Pharmacists in Quebec are gaining prescribing privileges and other expanded authorities in line with changes that have been made in other provinces.
Quebec Health Minister Yves Bolduc introduced Bill 41 in the National Assembly on November 15, 2011, and it was passed December 8. The changes will allow Quebec pharmacists to extend or adjust certain prescriptions, administer some injections for education purposes and order lab tests to ensure appropriate uses of medication.
In addition, pharmacists will be permitted to prescribe medications that don't require a diagnosis. Examples include folic acid and anti-nausea medication for pregnant women, malaria pills for travellers and smoking cessation medications.
“We are confident these new activities will give patients better access to the health care system and will give pharmacists the ability to better manage drug therapy,” says Diane Lamarre, president of the province's pharmacist regulatory body, l'Ordre des pharmaciens du Québec. Access is very important, she notes, given that around 2 million Quebec residents are without a family physician.
Proposals developed in collaboration with physicians' college
L'Ordre worked very closely with the provincial College of Physicians to develop proposals for government, and both the Pharmacy Act and the Medical Act were to be amended to put the new authorities in place.
L'Ordre presented the physicians' college with curriculum materials from the faculties at the Universities of Laval and Montreal — to demonstrate that pharmaceutical care has been the foundation of pharmacy education for the past 2 decades, says Ms. Lamarre. “We have 20 years of graduated pharmacists educated in pharmaceutical care. We showed that pharmacists are able to evaluate signs and symptoms, and can identify warning signals calling for referral to a physician. We gave the physicians confidence that we can undertake these activities.”
However, during the committee study, the federation representing general practitioners expressed some concerns with Bill 41, namely measures that allow pharmacists to prescribe certain drugs, such as anti-nausea medication for pregnant women. And the nursing college expressed frustration that pharmacists are getting prescribing privileges, claiming that pharmacists have been stonewalling on the matter of giving the same privileges to nurses.
The nurses' claim is not accurate, according to Ms. Lamarre. “We are not opposed to other health professionals acquiring new authorities. If nurses are able to do more, I think we should listen to the patients' needs and fulfill them. Many health professionals, pharmacists included, are underutilized in the health care system.”
The provincial government has said it wants regulations supporting the new legislation to be developed and implemented by the end of 2012.