a minor health issue?
Yes. If the condition and treatment required is within pharmacists' prescribing limits, you may still receive treatment even if you do not have a doctor.
This service is intended to improve access to health care.
Give me some examples
Prescribing is allowed in various circumstances (see list below) and when pharmacists have advanced skills.
Instead of having to contact your doctor first, your pharmacist can make these prescribing decisions for you and then tell your doctor about them. For example:
Continuing maintenance therapy - You are taking medications regularly, your prescription has run out and you can’t get in to see your doctor for several days. Your pharmacist can provide the supply you need until you are able to visit your doctor, and will let your doctor know.
Emergencies - You take a medication once in a while when needed, or perhaps regularly. You are on a trip, have left this medication at home and need it. Your pharmacist can provide you with a supply until you return home, and will let your doctor know.
Incomplete prescriptions - Sometimes your doctor will inadvertently forget to include some details important to your pharmacist about the drug being prescribed for you. Because your pharmacist knows you and your doctor and is reasonably certain of your doctor’s intent, s/he fills in the details to complete the prescription. Again, your pharmacist will let your doctor know.
Physician’s absence - Doctors sometimes temporally leave their practices for extended periods of time, such as for vacation or education. When that happens, they can leave instructions with your pharmacist to continue the medications for you and other patients if prescriptions run out while s/he is away.
Seamless care - When you are ill and admitted to a health care facility, your medications can change. If you are transferred from that health care setting to another, for example are discharged and return to your community, your pharmacist can make sure that your new medication therapy continues uninterrupted. Again, your pharmacist will let your doctor know.
Self-care – see "What is a minor ailment and what can my pharmacist do to help?' and "What happens if the minor ailment turns out to be more serious?" questions.
Pharmacists with advanced skills – Please see the "What can pharmacists do with advanced skills or training?" question.
In prescribing drugs, who else does my pharmacist work with?
Besides family doctors and medical specialists, the new laws recognize that the pharmacist can also work with nurse practitioners, dentists, optometrists, and midwives.
Besides your doctor who is a licensed physician, licensed Nurse Practitioners, Dentists, Optometrists and Midwives are also allowed under the law to prescribe drugs according to their training. So, when one of these professionals is directly involved in your care, your pharmacist will work with them in the same way that s/he would work with your doctor.
Are there times when the pharmacist is able to prescribe, but decides not to?
Yes, under two main circumstances and with some limits.
The first is that your pharmacist believes, for a wide variety of reasons, that your doctor might not support his/her decision. That will mean that your pharmacist will check firstly with your doctor.
The second is when, in the judgment of your pharmacist, prescribing a drug is not the right thing to do for you. This can occur for a variety of reasons that can often be related to a change in your health status. Your pharmacist is trained to recognize when it is appropriate to refer you to medical care.
What is a minor ailment and what can my pharmacist do to help?
A minor ailment is generally a condition that is less serious for which you can look after yourself and may not need to see your doctor. For some ailments, your pharmacist can provide you with a limited course of treatment with a prescription drug that may be more effective than an over-the-counter medication.
Minor ailments, besides being less serious, can also be self-limiting meaning that they only last for a short period of time. Many medications and remedies are available to you over-the-counter without a doctor’s prescription to help you treat these ailments yourself. Your pharmacist can continue to help you with selecting the most appropriate remedy or medication and is able to provide prescription drugs for some ailments such as:
- mild acne
- hay fever, seasonal allergies
- cold sores
- diaper rash
- insect bites
- canker sores
- oral thrush
- painful menstruation
- gastric reflux
- muscle strains and sprains
- bacterial skin infections
- athlete's foot, ring worm, groin itch
- emergency contraception
- bladder infections (urinary tract infections)
- birth control
Over-the-counter remedies you have tried do not help. Your pharmacist will help you assess your need for relief and may be able to provide a prescription drug that is a better option for you.
What happens if the minor ailment turns out to be more serious?
When your pharmacist prescribes a drug for a minor ailment for you, s/he will let your doctor know. Your pharmacist will work with you to determine the success of the treatment. If for example the drug does not work as well as it is supposed to or your condition is more serious, your pharmacist will refer you to your doctor.
Is this safe?
Yes. All licensed pharmacists have mandatory training on the processes and standards before they can offer you this service.
What can my pharmacist do with advanced skills or training?
They can become even more involved in helping you and your doctor manage your drug therapy.
The new law allows more advanced prescribing for pharmacists with additional skills or training. This is allowed under special formal agreements with doctors. Doctors and pharmacists can agree to allow the pharmacist to decide on the appropriate medications that should be used to treat the condition as diagnosed by your doctor. For example, some pharmacists have advanced training in the treatment of diabetes, and under these special agreements, doctors will refer their diabetic patients to these pharmacists for selecting the medications and monitoring patient response to these medications.
When did this law become effective?
March 4, 2011 was the effective date for these new laws.
On March 2, 2011, the Minister announced that new legislation would come into force March 4, 2011. This followed a period of time that was needed to receive feedback from interested parties, and to provide pharmacists with all of the tools and assistance they will need for this new role.
Is this happening in other provinces?
Pharmacists can prescribe in most, but not all provinces at this time.
Different provinces are in different stages of allowing pharmacists to prescribe. Those that do may have different rules. What we are describing here applies to pharmacists in Saskatchewan.