Frequently Asked Questions from Pharmacy Practice - Summer 2018

PRIVACY

Q: I received a summons from another regulatory body requesting patient identifying information for an investigation. Is there any requirement on my part to obtain patient consent to release this confidential information?

Q: A police officer has requested information regarding a patient currently under investigation for fentanyl diversion and patch tampering. Can I provide this information?

ANSWER

Please refer to the Fact Sheet — Releasing Personal Health Information, which describes a few of the more common disclosures permitted by health information custodians, which pharmacists are, under the Personal Health Information Protection Act (PHIPA). You can also to refer to the legislation directly for complete details or contact the Information and Privacy Commissioner of Ontario.

Regarding requests from health regulatory colleges in Ontario, all colleges including OCP must follow the same Health Professions Procedural Code (set out in the Regulated Health Professions Act). Colleges also establish Rules of Procedure, as any hearings in Ontario must meet the standard for procedural fairness mandated by the Statutory Powers Procedure Act. You could reach out to the investigator directly regarding questions about their rules of procedure.

Specific to fentanyl, please refer to the Patch-For-Patch Fentanyl Return Program: Fact Sheet. Regulation 305/16 under the Safeguarding Our Communities Act (Patch for Patch Return Policy) has specific provisions for dispensers providing information to law enforcement. Please refer to section 4(3) under Contingency Plan’ in the regulations.

CLOSING A PHARMACY

Q: I am closing my pharmacy and need to transfer patient files. However, I am uncertain of the rules pertaining to narcotics and controlled substances; would patients be required to get a brand new prescription for all narcotic and controlled medication, or is there a system in place for moving these items, recognizing that there are no “transfers” of narcotic and controlled substances, except benzodiazepines?

ANSWER

When closing a pharmacy, the patient files and prescription records are transferred or relocated to the receiving Designated Manager (DM)/owner, and the prescriptions will then belong to the receiving pharmacy. Exactly “how” the records are entered or merged into the receiving pharmacy’s software system is sorted out by the DMs and the vendor(s). Ideally, it should be seamless to the patient.

This “transfer of records” process is not the same as a prescription transfer (as permitted by the Drug and Pharmacies Regulation Act) from one accredited pharmacy to another at the patient’s request, where transfer of narcotics and controlled prescriptions is prohibited by federal regulations.

Pharmacies and pharmacy professionals participating in the closure of a pharmacy should review the College’s Closing a Pharmacy webpage. Additionally, the College’s Guideline on Record Retention, Disclosure and Disposal can provide additional information on the management of patient records.

MOHLTC PROGRAMS (MedsCheck, Smoking Cessation, etc.)

Pharmacy Practice often receives questions about Ministry of Health and Long Term Care programs that are not administered by the College, for example, MedsCheck, Pharmaceutical Opinion Program, Smoking Cessation, the Universal Influenza Immunization Program, and the Narcotic Monitoring System. For Quick Links to the Ministry of Health and Long-Term Care Ontario Public Drug Programs, please see Quick Links to Ontario Public Drug Programs, MOHLTC. The following Frequently Asked Questions illustrate scenarios when it is necessary to contact an external resource.

Q: I’m a pharmacist practicing in Ontario. Is there a course I need to take to perform a Diabetes MedsCheck? Also, can my pharmacy student do a MedsCheck and sign the forms on his own?

ANSWER

From a scope of practice perspective, a pharmacist may conduct a comprehensive medication review for a patient according to the Standards of Practice.

Establishing the MedsCheck program eligibility criteria for patients and pharmacists falls under the mandate of the Ministry of Health and Long Term Care (MOHLTC). Information related to billing, such as submitting a claim for reimbursement and the required paperwork, can be found in the materials available on the MOHLTC website, such as the Professional Pharmacy Services Guidebook, and the Ontario Pharmacists Association’s MedsCheck FAQ. Additional questions can be directed to the ODB HelpDesk or Medscheck.Moh@ontario.ca.

For example, the MOHLTC may require the pharmacist to meet certain education requirements to be eligible to receive reimbursement for providing a MOHLTC professional service program.

As pharmacists are self-regulated professionals, the College cannot interpret the Guidebook on behalf of a member and/or determine whether or not the Ministry’s criteria have been met.

Q: I have a question regarding the Smoking Cessation Program. Are pharmacists required to take a smoking cessation training program or special course? If so, which specific programs will qualify?

ANSWER

As explained in the Guideline, “Initiating , Adapting and Renewing Prescriptions,” pharmacists have the independent authority to initiate treatment for smoking cessation with buproprion or varenicline under O. Reg 202/94 of the Pharmacy Act.

The regulations do not require a pharmacist to complete specific training prior to initiating treatment for smoking cessation. Similarly, OCP does not require or endorse a particular program you may wish to take. As with any patient care scenario, pharmacists are relied upon to practice within the limits of their competence, and to obtain the knowledge and skills necessary to carry out their professional duties.

However, you may be required to complete a certification course for the purposes of obtaining reimbursement for providing a specific smoking cessation service offered through a patient’s third-party insurer or the MOHLTC.