In Alberta, the College of Physicians & Surgeons of Alberta (CPSA) can impose conditions on a physician’s practice permit that restrict their prescriptive authority under certain situations. Using data, including information from the Tracked Prescription Program Alberta (TPP Alberta), CPSA imposes these conditions to support appropriate prescribing and enhance patient safety. These restrictions generally pertain to Type 1 and Type 2 medications monitored by TPP Alberta but may also include drugs such as anabolic steroids or cannabis.
It is important for pharmacy teams to stay informed to avoid dispensing prescriptions that are not valid due to the prescription being written by a prescriber with a condition on their practice permit.
Standardization of prescribing conditions: Updates from TPP Alberta
TPP Alberta is updating their processes to improve consistency and clarity.
As medications are added to or removed from the TPP Alberta medication lists, conditions restricting physicians’ prescribing are now updated to reflect these changes. In some situations, a condition applied to a physician’s practice permit may include specific exceptions, for example, restricting the prescribing of TPP Type 1 and Type 2 medications, with allowances only for certain categories such as antibiotics.
Moving forward, new conditions that restrict prescribing will now adopt clearer and more objective language. You’ll see less use of subjective terms such as “acute pain” or “emergency situations” and more precise descriptions to enhance interpretation and consistent application.
Staying informed: Your responsibilities
Pharmacy teams are responsible for remaining informed about each prescriber’s prescribing authority, including any conditions related to TPP Alberta medications. This means routinely reviewing the TPP list of physicians with prescribing restrictions and staying current with the TPP Alberta medication lists. If you are not already doing this, consider ways in which it can be added to your workflow.
When assessing your patient, you must ensure that their prescriptions are from an authorized prescriber. According to the Standards of Practice for Pharmacists and Pharmacy Technicians, you’re expected to ensure the authenticity and completeness of all prescriptions you dispense. To accomplish this, you need to take reasonable steps to determine whether the prescriber is legally authorized to prescribe the drug. This includes ensuring that there are no restrictions on the prescriber’s practice permit that limit their authorization to prescribe that particular drug or class of drugs.
For more on the importance of understanding prescriber status, see ACP’s advice on Prescriptions and refills written by a prescriber whose practice has been cancelled, suspended, or made subject to conditions.
Supporting continuity of patient care
If you learn a prescriber is no longer authorized to prescribe a medication due to a condition being applied to their practice permit, you play a critical role in minimizing disruptions to therapy and maintaining continuity of patient care. As the pharmacist, you may need to consider
- Refilling an existing prescription for the patient if it was written before the restrictions came into place and your assessment deems it appropriate.
- Note that prescriptions issued before the date of an order prohibiting or restricting prescribing are not invalid, provided the pharmacist assesses their ongoing appropriateness for the patient. Refer to ACP’s Advice to the Professions on this topic for more information.
- Extending a prescription within your scope and using professional judgement.
- Collaborating with the original prescriber.
- Collaborating with the patient in finding an alternative prescriber.
As the patient’s pharmacy team, you are integral to ensuring care continues safely and effectively when changes to prescribing authorities occur.
More information
If you have questions related to prescribing conditions or medication lists, contact TPP Alberta directly at tpp.info@cpsa.ab.ca.
For pharmacy-specific practice guidance, contact ACP at info@abpharmacy.ca.
