The Collège des médecins du Québec and the Ordre des pharmaciens du Québec conclude an historic agreement

Original source: L’Ordre des pharmaciens du Québec

Translated by: Canadian Pharmacists Association

The bill to amend the Pharmacy Act was tabled today in the National Assembly. The content of this bill reflects an historic agreement concluded recently between the Collège des médecins du Québec and the Ordre des pharmaciens du Québec.

Under this agreement, the Pharmacy Act will allow pharmacists to carry out the following activities aimed at improving the accessibility and continuity of public health care:

I.   Renewal of prescriptions
II.  Adjustment of prescriptions
III. Administration of medications for instructional purposes
IV. Initiation of medication therapy for preventive purposes
V.  Request of laboratory analyses to ensure appropriate use of medications in a health-care institution

In addition, under the agreement between the College and the Order, pharmacists will be able to initiate medication therapy for minor conditions for which the diagnosis and treatment are already known, and to request certain laboratory analyses in a community pharmacy. Both these activities will be possible pursuant to the Medical Act.

Procedure

Changes to the Pharmacy Act
For activities I. (Renewal), II. (Adjustment), III. (Administration for instructional purposes), IV. (Initiation for preventive purposes) and V. (Analyses in a health-care institution), the bill provides for amendment of the Pharmacy Act.

Both professional bodies have identified a priori the following conditions as circumstances in which a medication would be used for preventive purposes: smoking cessation, malaria prevention, traveller’s diarrhea, hormonal contraception following emergency oral contraception, the prevention of infant abnormalities through the use of vitamin supplements (folic acid and multivitamins) during pregnancy, pediculosis, pinworms, and nausea and vomiting associated with pregnancy.

Authority pursuant to section 19(b) of the Medical Act
For the treatment of minor conditions for which the diagnosis and treatment are already known, and to request laboratory analyses in a community pharmacy, our two professional bodies have agreed to the adoption of a regulation pursuant to section 19(b) of the Medical Act.

Section 19(b) of the Medical Act stipulates that the board of directors of the Collège des médecins may, by regulation, “determine among the activities referred to in the second paragraph of section 31 those which, under certain prescribed conditions, may be engaged in by classes of persons other than physicians; for that purpose, the board of directors may, in the regulation, establish an advisory committee”.

The conditions which, thus far, have been formally agreed upon between the two professional bodies in this context are: labial herpes, allergic rhinitis, urinary infection, allergic conjunctivitis, contact dermatitis, dysmenorrhea, diaper rash, swimmer’s ear, vaginal yeast infection, and acne (topical treatments).

Intensive effort to draft regulations to respond quickly to patient needs
In view of the significant patient needs, our two professional bodies, even before the bill’s adoption, have begun the task of drafting regulations to allow pharmacists to carry out these new activities. The regulations will provide safeguards and decision trees for ensuring the quality of procedures and the safety of patients.

This task will involve intensive, close cooperation between the College and the Order. We have set a 12‑month timeframe for the adoption of these regulations, and hope that the necessary legislative instruments are quickly adopted by the National Assembly to make these intentions a tangible reality for the people of Quebec.

Interdisciplinary practice
From the start of the discussions, the Order made it clear that it does not intend for its members to make diagnoses. In addition, the College pointed out that the training of pharmacists includes recognition of signs and symptoms in patients to enable them to dispense advice for choosing over-the-counter medications, as well as recognition of warning signs requiring referral to a physician.

The discussions also enabled the two bodies to look at collective prescriptions from a new perspective and to provide for collaborative practice with other health-care professionals when a diagnosis or physical examination is called for. This new approach to collective prescriptions could help improve access. Exchanges on this subject will continue.

The result of a collaborative effort
We are very pleased with this agreement, the result of a remarkable collaborative effort and of the very fast and effective work of the joint committee of our two bodies. Patient needs call for new approaches. Thanks to the work that has been done, we have found ways of addressing the needs of the public, while ensuring that the two disciplines and their respective qualifications are respected.  

For more information:

L’Ordre des pharmaciens du Québec, le Collège des médecins du Québec or Bill n°41 : An Act to amend the Pharmacy Act