Should pharmacists with additional prescribing authorization (APA) collaborate with other regulated health professionals?

July 25, 2018

Collaboration among health professionals can benefit patients, but there are rules pharmacists with APA must follow.

It’s generally accepted that two heads are better than one, so it makes sense that more and more pharmacists are collaborating with other health professionals to provide the best care possible to their patients. For pharmacists with additional prescribing authorization, however, there are rules that must be followed when collaborating with other health professionals to prescribe medication to individuals.

“It’s important to follow the standards of practice and be aware of these rules, because not all health professionals are authorized to prescribe medication,” said Jeff Whissell, ACP’s Deputy Registrar. “In many instances, pharmacists with additional prescribing authority need to take sole responsibility to prescribe.”

Standard 14 from the Standards of Practice for Pharmacists and Pharmacy Technicians provides clarity regarding collaboration when prescribing. According to Standard 14.6, a pharmacist who prescribes based on the recommendation of another authorized prescriber must

  1. receive a written recommendation from the prescriber or reduce a verbal recommendation to writing,
  2. confirm that the prescriber is authorized to prescribe in Alberta, and
  3. develop a collaborative relationship with the prescriber to obtain diagnostic and other relevant health information and to determine mutual goals for therapy.

If a pharmacist wishes to prescribe based on collaboration with another regulated health professional who does not have prescribing authority, Standard 14.7 states that the pharmacist must

  1. confirm that the health professional is a regulated member of a college with whom the Alberta College of Pharmacy has a memorandum of understanding in relation to collaborative prescribing, and
  2. develop a collaborative relationship with that other regulated health professional to obtain diagnostic and other relevant health information and to determine mutual goals of therapy.

Currently, physiotherapists are the only regulated health professionals with whom ACP has a memorandum of understanding. That means pharmacists with additional prescribing authorization must not prescribe based on collaboration with any other regulated health professional who is not authorized to prescribe themselves.

“For example, if a pharmacist has discussed a patient’s condition with the patient’s naturopath, the pharmacist needs to make their own, fulsome assessment of the patient when prescribing medication,” said Jeff. “No matter what conversations have taken place, the pharmacist and pharmacist alone is responsible for making an assessment and prescribing what they feel is most appropriate for the patient.”

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