ACP would like to remind pharmacists without additional prescribing authorization (APA) that it is not appropriate to prescribe medications to patients, dispense the medication, and then have a pharmacist with APA authorize or sign the prescription after the medication has already been dispensed.
Within Domain 7 (Patient assessment and providing care) of the Standards of Practice for Pharmacists and Pharmacy Technicians (SPPPT), it is stated that a pharmacist may prescribe a Schedule 1 drug to initiate therapy or to manage ongoing therapy if
- the pharmacist has been granted APA, and
- the pharmacist prescribes
- based on the pharmacist’s own assessment of the patient or,
- when working within a team of regulated health professionals, the pharmacist collaboratively makes a team-based assessment of the patient.
The pharmacist with APA must also have seen the patient in person at the time of prescribing or have a current professional relationship with the patient established over a period of time.
Pharmacists without APA are not authorized to assess or prescribe to initiate therapy or to manage ongoing care except in the case of an emergency. Further to that, pharmacists with APA must not authorize or sign a prescription if they did not assess the patient in person or make a collaborative, team-based assessment of the patient. Pharmacists with APA must have established professional relationships with patients for whom they prescribe to initiate therapy or to manage ongoing care. Signing and taking responsibility for a prescription written by another pharmacist without APA who independently assessed and dispensed medications is not enabled by ACP’s standards.
In the event of an emergency, the SPPPT makes allowances for pharmacists who do not have APA to prescribe Schedule 1 drugs at initial access when there is an immediate need for drug therapy, and it is not reasonably possible for the patient to see a prescriber to obtain a prescription. Otherwise, only pharmacists with APA may prescribe Schedule 1 drugs at initial access provided the above standards are met.
