COVID-19 Guidance for Pharmacists and Pharmacy Technicians

With the exception of health care facilities, all mandatory public health restrictions in Alberta related to COVID-19 were lifted on June 14, 2022. However, the COVID-19 pandemic continues, and public health measures may change to adapt. The guidance provided in this document is intended to provide pharmacists and pharmacy technicians with foundational information and advice, but be advised that anything that appears in this document is subject to change.

Page last updated on June 30, 2022, at 10:00 a.m. MT.

June 2022

Document Update Date
Temporary accomodation to prescribe without seeing a patient in person  Removed guidance: Authorization expired. June 30, 2022
Temporary guidance for Opioid Agonist Therapy (OAT) Updated guidance: Edited for clarity. June 30, 2022
Guidance for prescription delivery Updated guidance: Edited for clarity. June 30, 2022
Delivery of drugs to assisted living facilities Removed guidance: No longer relevant due to changes to public health orders. June 30, 2022
Pharmacists and pharmacy technicians working remotely Removed guidance: No longer relevant due to changes to public health orders. June 30, 2022
Temporary authorization to collect a throat swab specimen for testing for COVID-19 Updated guidance: Edited for clarity. June 30, 2022
COVID-19 assessment and referral Updated guidance: Adjusted based on changes to public health orders. June 30, 2022
General advice to pharmacy licensees and registrants Updated guidance: Adjusted based on changes to public health orders. June 30, 2022
Planning and preparation for pharmacy staff shortages resulting from COVID-19 Removed guidance: No longer relevant due to reduction of COVID-19 cases. June 30, 2022
Preventative COVID-19 exposure measures in pharmacies Removed guidance: No longer relevant due to changes to public health orders. June 30, 2022
Personal Protective Equipment (PPE) for direct patient care Updated guidance. Adjusted based on changes to public health orders. June 30, 2022
Management of staff illness Removed guidance: No longer relevant due to changes to public health orders. June 30, 2022
Management of patient illness Removed guidance: No longer relevant due to changes to public health orders. June 30, 2022
Noncompliance with mandatory requirements to self-isolate Removed guidance: No longer relevant due to changes to public health orders. June 30, 2022

March 2022

Document Update Date
Planning and preparation for pharmacy staff shortages resulting from COVID-19 Updated guidance: Adjusted based on public health order changes effective March 1, 2022. March 7, 2022
Personal protective equipment (PPE) for direct patient care Updated guidance: Adjusted based on public health order changes effective March 1, 2022. March 7, 2022
Management of patient illness Updated guidance: Adjusted based on public health order changes effective March 1, 2022. March 7, 2022

February 2022

Document Update Date
Delivery of drugs to assisted living facilities Updated guidance: Updated outdated standards reference. February 23, 2022
COVID-19 assessment and referral Updated guidance: Updated outdated web links and removed guidance that was no longer relevant. Feburay 23, 2022
General advice to pharmacy licensees and registrants Updated guidance: Updated outdated web links and removed guidance that was no longer relevant. February 23, 2022
Preventative COVID-19 exposure measures in pharmacies Updated guidance: Removed guidance that was no longer relevant. February 23, 2022
Personal protective equipment (PPE) for direct patient care Updated guidance: Removed outdated web links. February 23, 2022
Management of staff illness Updated guidance: Updated outdated web links and removed guidance that was no longer relevant. February 23, 2022
Management of patient illness Updated guidance: Updated outdated web links and removed guidance that was no longer relevant. February 23, 2022

January 2022

Document Update Date
Temporary guidance for Opioid Agonist Therapy (OAT) Updated guidance: Updated references in the Pharmacist prescribing of OAT section. January 27, 2022
Guidance for prescription delivery Updated guidance: Removed outdated reference to retired guidance. January 25, 2022
Temporary accommodation to prescribe without seeing the patient in person New guidance: To meet the needs of patients who are isolating or quarantining due to COVID-19, ACP is providing temporary accommodation for pharmacists to prescribe for patients without seeing them personally January 20, 2022
Temporary authorization to waive requirements to see patients personally Removed guidance: Authorization expired January 5, 2022

October 2021

Document Update Date
Health Canada s56(1) exemption for controlled substances Removed guidance: Replaced by Controlled drugs and substances exemption guidelines October 5, 2021

July 2021

Document Update Date
Administering influenze immunizations to patients during the COVID-19 pandemic Removed guidance: Outdated. July 7, 2021
Prescribing and dispensing drugs to treat COVID-19 Removed guidance: Outdated. July 7, 2021
Administering injections to patients during the COVID-19 pandemic Removed guidance: Outdated. July 7, 2021
Providing virtual care to patients Removed guidance: Replaced by Providing virtual care to patients. July 7, 2021
Pharmacists and pharmacy technicians working remotely Updated guidance: Updated references to virtual care to reflect Providing virtual care to patients. July 7, 2021
Temporary authorization to waive requirements to see patients personally Updated guidance: End date of July 31, 2021 added. July 7, 2021
Repackaging non-prescription medications Removed guidance: Outdated. July 7, 2021
Patient medication supply Removed guidance: Outdated. July 7, 2021
Protecting the vulnerable Removed guidance: Outdated. July 7, 2021
General advice to pharmacy licensees and registrants Updated guidance: Removed references to outdated CMOH orders and travel advisories. July 7, 2021
Personal protective equipment (PPE) for direct patient care Update guidance: Updated requirement for continuous masking to recommendation/best practice. July 7, 2021
Personal protective equipment (PPE) for compounding Removed guidance: Outdated. July 7, 2021
Post-consumer returns Removed guidance: Outdated. July 7, 2021

March 2021

Document Update Date
Administering injections to patients during the COVID-19 pandemic Updated guidance: This document has been updated with guidance and recommendations from the National Advisory Committee on Immunization (NACI) that address the continuity of immunization programs during the COVID-19 pandemic and provide specific recommendations on the use of COVID-19 vaccines. March 12, 2021
Administering influenza immunizations to patients during the COVID-19 pandemic Updated guidance: This document has been updated with guidance and recommendations from the National Advisory Committee on Immunization (NACI) that address the continuity of immunization programs during the COVID-19 pandemic and provide specific recommendations on the use of COVID-19 vaccines. March 12, 2021

February 2021

Document Update Date
Personal protective equipment (PPE) for direct patient care Updated guidance: This guidance has been altered to reflect Alberta Health's new recommendation that pharmacy teams in community practice should evaluate the benefits of adding protective eyewear to their PPE requirements. February 12, 2021

November 2020

Date Update Date
Temporary authorization to collect a throat swab specimen for testing for COVID-19 New guidance: This temporary guidance has been altered in recognition of the pharmacies that are working with government to provide COVID-19 testing. Additionally, this will support COVID-19 testing within Alberta Health Services. November 4, 2020

October 2020

Document Update Date
Temporary changes to care provided to nursing home residents Deleted document: This legislative change is now permanent. October 23, 2020
Temporary compounding of alcohol-based hand sanitizer by pharmacists and pharmacy technicians Deleted document: There is sufficient commercially prepared hand sanitizer to meet the demand. October 23, 2020
Temporary authorization to waive Standard 11.9 when adapting prescriptions Deleted document: Pharmacists should currently be able to fulfill this requirement in their practices. October 23, 2020
Repackaging non-prescription medications Updated guidance: Minor language changes have been made to this guidance. October 23, 2020
Administering influenza immunizations to patients during the COVID-19 pandemic guidance Updated guidance: The post immunization requirements have been updated to ensure that pharmacy team members are advising patients to isolate for 48 hours if they develop symptoms that are consistent with COVID-19. October 23, 2020
COVID-19 assessment and referral Updated guidance: Links within this document have been updated, and a reference to referring Albertans to 811 has been removed. October 23, 2020
Post-consumer returns Updated guidance: Additional guidance for accepting returns has been included, and the reference to the Health Canada Office of Controlled Substances bulletin has been updated. October 23, 2020
Personal protective equipment (PPE) for compounding Updated guidance: The introduction for this guidance has been rewritten as has the section on Considerations when anticipating PPE shortages. References have also been updated. October 23, 2020
Management of staff illness Updated guidance: Updates to the screening protocol for pharmacy staff members for COVID-19, and what to do when a pharmacy staff member has tested positive for COVID-19 has been included. October 23, 2020
Personal protective equipment (PPE) for direct patient care Updated guidance: Information related to PPE shortages has been deleted from this guidance, and additional information on masking has been included. October 23, 2020
Management of patient illness Updated guidance: Additional guidance for screening of patients when arriving to the pharmacy, and guidance in providing care has been included. October 23, 2020
Planning and preparation for pharmacy staff shortages resulting from COVID-19 Updated guidance: Additional resources from CPhA, and suggestions for mask use in the pharmacy have been included in this guidance. October 23, 2020
General advice to pharmacy licensees and registrants Updated guidance: Chief Medical Officer of Health (CMOH) orders have been updated, along with a reference to adhering to municipal bylaws with respect to masking. October 23, 2020
Pharmacists and pharmacy technicians working remotely Updated guidance: Clarity on the provision of services across provincial jurisdictions has been included. October 23, 2020
Administering injections to patients during the COVID-19 pandemic Updated guidance: Additional guidance has been provided for assessing if administering a drug by injection is appropriate, and references have been updated. October 23, 2020
Guidance for prescription delivery Updated guidance: Additional guidance has been provided for documenting delivery of medications. October 23, 2020
Temporary guidance for Opioid Agonist Therapy (OAT) Updated guidance: Additional guidance for witnessed dosing has been included. October 23, 2020
Protecting the vulnerable Updated guidance: Additional guidance for protecting vulnerable individuals including resources has been included. October 23, 2020
Health Canada s56(1) exemption for controlled substances Updated guidance: The introduction to this guidance has been rewritten. This exemption now extends to September 30, 2021, and additional restrictions for extending prescriptions has been included. October 23, 2020

July 2020

Document Update Date
Temporary authorization for throat swab specimen collection New guidance: Due to the COVID-19 pandemic, ACP is supporting Alberta Health’s asymptomatic COVID-19 testing in pharmacies by temporarily enabling the collection of throat swab specimens when conducted as part of a specimen collection program in accordance with Standard 29 of the Standards of Practice for Laboratory and Point of Care Testing (POCT). This document will detail the standards related to specimen collection. In addition, the entire laboratory and point of care testing standards and guidance must be adhered to, including standards related to patient assessment, ordering and interpreting laboratory tests, documentation, and follow up. July 3, 2020
Patient medication supply Updated guidance: Patient medication supply was previously limited to a 30-day supply limit to help ensure that individuals requiring drug therapy had access to their prescribed drug needs. Alberta Health is relaxing its policy that limited prescriptions to a 30-day supply, effective June 15, 2020. This means that pharmacists in Alberta can dispense larger quantities again—up to a 100-day supply. Despite this, pharmacists should use their professional judgement to limit the dispensed quantities of specific drugs that continue to be in short supply, or at risk of a shortage. Alberta Blue Cross, at the direction of Alberta Health, will maintain a list of products in a critical supply situation that pharmacists are able to access. July 3, 2020

June 2020

Document Update Date
Providing virtual care to patients Updated guidance: To support pharmacies that wish to integrate virtual care technology into their practice in response to COVID-19, ACP has updated the Evaluate virtual care technologies and Notify the Office of the Information and Privacy Commissioner (OIPC) sections of the Providing virtual care to patients guidance document. Questions for consideration have been added to assist pharmacy teams in assessing the privacy impact of their proposed changes. Additional information on the requirement to notify OIPC have been provided. June 5, 2020

May 2020

Document Update Date
Additional resources New guidance: A section was added to provide links to documents and websites recommended by the CMOH. May 29, 2020
Management of patient illness Updated guidance: The Screening of patients and Interacting with patients subsections were updated with additional details added to the screening protocol, and what steps to take if a patient screens positive. The Treating symptomatic patients or asymptomatic patients who are required to quarantine in exceptional circumstances subsection was updated with additional guidance along with a link to support pharmacists when they need to treat symptomatic patients or asymptomatic patients who are self-isolating. May 29, 2020
Management of staff illness Updated guidance: The Screening pharmacy staff for COVID-19 subsection was updated. May 29, 2020
Preventative COVID-19 exposure measures in pharmacies Updated guidance: The Alberta Health Services 4 Moments for Hand Hygiene document was added as a link to the hand hygiene sub-section, and additional guidance in the cleaning and disinfecting subsection was added. May 29, 2020
Planning and preparation for pharmacy staff shortages resulting from COVID-19 Updated guidance: A link was added for the Health Canada Risk-informed decision-making guidelines for workplaces and businesses during the COVID-19 pandemic document. May 29, 2020
General advice to pharmacy licensees and registrants Updated guidance: New information on signage, as well as links for signs and infection prevention was added. May 29, 2020
Interim guidance on continuity of immunization programs during the COVID-19 pandemic Updated guidance: To assist providers in supporting patients who may require immunizations during COVID-19, ACP has updated its guidance on administering injections to include a link to Interim guidance on continuity of immunization programs during the COVID-19 pandemic from the National Advisory Committee on Immunization. This guidance document addresses immunizing individuals during the COVID-19 pandemic and the impact of immunization deferral. May 22, 2020
Temporary changes to care provided to nursing home residents New guidance: ACP has added the guidance document “Temporary changes to the care provided to nursing home residents.” This guidance document provides information about Ministerial Order 6/2020 and its temporary modification to the manner in which health services, including prescription services, can be provided to nursing home residents. These temporary changes will give nursing home residents greater access in fulfilling their medication needs and help ensure their medication therapy is not disrupted. May 15, 2020
Management of patient illness New guidance: This section has been added and provides pharmacy team members with guidance on screening patients for COVID-19 and how to conduct appropriate interactions with patients during the pandemic. Additionally, guidance is provided on how to treat symptomatic patients when required for exceptional circumstances. May 15, 2020
Management of staff illness Updated guidance: Screening information, direction on how to manage symptomatic team members, direction on working with Alberta Health Services, and direction on how and when ill team members should return to work has been updated. May 15, 2020
Preventative COVID-19 exposure measures in pharmacies Updated guidance: Significant additional information has been added on hand hygiene, cleaning, and disinfecting the pharmacy, and on workflow adjustments required due to COVID-19. May 15, 2020
Planning and preparation for pharmacy staff shortages resulting from COVID-19 Updated guidance: Additional information has been provided on ensuring compliance with the requirements and recommendations of the CMOH public health order 16-2020 and the Alberta government. May 15, 2020
General advice to pharmacy licensees and registrants Updated guidance: Guidance and links have been added outlining how to achieve compliance with the mandatory CMOH  public health order 16-2020. Additional information on signage has also been added. May 15, 2020

April 2020

Document Update Date
Temporary guidance for Opioid Agonist Therapy (OAT) Updated guidance: When a patient requires an extension or renewal of their OAT prescription and the pharmacist is unable to contact the original prescriber, pharmacists now have the option to assess the patient and prescribe these medications. The updated guidance provides a clinical resource, available to all prescribers, that enables consultation with an OAT specialist physician when additional support with assessment or patient management is required. April 24, 2020
Guidance for pharmacy staff occupational illness Updated guidance: ACP has updated the advice to pharmacy licensees, pharmacists, and pharmacy technicians about preparing for staff illness due to COVID-19, and steps to be taken when a staff member has tested positive. Included are links to resources on cleaning and disinfecting, as well as the AHS protocol for when it is appropriate to return to work. April 24, 2020
Patient medication supply guidance Updated guidance: Given the worldwide disruptions to drug manufacturing, distribution channels, as well as increasing shortages of certain medications, ACP, along with Alberta Health and the Alberta Pharmacists’ Association, have established the expectation that prescriptions are to be provided in quantities that do not exceed a 30-day supply. Questions have been received from the public about this direction and ACP has updated its advice for the public and guidance for patient medication supply for pharmacy professionals. April 24, 2020
Guidance for pharmacists and pharmacy technicians working remotely New guidance: ACP recognizes that some pharmacists or pharmacy technicians may need to work remotely during the COVID-19 pandemic due to self-isolation or pharmacy closure. This guidance provides a framework for pharmacists and pharmacy technicians working remotely, and includes direction on the various requirements, limitations, and on how to mitigate security concerns. April 24, 2020
Post-consumer returns New guidance: Due to COVID-19, there is an increased level of risk associated with accepting post-consumer returns from patients, including unused drugs, expired drugs, and sharps. The ACP post-consumer returns guidance provides pharmacists direction on accepting or refusing to accept these items for disposal. It also provides a link to the bulletin published by the Health Canada, Office of Controlled Substances, on temporary measures for accepting post-consumer returns of controlled substances. April 24, 2020
Personal protective equipment (PPE) for direct patient care Updated guidance: As information about asymptomatic and pre-symptomatic transmission of COVID-19 evolves, additional guidance has been provided by Alberta Health Services (AHS) regarding the need for continuous masking for pharmacy professionals and team members when providing direct patient care services and where physical distancing is difficult. For more information, please review the updated guidance on PPE for direct patient care. April 17, 2020
Administering injections during the COVID-19 pandemic New guidance: ACP has received concerns about pharmacists refusing to provide patients with essential drugs by injection, such as vitamin B12 for cancer patients. This guidance has been developed to support pharmacists in their decision making when a patient requires an injection and to inform pharmacists of their options and obligations when it is determined not safe to perform this activity. April 17, 2020
Temporary guidance for Opioid Agonist Therapy (OAT) Updated guidance: Due to the requirements for self-isolation and social distancing, many Opioid Agonist Therapy (OAT) patients might be receiving carried doses more frequently than normal. The OAT section update provides guidance on the importance of an assessment and providing an adequate supply of naloxone to avoid opioid poisoning in these vulnerable patients. April 9, 2020
Health Canada s56(1) exemption for controlled substances Updated guidance: There may be times where a pharmacy is temporarily closed due to COVID-19 and patients cannot access their prescriptions for controlled substances. The s56 exemption section update describes circumstances when it would be appropriate for a pharmacist to prescribe an extension for controlled substances when they do not have a copy of the original prescription at their pharmacy. April 9, 2020
Preventative COVID-19 exposure measures for pharmacists and pharmacy technicians Updated guidance: As knowledge of COVID-19 transmission develops, we are providing updates on crucial measures for minimizing exposure risks in pharmacies. The update in this document is the reminder that hand hygiene activities should be completed after doffing each PPE element as well as after disposal of these items. April 9, 2020
Personal protective equipment (PPE) for direct patient care Updated guidance: The Alberta Pharmacists’ Association (RxA), with the support of ACP, have worked together to supply personal protective equipment (PPE) for all community-based pharmacies. Pharmacy professionals are reminded that there is a limited supply of PPE across the health system. Judicious use of PPE is imperative. PPE is for direct patient care activities only and must not be sold to the public. More information on allocation, distribution, and best practice when using PPE can be found in this guidance. April 9, 2020
Health Canada s56(1) exemption for controlled substances Updated guidance: Health Canada’s Office of Controlled Substances has provided ACP clarification that targeted drugs may be transferred interprovincially and may be transferred more than one time. The guidance has been updated to reflect this new information. April 6, 2020
Temporary guidance for Opioid Agonist Therapy (OAT) Updated guidance: Information to support pharmacists was reorganized, updated, and moved from the Health Canada s56(1) exemption page of the guidance to its own section. April 6, 2020
Guidance for prescription delivery Updated guidance: When delivering prescriptions to patients, pharmacy professionals are reminded of their responsibility to ensure the safety and integrity of drugs as well as the security of confidential health information. The guidance for prescription delivery section has been updated to highlight these responsibilities.  April 6, 2020
General advice to pharmacists and pharmacy technicians Updated guidance: ACP has updated the general advice to pharmacists and pharmacy technicians section to reflect the current direction from public health. Pharmacy professionals are encouraged to review this to ensure that their information is up to date when triaging patients. April 6, 2020
Preventative COVID-19 exposure measures for pharmacists and pharmacy technicians Updated guidance: The key updates in this article include more details about routine cleaning activities within the pharmacy and workflow strategies that support effective physical distancing. This guidance document also provides links to additional practice resources on hand hygiene, cleaning, and physical distancing efforts. April 6, 2020
Providing virtual care to patients New guidance: ACP has provided temporary guidelines for pharmacy professionals on delivering pharmacy services to patients remotely using virtual care technologies in a manner that meets the standards of practice. April 6, 2020

March 2020

Document Update Date
Pharmacist and pharmacy technician occupational illness Use the online healthcare worker self-assessment tool to help determine whether you need to be tested and to get additional advice on COVID-19, such as the need to self-isolate. This self-assessment tool is for all healthcare workers who think they may have COVID-19 or may have been exposed to COVID-19. March 27, 2020
Temporary compounding of alcohol-based hand sanitizer This temporary guidance is provided to assist pharmacy staff members in carrying out the compounding of ABHS appropriately to reduce the spread of the COVID-19 virus. March 27, 2020
Delivery of drugs to assisted living facilities This document provides guidance in situations when it is not possible to deliver drugs directly to a resident in an ALF. The temporary guidance outlines steps to ensure the integrity of the drug and the confidentiality of patients’ health information during delivery. It also outlines steps to maintain a secure drug supply and minimize risks to others who might come in contact with drugs during transport. March 27, 2020
Non-compliance with mandatory requirements to self-isolate If a pharmacist or pharmacy technician suspects a patient, pharmacy professional, or other healthcare provider is not complying with mandatory Alberta Health measures, guidance has been developed to assist a pharmacist or pharmacy technician in addressing the non-compliance. March 27, 2020
Repackaging non-prescription medications Guidance has been provided to assist in completing repackaging appropriately and safely according to our Standards of Practice for Pharmacists and Pharmacy Technicians and Code of Ethics. March 27, 2020
Guidance for prescription delivery New guidance: information to assist pharmacy professionals with ensuring the safety of patients and delivery persons, security and stability of drugs, and the security of patient health information. March 24, 2020
Patient medication supply Updated guidance: ACP, along with Alberta Health and RxA, have established the expectation that, effective immediately, prescriptions are to be provided in quantities that do no exceed a thirty (30) day supply.  March 24, 2020
Personal Protective Equipment (PPE) for compounding Updated guidance:  Guidance on conservation measures for garb and PPE have been updated to address shortages as ACP actively works to address needs. March 24, 2020
Health Canada s56(1) exemption for pharmacists Updated guidance: Health Canada has published an FAQ to accompany their s56(1) exemption guidance.  March 24, 2020
Prescribing and dispensing of drugs to treat COVID-19 New guidance: ACP has received reports of increased demand for some drugs (e.g., Kaletra®, hydroxychloroquine) due to reports of them being prescribed as treatments for COVID-19. There is an increased urgency to affirm appropriateness of use as per Standard 3 of the Standards of Practice for Pharmacists and Pharmacy Technicians. March 21, 2020
ACP Guidance - Temporary authorizations for controlled substances New guidance: ACP Guidance - Temporary authorizations for controlled substances includes information on how to use the exemption in context with the Standard of Practice for Pharmacists and Pharmacy Technicians. March 19, 2020
Joint message about s56(1) exemption from ACP and CPSA New guidance: Joint message about s56(1) exemption from ACP and CPSA to communicate to their respective members on how to interpret these temporary exemptions and put them into practice. March 19, 2020
Health Canada s56(1) exemption for pharmacists New guidance: Health Canada s56(1) exemption for pharmacists includes information about Health Canada's exemptions for prescriptions of controlled substances under the Controlled Drugs and Substances Act (CDSA) and its regulations. March 19, 2020
COVID-19 Guidance for Pharmacists and Pharmacy Technicians

New guidance: The COVID-19 Guidance for Pharmacists and Pharmacy Technicians includes updated advice in the following areas as they relate to the pandemic:

  • requirements if temporary pharmacy closures extend beyond 14 days;
  • temporary authorization to waive requirements to see patients personally;
  • temporary authorization to waive Standard 11.9 when adapting prescriptions;
  • updated patient advice for COVID-19 assessment and referral;
  • preventative measures such as cleaning surfaces touched by staff and customers, social distancing, and avoiding procedures that generate droplets;
  • and compounding hand sanitizer.
March 17, 2020
COVID-19 Guidance for Pharmacists and Pharmacy Technicians

New guidance: The COVID-19 Guidance for Pharmacists and Pharmacy Technicians includes advice in the following areas as they relate to the pandemic:

  • preventative measures to protect yourself, pharmacy team members, and the public;
  • COVID-19 assessment and referral;
  • hand hygiene and cleaning;
  • medication supply;
  • personal protective equipment (PPE);
  • compounding; and more.
March 13, 2020

 

Pharmacy professionals should also review ACP's COVID-19 resources page on an ongoing and frequent basis for the latest updates.

Caring for patients

Temporary guidance for Opioid Agonist Therapy (OAT)

None of the guidance herein requires a pharmacist to provide Opioid Agonist Therapy (OAT) in a manner that they believe is unsafe for the patient, the pharmacy staff or the public.

Particular consideration should be given to patients who are, because of COVID-19, receiving more carried doses than they normally would. 

Pharmacist prescribing of OAT

Under Health Canada’s Section 56 exemption, pharmacists are permitted to prescribe controlled substances in specific circumstances, including for continuity of OAT. Refer to the ACP Controlled drugs and substances exemption guidelines and the OAT guidelines for specific details to guide your prescribing.

Carried doses

For patients using OAT medications and are isolating due to COVID-19:

  • Pharmacists may accept prescriptions for methadone and buprenorphine-naloxone that include a number of carried doses greater than the standard 14 days.
  • Buprenorphine-naloxone patients may receive up to a 30-day supply of carried doses, in collaboration with the prescriber.
  • The threshold for when to provide carried doses may need to be lowered, and the maximum number of carried doses permitted may need to be altered based on the circumstances of the patient, the prescriber, and the pharmacy. Pharmacists should collaborate with prescribers to consider prescribing carried doses for patients whenever possible, unless the risk of opioid poisoning, to the patient or others around them such as children or roommates, outweighs the risks of presenting in person to the pharmacy.

Guidance for prescription delivery

Pharmacy professionals should exercise professional judgment to determine the most appropriate process to deliver prescriptions based on the circumstances at hand.

  • A patient who is in self-isolation due to COVID-19 should be advised to get someone from outside of their household to pick up their medications. Alternatively, the pharmacy should arrange for the delivery of medications if this service is available.  The medication should be delivered to the patient without direct contact. Operationally, there may be more than one way to accomplish this, which is left to the professional judgment of the pharmacist (e.g., place in mailbox, have delivery person call the recipient once the medication is left, wait or follow up by phone to confirm they have successfully received it, etc.)
  • Pharmacies that require a signature to confirm delivery should consider alternative methods of documentation that would achieve the same purpose.  This may include having the delivery person call the recipient once the medication is dropped off or having the delivery person knock and then waiting at a distance to visual confirm the medication was received or following up by phone to confirm they have successfully received it. Successful delivery should then be documented.
  • When delivering controlled substances, the individual making the delivery must identify the patient or their agent and observe the receipt of the medications prior to leaving the delivery site.
  • Process any payments in advance, if applicable, by secure means when delivery is arranged with the patient, to limit interaction between patients and delivery personnel.
  • On the outside of the packaging, indicate transport conditions (related to temperature, fragility, and safety) and only the information required for delivery to the patient or other recipient (name, address, etc.).
  • Maintain social distancing requirements during the delivery.
  • Ensure any reusable totes used for delivery are sanitized inside and out before they come into the pharmacy and between each use.

Temporary authorization to collect a throat swab specimen for testing for COVID-19

ACP is supporting testing procedures in pharmacies by temporarily enabling regulated members to collect throat swab specimens, when conducted as part of a specimen collection program in accordance with Standard 29 of the Standards of Practice for Laboratory and Point of Care Testing (POCT). Specifically, under Standard 29(b), regulated members may “only collect specimens of capillary blood, saliva, or urine.” This temporary authorization will additionally allow the collection of throat swab specimens.

 When collecting throat swab specimens, all other requirements of Standard 29 apply.

In addition to the standards related to specimen collection, the entire laboratory and point of care testing standards and guidance must be adhered to, including standards related to patient assessment, ordering and interpreting laboratory tests, documentation, and follow up.

COVID-19 assessment and referral

In accordance with current Alberta Health guidance, pharmacists should recommend that patients with symptoms consistent with COVID-19 or that test positive for COVID-19 self-isolate and access the AHS COVID-19 Assessment and Testing Online Tool or call 811. Patients with severe symptoms should be advised to call 911.

Protecting pharmacy staff and patients from COVID-19 transmission in the pharmacy

General advice to pharmacy licensees and registrants

This guidance applies to pharmacy staff working in a dispensary or those who have direct contact with pharmacy patients.

This information is not intended to exempt employers from existing occupational health and safety (OHS) requirements. OHS questions and concerns can be directed to the OHS Contact Centre by telephone at 1-866-415-8690 (in Alberta) or 780-415-8690 (in Edmonton) or online.

There are many things pharmacy licensees must do to best protect themselves, their staff, and patients from exposure to COVID-19. Nonetheless, all regulated members share responsibility for ensuring compliance with the guidance provided by Alberta Health and ACP.

All pharmacists, pharmacy technicians, and pharmacy staff must

Review Health Canada’s Infection prevention and control for COVID-19: Second interim guidance for acute healthcare settings and the AHS Routine Practices in Community-based Services. Licensees must review the pharmacy’s occupational health and safety procedures with all pharmacy staff.

Pharmacists and pharmacy technicians have a shared responsibility for informing and educating the public about COVID-19, including promoting infection prevention and control. Multilingual resources are available from Alberta Health Services.

Personal protective equipment (PPE) for direct patient care

Continuous masking

  • Mandatory masking may still be required by provincial order in certain settings, local bylaw, or by AHS, and in these circumstances, pharmacy team members must continuously wear masks.
  • Where masking is no longer legally required, ACP recommends that pharmacy teams apply professional judgement to determine the risk of transmission of COVID-19 to the pharmacy team and to the public, and wear masks when appropriate. 
  • Infection prevention and control measures (IPAC) can slow the spread of COVID-19 and other infections. Viral transmission in healthcare settings remains a concern, and ACP recommends regulated members continue to adhere to IPAC.
  • Alberta Health recommends that individuals self-isolate when sick, and no healthcare worker with symptoms of illness should come to work.

 

Pharmacists and pharmacy technicians need to keep themselves aware of the situation as it develops by checking for updates and changes on a frequent and ongoing basis.