Prescribing by pharmacists in Alberta

Abstract

The evolution of prescribing by pharmacists in Alberta is described. The prescribing model for pharmacists registered with the Alberta College of Pharmacists is defined by three categories of prescribing a Schedule 1 drug, a drug available only by prescription in Alberta. Pharmacists are not authorized to prescribe narcotics and controlled drugs (i.e., opium and its derivatives, barbiturates, and benzodiazepines) that are federally regulated. The first two categories of prescribing, adapting a prescription and prescribing in an emergency, legitimize existing practices that were not previously recognized in legislation. When adapting a prescription, the pharmacist modifies an existing prescription either to meet the unique needs of the patient or to extend therapy on an incidental basis when the patient is unable to contact the original prescriber. Emergency prescribing enables pharmacists to prescribe in unique situations when patients are unable to access other health services. Additional prescribing, the third category, provides pharmacists who successfully complete an application process the ability to independently prescribe--a privilege that is not authorized in any other jurisdiction in North America. By April 1, 2007, over 2800 pharmacists who were registered on the clinical registry had completed the orientation program necessary for prescribing to adapt a prescription or for an emergency encounter, and by September 1, 2007, over 3300 had completed the program. Fifteen pharmacists were granted additional prescribing privileges after completing a pilot program. Collaborative efforts among health care professionals, regulatory health authorities, and patients led to the development of the current prescribing model for pharmacists practicing in Alberta. The model includes provisions for adapting a prescription, prescribing in an emergency, and additional prescribing by pharmacists who obtain authorization.