prescribing
Both colleges expressed concerns to Health Canada that these requirements were outside of the normal distribution system for medications
Options Consistent with Health Canada Stipulations :
• Patients can take the prescription to a pharmacy of their choice and have the medication delivered to the physician ’ s office , or
• Physicians can sell and dispense the medication to the patient in accordance with CPSO ’ s Dispensing Drugs policy .
Direct Patient Dispensing Option :
• Patients can take the prescription to a pharmacy of their choice and receive the medication directly from the pharmacist .
It is within the scope of practice of pharmacists in Ontario to dispense medications directly to patients , therefore in alignment with provincial legislation , pharmacists are able to dispense Mifegymiso directly to the patient .
Administering and Ingesting Mifegymiso The monograph outlines that the drug should be “ administered under the supervision of the prescriber ” and instructs patients to take Mifegymiso “ as directed by their doctor or given to them by medical staff .” Health Canada provided clarification that the intent of the wording in the product monograph is to allow prescribers to use their discretion for each individual patient and does not mandate that the medication be ingested in the presence of the prescriber . Determining details of medication therapy is a treatment decision between the physician and patient .
Communication between Physicians , Patients and Pharmacists When dispensing Mifegymiso , the pharmacist must be aware of and understand the dispensing option the physician and patient determined would be appropriate . Given this , it is the physician ’ s responsibility to clearly indicate the dispensing option on the prescription , along with clear directions for ingestion . This is to ensure no confusion exists for the patient and the pharmacist . As is the case with any medication , the pharmacist has the responsibility to confirm with the physician if the prescription is unclear .
Physician Training It is the professional responsibility of a physician to ensure that they have sufficient knowledge , skills and abilities to competently prescribe any medication and supervise patient care . A physician must ensure that they have undergone the appropriate training and has the required resources to evaluate the potential risks and benefits , and any other relevant factors specific to the situation , to ensure the drug is appropriate for the patient . A mandatory education program has been developed by the Society of Obstetricians and Gynecologists of Canada , the College of Family Physicians of Canada , and the Canadian Pharmacists Association . The free course is available to physicians and pharmacists through the e-learning portal of the Society of Obstetricians and Gynecologists of Canada ( sogc . org / online-courses / courses . html /). MD
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Dialogue Issue 1 , 2017