Table 2.

Prescriptive Pharmacist Services as Depicted by Scenarios in Survey^*

Province	Provide Emergency Prescription	Adapt Prescription		Initiate Prescription for Chronic Condition	Prescriptive Authority Overview
		Extend Prescription	Alter Dose for Organ Function
British Columbia	All pharmacists	All pharmacists†	No pharmacist‡	No pharmacist	Adaptation allows change to dose/formulation/regimen, renewal, and substitution.2 Excludes drugs for cancer, cardiovascular disease, asthma, seizures, and psychiatric conditions.
Alberta	All pharmacists	All pharmacists	All pharmacists	Select (APA) pharmacists (n = 1150)	Pharmacist must apply to (and be approved by) ACP to obtain APA, which enables prescribing (initiation/alteration) of any provincially regulated drug.
Saskatchewan	All pharmacists	All pharmacists	Select (level 2) pharmacists (n = 12)	Select (level 2) pharmacists (n = 12)	Adaptation allows changes as required for incomplete/inaccurate prescriptions or those needing alteration of dosage form. Level 2 pharmacists must have a CPA with a physician, identifying specific medical condition(s) and drugs that the pharmacist is allowed to prescribe. Minor-ailment prescribing is allowed for list of 17 conditions, with a specific list of drugs that all pharmacists are allowed to prescribe.3
Manitoba	No pharmacists	All pharmacists	Select EPP pharmacists (n = 6)	Select EPP pharmacists (n = 6)	Adaptation allows changes as required because a product is not commercially available, because information is missing from prescription, or because the action will facilitate adherence or enable drug coverage. EPPs must have a CPA with a physician, identifying specific medical condition(s) for which the pharmacist can prescribe. Minor-ailment prescribing, from a limited list of drugs for a list of 11 conditions, is allowed once additional training has been completed.4
Ontario	All pharmacists	All pharmacists	All pharmacists	No pharmacists	All pharmacists are allowed to prescribe smoking cessation products.
Quebec	All pharmacists	All pharmacists	All pharmacists	No pharmacists	All pharmacists are allowed to extend prescriptions, prescribe in situations where no diagnostic test is required (e.g., smoking cessation), adjust prescriptions (modify form, dose, or quantity) if they know diagnosis and target of therapy (but must collaborate with physician for dose adjustment), and substitute drug if prescribed product is on back order. Minor-ailment prescribing is allowed for a list of 12 conditions, with some restrictions on products that can be prescribed.
Prince Edward Island	All pharmacists	All pharmacists	All pharmacists	No pharmacists	Minor-ailment prescribing is allowed for a list of 31 conditions.5
Newfoundland and Labrador	All pharmacists	All pharmacists	No pharmacists	No pharmacists	Adaptation allows changes in dosage form, regimen, or quantity, as well as changes to complete missing information, make a generic substitution, or make therapeutic substitutions. Minor-ailment prescribing is allowed for a list of 23 conditions; pharmacist may also substitute a prescribed medication with an equivalent drug for these 23 conditions.6
Nova Scotia	All pharmacists	All pharmacists	All pharmacists	No pharmacists	Minor-ailment prescribing is allowed for a list of 31 conditions.7
New Brunswick	All pharmacists	All pharmacists	All pharmacists	Select CPA pharmacists (n = 11)	CPA between pharmacist and physician must be in place, identifying specific medical condition(s) for which the pharmacist can prescribe. Minor-ailment prescribing is allowed for a list of 32 conditions.8

ACP = Alberta College of Pharmacists, APA = additional prescribing authorization, EPP = extended pharmacist practice, CPA = collaborative practice agreement.

^*Responses were specific to the scenario presented. The scenario did not capture all forms of prescribing in each category.

^†Cannot renew any psychiatric medications unless part of a multidisciplinary team

^‡Unless working within a multidisciplinary work environment, the pharmacist will not change the dose or regimen of prescriptions for cancer, cardiovascular conditions, seizures, or psychiatric conditions.