March is Pharmacy Awareness Month: #whatwedoinpharmacyNL

March 1-31 is Pharmacy Awareness Month and NLPB would like to try something different this year to create public awareness of pharmacy practice in Newfoundland and Labrador (NL).

Internationally, the social media hashtag “#whatwedoinpharmacy” has gained some popularity as a pharmacy public awareness campaign for pharmacy professionals to talk about their everyday activities with the goal of better explaining what it is they do.

During the month of March, NLPB will be using its Twitter and Facebook accounts to share messages about the role of the regulatory body in NL pharmacy.

We also encourage pharmacy professionals to get involved and engage by using the hashtag #whatwedoinpharmacyNL to provide insight on your daily activities and share how you contribute to patient safety and quality health care.

Let’s take this opportunity to educate the public on what pharmacy looks like in NL, and how pharmacy professionals contribute to safety and quality care in the province!


 

Board Member Elections 2020: We want your expertise on our Board!

NLPB’s job is to promote and protect the health and well-being of the people of Newfoundland and Labrador (NL) by regulating the pharmacy profession and advancing pharmacy practice. We have four positions on our Board that are up for grabs this year.

  • In Zone 5, we need one pharmacist who is employed the majority of their time in a hospital.
  • In Zone 6, we need one pharmacy technician.
  • In Zone 7, there are two pharmacist positions available.

Registrants in these zones received an email on February 7, 2020 with the nomination form and links to information about the Board, NLPB’s strategic action plan and more. If you’re thinking about becoming involved with NLPB — this is a great opportunity to increase your knowledge about your regulatory body and to be a part of the movement to protect the public interest.

All nominees are required to review So you want to be a Board member before submitting a nomination form.

The deadline for nominations is March 8, 2020.


 

Electronic Prescription Requirements

With the continued roll-out of NLMA’s eDOCNL project and the release of other electronic prescribing systems, NLPB has received an increase in questions related to electronic prescriptions. A response to this question, among others, is included on the Frequently Asked Questions About Pharmacy Practice page and is updated as new information and technologies become available.

Pharmacy professionals are reminded that, as with all prescriptions, they must be able to ensure the authenticity of prescriptions that have been generated electronically and be confident that the document presented to them has not been replicated or altered.

At this time, prescriptions generated as follows are considered to be acceptable:

  • Prescriptions generated electronically by a prescriber’s password-protected electronic medical record (EMR) and faxed directly to a pharmacy.
  • Prescriptions generated electronically, printed, hand-signed by the prescriber, and faxed to a pharmacy from the prescriber’s/clinic’s fax machine.
  • Prescriptions generated electronically, printed, hand-signed by the prescriber, and given to the patient to bring to their pharmacy.

The following would NOT be acceptable:

  • Prescriptions generated electronically, with pre-printed signature images that are given to the patient to bring to their pharmacy, without being hand-signed or initialed by the prescriber.
  • Prescriptions sent via email.
  • Prescriptions for drugs referenced in section 4.(1) of the Pharmaceutical Services Regulations – i.e. the “Drugs Required to be Written on Tamper Resistant Pads”.

 

Provincial Drug Schedules Updated To Reflect NAPRA Policy Changes

Updates to the Newfoundland and Labrador Provincial Drug Schedules have taken place to reflect changes by NAPRA to their Natural Health Products (NHPs) policy.

The National Drug Schedules (NDS) were developed before Health Canada began regulating the sale of NHPs in Canada. When NHP regulations came into force in 2004, many products included in the NDS became reclassified as NHPs. Since NHPs are beyond the scope of NAPRA’s NDS, NAPRA has decided to remove NHPs currently listed within the NDS in a stepwise, risk-based approach. See NAPRA’s full explanation.

Changes are as follows:

1) Effective January 2, 2020: NHPs currently listed within the Unscheduled category and within Schedule III will be removed from the NDS.

2) Effective January 2, 2022: NHPs currently listed within Schedules I and II will be removed from the NDS.

As of 2022, all products with a Natural Product Number (NPN) or Drug Identification Number-Homeopathic Medicine (DIN-HM) from Health Canada will be considered outside the scope of NAPRA’s National Drug Schedules.

Please see the Provincial Drug Schedules page for more information.
 

Compounding Standards Implementation: Are you on track?

Based on recent results of QA assessments and questions received by NLPB, it seems that many registrants do not fully understand the requirements of the non-sterile compounding standards and the related implementation deadlines. Specifically, many pharmacies have yet to complete the activities of Phase 1, which should have been completed by December 31, 2019. It is critical that pharmacists-in-charge and compounding supervisors assess where they are with implementation of the standards and address deficiencies from Phase 1 early in the year so that they can still achieve full implementation of the applicable standards by the December 31, 2020 deadline.

Implementation of sterile compounding standards is primarily a focus for hospital pharmacies throughout the province. Pharmacists-in-charge and compounding supervisors of affected practice sites are expected to have an action plan in place to meet the implementation deadlines set out by the Board and are encouraged to submit an application for renovation as soon as possible. If you have questions about sterile compounding standards, contact NLPB Practice Site Assessor Ken Walsh at kwalsh@nlpb.ca.

Please review the full “Compounding: Are you on track?” article in the Winter 2020 Apothecary. We also have a new Compounding FAQ posted to nlpb.ca.

 

Assessing Appropriateness of Drug Therapy: Buprenorphine-naloxone for pain management

In recent months, NLPB has received inquiries from pharmacists regarding the prescribing and dispensing of the buprenorphine-naloxone combination product (Suboxone® or generic equivalent). As per the drug product monograph for Suboxone®, buprenorphine-naloxone is approved for the treatment of opioid dependence in adults. The intention of the naloxone component is to deter intravenous misuse. When used for the treatment of opioid use disorder, patients prescribed buprenorphine-naloxone should be carefully monitored within a framework of medical, social and psychological support as part of a comprehensive opioid dependence treatment program. While single entity buprenorphine (e.g., the transdermal patch Butrans®) is indicated for the treatment of pain, the combination therapy buprenorphine-naloxone has not been approved by Health Canada for pain management; therefore, prescribing of buprenorphine-naloxone for pain would be considered “off-label.” Furthermore, the NLPB Standards for the Safe and Effective Provision of Opioid Agonist Maintenance Treatment are not relevant to the use of buprenorphine-naloxone for pain management unless the patient has a concurrent opioid use disorder.

Faced with a situation where buprenorphine-naloxone is being prescribed for pain, pharmacists are expected to rely on their knowledge, skills, patient assessment and professional judgment to act in the best interest of the patient and determine the appropriateness of drug therapy, just as they would be expected to do so with any other prescription. Pharmacists may need to collect information regarding the rationale for treatment choice from the prescriber, as well as do their own research regarding when buprenorphine-naloxone may be considered an option for treatment of pain and suggested dosing for this indication. Supporting documentation for decision-making should be filed in a retrievable manner in the dispensary – ideally in the patient’s record.

Assessing the appropriateness of drug therapy is a core professional responsibility of pharmacists as described in the NLPB Standards of Pharmacy Operation and the Standards of Practice for Canadian Pharmacists. Pharmacists are encouraged to review these two documents to re-familiarize themselves with these expectations.

 

Regular reminders

Registrant Contact Information – Registrants are responsible for ensuring that the contact information on their registrant profile, including email address and practice site, is accurate at all times. The NLPB primarily uses email communication to send newsletters, renewal reminders, practice site assessment information, professional development audit information, calls for interest for committees, and other alerts. If the email address on file is incorrect, important information may be missed and/or disclosed to the wrong person. If your contact information changes, please log into the NLPB Registrant Login to update your file with your new contact information as soon as you can.

Forgot Your Password? – You can retrieve your NLPB Online Registrant Portal password at any time. Under the Login box, click the message that says, “Forgot your password? Click here to restore it.” On the next screen, enter your NLPB username, if you know it, or your email address. Click “Retrieve.” In a few minutes, you will receive an email with your username and password. Once you are logged into your profile, you can change your password.

Receipts & Invoices – NLPB’s Registrant Portal maintains all receipts created by the system. If, for any reason, you need a receipt or to view an invoice, you can do so from your registrant profile. Once logged in, click on “Renewal Other/Invoices” and then select either “view invoice” or “print invoice” next to the one you are interested in.

 

This e-newsletter contains information on a wide variety of topics intended to enhance the practice of pharmacy in the province of Newfoundland and Labrador. As it is published and circulated to all registrants on a monthly basis, it is the expectation of NLPB that all registrants are aware of the matters contained therein.

©2020 Newfoundland & Labrador Pharmacy Board