PQ APRIL 2014 | Issue 06
10
BH
That is a great question. My answer is very specific
to the Alberta model of APA because with the
exception of New Mexico, USA1 where they can
prescribe opioids and controlled substances, no
other jurisdiction has implemented APA as
comprehensively as Alberta. The Alberta APA
legislation, regulations and execution are second
performing the last step, prescribing what you
wer;
-‐
restrict
our
activities
to
defined
conditions/diagnoses or to collaborative-‐only
settings. We allowed prescribing on the request of
another regulated health professional and we
stated our own competence would be the only
defined limitation on which federal Prescription
Drug List drugs we could prescribe. The other
provinces have only piecemeal prescribing
compared to Alberta. And I said exactly that to
Greg Eberhart when I last spoke with him in
January 2014 at the White Coat Ceremony.
complete the care cycle by prescribing what the
patient needs-‐ and now our laws and regulations
validate and confirm that. Prescribing is included
With that preamble, my answer is that in Alberta
pharmacists and students should consider APA
the de facto scope of practice for pharmacists. It
; non-‐
APA practice rather, should be considered partial-‐
scope of practice. Do you get the nuance, do you
authorized to fulfill that need. And prescribe. If all
new pharmacists get their APA and practice with
their APA, we will change what our de facto scope
of practice is. And as a profession we will arrive
where we should have been all along.
match our competence, our abilities, our
expertise, our natural role. Students, embrace this
prescribe. But when you do know what your
KH
public] have legislated this full scope of practice
and the Alberta College of Pharmacists
[protecting the public] has regulated the full scope
of practice. So the student considering APA
should look at it this way: you detect and define a
drug-‐related problem, perhaps the patient has an
untreated condition. You know the patient, you
set out your alternatives, you make your
recommendation and you know what to monitor if
your medication gets prescribed. But then what?
The old way, the non-‐Alberta way, the partial-‐
scope-‐of-‐practice-‐way, you hand off this last step-