We have had inquiries from our clients as to what can be done to obtain a prescription renewal when their physician is not available. Ideally, prescriptions for maintenance medications are issued at your physician visit with enough renewals to last until your next scheduled appointment. When the appointment requires re-scheduling (as has happened for many patients in the last couple of months), this can mean repeats have run out before the prescribing physician can be seen.
According to the Ontario College of Pharmacists, to ensure continuity of care, pharmacists have the authorization under their scope of practice to renew a quantity of the drug that does not exceed the lesser of:
- The quantity that was originally prescribed, including any refills that were authorized by the original prescriber; or
- A six month’s supply
Pharmacists do not have the authority to renew or adapt a controlled substance (narcotic, controlled drug and targeted substance), or a drug designated as a monitored drug under the Narcotic Safety and Awareness Act.
In order to extend a renewal the pharmacist determines that the therapy is safe and effective by considering the risks and benefits and other relevant individual circumstances of the patient, including, but not limited to the following:
- The patient’s medical history, including co-morbid disease states and chronic conditions;
- Laboratory or other tests, as available;
- Symptoms reported by the patient;
- The patient’s allergies and other contraindications and precautions;
- Other medications the patient may be taking;
- The patient’s gender, age, weight and height (where applicable);
- Pregnancy and lactation status, if applicable;
- Any other inquiries reasonably necessary in the circumstances.
The pharmacist must also document in the patient record his or her rationale for renewing the prescription (i.e. patient assessment, monitoring plan, etc.) and indicate the patient’s consent has been given for the pharmacist to renew. The original prescriber must also be notified within a reasonable time frame after issuing the renewal.
Pharmacists have been exercising their scope of practice to support patients in many ways as they are the public’s most accessible health professional. I am proud of the dedication and hard work of my pharmacist colleagues during these challenging times.
Carolyn Whiskin is the Pharmacy Manager for Charlton Health. Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.