NLPB Office Closed to the Public
As per current public health guidelines, the NLPB office is currently closed to the public and all staff members are working from home.
Professional Development Audit Postponed
NLPB has decided to postpone the 2022 professional development audit due to the increased workload and stressors many pharmacy professionals are facing as a result of the ongoing COVID-19 pandemic. Traditionally, registrants are notified of their selection for the annual professional development audit by the end of January. NLPB will continue to monitor the situation and reassess this decision in the coming months. Registrants will be notified in advance should an audit proceed.
COVID-19 Pharmacy Service Disruptions
If your pharmacy has been affected by the recent increase in COVID-19 cases in the province, please refer to NLPB’s COVID-19 Guidance for Pharmacy Professionals webpage for guidance on navigating pharmacy service disruptions.
Please note that the pharmacist-in-charge should notify NLPB if/when they have pharmacy staff members that test positive for COVID-19 so we can be aware of the situation and any potential impacts on pharmacy services, such as a change in hours of operation or temporary closure. Patients should be notified of the changes to pharmacy services at the earliest opportunity, and continuity of care must be considered.
Tramadol Scheduling Changes Coming March 31, 2022
As of March 31, 2022, Health Canada will be amending the Prescription Drug List (PDL) to remove Tramadol. It will subsequently be listed in Schedule I of the Controlled Drugs and Substances Act (CDSA) and in the Schedule of the Narcotic Control Regulations (NCR), and therefore subject to all the regulatory requirements set out in the CDSA and NCR.
This change is intended to provide additional safeguards around the use of tramadol to help prevent problematic substance use and other harms, while also protecting access to these medications for patients who need them.
While Tramadol products sold and distributed by manufacturers after March 31, 2022, must include the updated labeling with the “N” narcotic symbol, in order to facilitate the transition and avoid disruption in market access, any products already sold and distributed by manufacturers prior to March 31, 2022, or product remaining at wholesalers or pharmacies, may continue to be sold until market depletion.
This change means that starting March 31, 2022, pharmacies will be expected to follow the same requirements for tramadol-containing products as they would for any other narcotic-containing product. This includes all requirements related to:
- Secure storage
- Recording of purchases and sales
- Perpetual inventory and physical inventory counts
- Filing and storage of prescriptions
- Documentation of destruction and/or returns
- Reporting of losses and/or thefts
- The use of the Health Canada “warning sticker” and patient information handout for opioids
For additional information, please see the related Controlled Substances Bulletin, section 1.6 of the Standards of Pharmacy Operation – Community Pharmacy and section 1.8 of the Standards of Pharmacy Operation – Hospital Pharmacy.
Please note that tramadol is already included in the list of drugs subject to the Tamper Resistant Prescription Pad Program.
Removal of Natural Health Products (NHPs) in Schedules I and II
In accordance with its Policy for Natural Health Products (NHPs), the National Association of Pharmacy Regulatory Authorities (NAPRA) has progressed with the planned removal of NHPs from the National Drug Schedules (NDS), in the stepwise, risk-based approach initiated in 2019.
Effective January 2, 2022, all NHPs that were listed within Schedules I and II were removed from the NDS, with the exception of ephedrine and pseudoephedrine. The removal of ephedrine and pseudoephedrine will occur on January 2, 2024. NHPs in the lowest risk categories, Schedule III and Unscheduled, were removed from the NDS in January 2020.
As of 2024, 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 NDS.
NAPRA believes the public interest will be best served through the development of a more comprehensive framework from the federal government that would better protect Canadians from the risks of the entire class of NHPs. As such, NAPRA will continue to engage in ongoing opportunities to further encourage the development of such a framework.
Paxlovid – Prescribing and Dispensing Information
Nirmatrelvir/Ritonavir (Paxlovid) is the first oral antiviral medication indicated for the treatment of mild-to-moderate COVID-19 in adults who are at high risk for progression to severe COVID-19, including hospitalization or death.
Due to the limited number of treatment doses, dispensing will initially be managed through the RHA pharmacies. A longer-term distribution plan is being developed which will include a role for community pharmacies when supply stabilizes. The initial supply of Nirmatrelvir/Ritonavir will not be available through standard pharmacy wholesale channels.
Individuals contacting community pharmacies regarding Paxlovid should be advised it is not yet available in community pharmacies and referred to their prescriber.
Prescribers are asked to complete the screening tool (see Resources below) and send it to the appropriate RHA pharmacy for processing and dispensing. Alternatively, if completion of the screening tool is not possible, a prescriber may telephone an identified site to verbally request treatment and provide the required screening information. The pharmacist will complete the screening tool on behalf of the physician and indicate that the prescription was received verbally. Screening tools completed in this manner are to be retained at the pharmacy for audit purposes. During dispensing, the RHA pharmacy will coordinate with the patient for delivery or contactless pickup.
More information will be released by the Department of Health and Community Services in the coming days as the treatment access evolves.
Patient Connect NL
The Department of Health and Community Services, in partnership with Eastern Health, has launched a new initiative to develop a registry for all members of the public in the eastern region that are currently without a primary care provider. Members of the public can self-register with Patient Connect NL and be waitlisted for a primary care provider at the new Collaborative Team Clinics.
Pharmacy professionals in the eastern region who become aware of patients who do not have a family doctor are encouraged to refer them to the program.
The program is in development to be expanded provincially but is currently only operational for the eastern region.
Pharmacies located in the eastern region can print and display the resources below:
Update – Reporting Loss or Theft of Controlled Substances or Precursors
Pharmacists can now self-register to Health Canada’s E-Services Portal to report loss or theft of controlled substances or precursors and no longer need to be invited onto the system.
A call centre is also available to provide technical support: firstname.lastname@example.org or 1-866-337-7705 (option 5)
For more information, visit Health Canada’s website: https://www.canada.ca/en/health-canada/services/health-concerns/controlled-substances-precursor-chemicals/controlled-substances/compliance-monitoring/loss-theft.html
Invitation to Participate in Opioid Dependence Treatment Needs Assessment
The Provincial Opioid Dependence Treatment Centre of Excellence is inviting pharmacy team members to participate in an Opioid Dependence Treatment needs assessment to determine how the Centre of Excellence can better support pharmacy teams in their practices, with the treatment of their patients, and increase knowledge surrounding opioid dependence treatment and harm reduction. The content was developed in close consultation with Sydney Peckham, Clinical Lead (Pharmacy) with the Centre of Excellence and regional ODT hubs, and PharmD students completing non-clinical placements with the COE.
This needs assessment targets pharmacists, pharmacy technicians, pharmacy assistants, and pharmacy students. It is designed to be completed individually, as each group has a set of questions that is applicable to their role.
What is the Provincial Opioid Dependence Treatment Centre of Excellence?
The Provincial Opioid Dependence Treatment (ODT) Centre of Excellence (COE) was created as part of the Hub and Spoke model for ODT across the province. While located in Eastern Health, the COE supports all health authorities and regions of Newfoundland and Labrador to help build capacity around ODT services. Goals of the COE include:
- Supporting the implementation of the provincial ODT Hub and Spoke model
- Supporting the implementation of evidence-informed ODT practices
- Strengthening ODT performance monitoring and evaluation
- Increasing opportunities for stakeholder collaboration
- Strengthening harm reduction education, program, policy, and practice development
- Increasing opportunities for knowledge exchange and care provider development
Privacy Details and Contact Information:
This needs assessment will be administered in a way that protects your privacy. It is your choice whether or not you complete the needs assessment; if you choose not to participate, it will not affect your employment in any way. If you choose to fill out the needs assessment, please answer as best you can. It should take about 10 – 15 minutes to complete.
Needs Assessment: https://www.surveymonkey.com/r/Needs_Assessment_for_Pharmacy_Teams_2022.
Please complete the needs assessment by March 1, 2022.
If you have any questions or if you would like to have this needs assessment in another format, please contact Kate Lambert, Knowledge Exchange Facilitator, at email@example.com or 752-3573.
Project ECHO NL: Opioid Use Disorder – Upcoming Sessions
Project ECHO NL: Opioid Use Disorder, is a virtual community advancing care and treatment for opioid use disorder in Newfoundland and Labrador. The goal is to help primary care providers and their teams build capacity in the treatment and management of opioid use disorder.
This project offers free, virtual learning sessions using an interactive, web-based platform to link healthcare providers with an interdisciplinary team of mentors with expertise in managing substance use care.
ECHO sessions are designed around case-based learning and mentorship and support healthcare providers in gaining the knowledge and skills required to provide needed services in their regions.
The primary audience for Project ECHO NL: Opioid Use Disorder is prescribers (family physicians and nurse practitioners) and pharmacists. The secondary audience is other healthcare professionals providing care for individuals with opioid use disorder, including registered nurses, licensed practical nurses, social workers, and addictions counsellors.
Cycle 1 will include 11 sessions held every three weeks between October 2021 and May 2022.
Session 6: Microdosing as an Induction Approach
February 22, 2022 – 8:30–9:30AM (NST)
Registration is free but required. Registration is completed on a per-session basis.
Register Today The deadline to register is February 18, 2022
ECHO sessions are one hour, held every three weeks on a rotating schedule of Tuesdays from 8:30 a.m. to 9:30 a.m. and 12:00 p.m. to 1:00 p.m. NDT.
|Session 7||March 15, 2022||12:00 p.m.– 1:00 p.m. NDT|
|Session 8||April 5, 2022||8:30 a.m.– 9:30 a.m. NDT|
|Session 9||April 26, 2022||12:00 p.m.– 1:00 p.m. NDT|
|Session 10||May 17, 2022||8:30 am – 9:30 am NDT|
More information about Project ECHO NL: Opioid Use Disorder, including frequently asked questions, can be found online here.
- 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 Online Registrant Portal 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 Online 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.