PC November/December 2008.pdf

Council Members

Council Members for Districts 1-17 are listed below according to District number. PM indicates a public member appointed by the Lieutenant-Governor-in-Council. DFP indicates the Dean of the Leslie Dan Faculty of Pharmacy, University of Toronto. DSP indicates the Director, School of Pharmacy, University of Waterloo.

1 Joseph Hanna2 Elaine Akers3 Sherif Guorgui4 Tracey Phillips5 Donald Organ6 Fayez Kosa7 Tracy Wiersema8 Saheed Rashid9 Bonnie Hauser10 Gerald Cook11 Christopher Leung12 Peter Gdyczynski13 Vacant14 Stephen Clement15 Gregory Purchase16 Doris Nessim17 Shelley McKinney

PM Joinal AbdinPM Thomas BaulkePM Andrea Chun PM Corazon dela CruzPM Babek Ebrahimzadeh PM David HoffPM Margaret Irwin PM Javaid KhanPM Lewis LedermanPM Aladdin MohagheghPM Gitu ParikhDFP Wayne HindmarshDSP Jake Thiessen

Statutory Committees• Executive • Accreditation• Complaints • Discipline • Fitness to Practice • Patient Relations• Quality Assurance • Registration

Standing Committees• Communications• Finance • Professional Practice

Special Committees• Standards of Practice Working Group • Pharmacy Technicians Working Group

College Staff

Office of the Registrar and Deputy Registrar/Director of Professional DevelopmentPharmacy Connection Editor x [email protected]

Office of the Director of Finance and Administration x [email protected]

Office of the Director of Professional Practice x [email protected]

Registration Programs x [email protected]

Structured Practical Training Programs x [email protected]

Investigations and Resolutions x [email protected]

Continuing Education Programs andContinuing Competency Programs x [email protected]

Pharmacy Openings/Closings,Pharmacy Sales/[email protected]

Registration and Membership Information:[email protected]

Pharmacy Technician Programs:[email protected]

Publications x [email protected]

ontario college of pharmacists483 Huron Street, Toronto, Ontario M5R 2R4 • Tel (416) 962-4861 • Fax (416) 847-8200 • www.ocpinfo.com

The mission of the Ontario College of Pharmacists is

to regulate the practice of pharmacy, through

the participation of the public and the

profession, in accordance with standards of

practice which ensure that pharmacists

provide the public with quality

pharmaceutical service and care.

July • August 2008 Volume 15 • Number 4

The objectives of Pharmacy Connection are to communicate information on College activities and policies; encourage dialogue and to discuss issues of interest with pharmacists; and to promote the pharmacist’s role among our members, allied health professions and the public.We publish six times a year, in January, March, May, July, September and November. We welcome original manuscripts (that promote the objectives of the journal) for consideration. The Ontario College of Pharmacists reserves the right to modify contributions as appropriate. Please contact the Associate Editor for publishing requirements.We also invite you to share your comments, suggestions, or criticisms by letter to the Editor. Letters considered for reprinting must include the author’s name, address and telephone number. The opinions expressed in this publication do not necessarily represent the views or official position of the Ontario College of Pharmacists.

Tracy Wiersema, R.Ph., B.Sc.Phm.President

Deanna Williams, R.Ph., B.Sc.Phm., C.Dir., CAE Registrar

Della Croteau, R.Ph., B.S.P., M.C.Ed.Editor, Deputy Registrar,Director of Professional [email protected]

Electoral Districts & Members of Council 6

Committee Appointments 2008/2009 8

Liability Insurance 12

The MedsCheck Consult Pilot Project 13

Provincial OpiATE Project 14

Pharmacy Technicians’ Commitment to Regulation 15

New Online Pharmacist Annual Renewal Process 20

A Summer Student’s Experience at OCP 24

Call for Preceptors 28

HPRAC Launches Non-physician Prescribers Project 29

regular featuresPresident’s Message 4

Editor’s Message 5

Council Report 9

Health Canada Notices 18

Registration Q&A 22

Practice Q&A 23

ISMP - Medication Incidents Report 26

Deciding on Discipline 30

Bulletin Board 32

Focus on Error Prevention - Pediatric Dosages 33

CE Resources 34

Laws & Regulations 35

pharmacyconnectionNovember/December 2008 Volume 15 • Number 6

contents

Sue RawlinsonAssociate [email protected]

Agostino PorcelliniProduction & Design / [email protected]

Neil Hamilton [email protected]

ISSN 1198-354X© 2008 Ontario College of Pharmacists

Canada Post Agreement #40069798Undelivered copies should be returned to the Ontario College of Pharmacists.Not to be reproduced in whole or in part without the permission of the Editor.

4 pharmacyconnection • November/December 2008

Tracy Wiersema, R.Ph., B.Sc. Phm.

President

I am beginning my year as President of the Ontario College of Pharma-cists at a very exciting time for our

profession. This past summer we have made a submission to the Health Pro-fessions Regulatory Advisory Coun-cil (HPRAC) regarding the scope of practice for pharmacists, in which we have proposed several changes to ad-vance the role of the pharmacist in pa-tient care. The regulation of pharmacy

technicians is also becoming more of a reality as we work toward introduction of legislation in 2009.

Most recently, HPRAC again has called on pharmacy and other profes-sions to make submissions regarding non-physician prescribing and use of medications. All of these advance-ments in our profession and in other professions which are being explored require and promote inter-professional collaboration.

This is not about pharmacists or

pharmacy technicians finally getting the recognition they deserve. This is not about us working in isolation, or trying to compete with other profes-sions. It is about a team of health pro-fessionals working together to provide better access and care to patients. The Minister of Health has asked HPRAC to “recommend mechanisms to facili-tate and support inter-professional col-laboration between health Colleges be-

ginning with the development of stan-dards of practice and professional prac-tice guidelines where regulated health professions share the same or similar controlled acts, acknowledge that in-dividual health Colleges independent-ly govern their professions and estab-lish the competencies for their profes-sion.” The Minister has also asked that HPRAC “take into account, when con-trolled acts are shared, public expecta-tions for high quality services no matter which health profession is responsible

for delivering care of treatment”.Are we as a profession ready for

the next level of inter-professional col-laboration? If pharmacists are given an increased scope of practice, are we ready to document and collabor-ate with physicians, nurses, and other health care providers as to the actions we take in patient care? Are we ready to collaborate with technicians as they receive a regulated scope of practice and become our partners in dispensing of medications?

It will take something on the part of all professions to use our expertise in improving the outcomes of our pa-tients, while giving up our reservations about other professions, and making them part of our team.

Taking on an advanced scope of practice may seem like a big change for pharmacists and pharmacy techni-cians, but perhaps the biggest change will be the inter-professional collabora-tion which will be required to truly have our expertise contribute to patient care and improve patient outcomes.

Taking on an advanced scope of practice may seem like a big change for pharmacists and pharmacy technicians, but perhaps the biggest change will be the inter-professional collaboration...

president’s message

5pharmacyconnection • November/December 2008

editor’s message

New Brunswick and Prince Edward Island have recent-ly passed legislation allowing

an expanded scope for pharmacists in those provinces. British Columbia pharmacists will begin to participate in medication therapy management as of January 1, 2009. Alberta pharma-cists have been practising with an ex-panded role since April 1, 2008. There is a growing trend across Canada to

give pharmacists a greater role in adapt-ing, modifying and extending prescrip-tions to contribute to better medica-tion therapy management outcomes for Canadians.

Here in Ontario, the government is considering expanded roles for several health professionals, including pharma-cists. A review of the scope of prac-tice for pharmacists was submitted to government in June. The Health Pro-fessions Regulatory Advisory Commit-tee is now conducting a review of non-

physician prescribing and pharmacy has been included in that review. It is ex-pected that there will be a further op-portunity for pharmacists to comment on this submission.

At the same time, the regulation of pharmacy technicians is on the hor-izon. We have had an overwhelming response to the last OCP certification examination and to the first bridging program. All of the pharmacy techni-

cians who have passed and maintained their certification with OCP are eligible to move forward to regulation if they choose. Details can be found on page 16 and 17.

The synchronicity is incredible! The College has pursued the regulation of pharmacy technicians in order to opti-mize the knowledge and skills of the pharmacist and free them up from the technical duties of dispensing. It ap-pears that as this new regulated phar-macy technician steps up to become

more accountable for the technical as-pects of dispensing, that pharmacists will also be asked to step up and be ac-countable for adapting, modifying and extending prescriptions.

It is the professional responsibility of pharmacists and pharmacy technicians to keep their knowledge and skills up to date, and advancing with the changes in legislation.

Have you got a learning plan in place to prepare you for the future? Have you considered what documentation will be required with these expanding roles? Have you discussed in your indi-vidual workplaces what the workflow might be? Now is the time to have these discussions as the momentum to an advanced scope for pharmacists and pharmacy technicians increases.

Della Croteau, R.Ph., B.S.P., M.C.Ed.

Deputy Registrar/Director of Professional Development

There is a growing trend across Canada to give phar-macists a greater role in adapting, modifying and extending prescriptions to contribute to better medica-tion therapy management outcomes for Canadians.

6 pharmacyconnection • November/December 2008 77pharmacyconnection • November/December 2008

Hospital Members

Electoral Districts &Members of Council

Public Members Public Members

Faculty of Pharmacy

Elected Members

District 15, Gregory PurchaseThunder Bay

District 3, Sherif GuorguiToronto

District 16, Doris NessimMississauga

District 4, Tracey PhillipsToronto

District 17, Shelley McKinneyPickering

District 5, Don OrganAurora

Wayne HindmarshDeanLeslie Dan Faculty of PharmacyUniversity of Toronto

District 6, Fayez KosaMississauga

Jake ThiessenHallman DirectorSchool of Pharmacy University of Waterloo

District 9, Bonnie HauserDunnville

District 12, Peter GdyczynskiPast PresidentBrantford

District 10, Gerald CookLondon

District 11, Chris LeungWindsor

District 8, Saheed RashidAncaster

District 14, Stephen Clement Vice PresidentCallander

District 7, Tracy Wiersema PresidentBarrie

District 2, Elaine AkersPeterborough

District 1, Joseph HannaOttawa

District 13, TBA (Vacant)

Joinal AbdinToronto

Margaret IrwinSault Ste.Marie

Thomas BaulkeCollingwood

David HoffOakville

Andrea ChunToronto

Javaid KhanMarkham

Corazon dela CruzToronto

Lew LedermanOttawa

Babek EbrahimzadehWoodbridge

Aladdin MohagheghToronto

Gitu ParikhToronto

Marissa CoruzziPharmacy Technician

Melody WarellPharmacy Technician

Council Observers


committee appointments 2008/2009

ACCREDITATIONElected Members:Stephen ClementShelley McKinney (Chair)Public Members:Margaret IrwinJavaid KhanNCCM:Roger BallErik ThibaultStaff Resource:Nicole Balan

COMMUNICATIONSElected Members:Gerry Cook (Chair)Peter GdyczynskiSaheed RashidPublic Members:Corazon dela CruzLew LedermanNCCM:Mayce Al-SukhniIana IvanovaStaff Resource:Connie Campbell

COMPLAINTSElected Members:Gerry CoockGreg Purchase (Chair)Public Members:Margaret IrwinGitu ParikhNCCM:Gurjit HussonStaff Resource:Maryan Gemus

DISCIPLINEElected Members:Peter GdyczynskiSherif Guorgui (Chair)Joseph HannaBonnie HauserWayne HindmarshFayez KosaChris LeungShelley McKinneyDon OrganDoris NessimSaheed RashidPublic Members:Joinal AbdinTom BaulkeAndrea ChunCorazon dela Cruz

Bob EbrahimzadehDavid HoffLew LedermanAladdin MohagheghNCCM:Larry BoggioErik BotinesDave MalianVijay RasaiahMark ScanlonJeanette SchindlerZita SemeniukDan StringerLaura WeylandStaff Resource:Maryan Gemus

EXECUTIVETracy Wiersema (President & Chair)Stephen Clement (Vice President)Peter Gdyczynski (Past President)Bonnie HauserPublic Members:Tom BaulkeDavid HoffAladdin MohagheghStaff Resource:Deanna Williams

FINANCEElected Members:Gerry CookPeter GdyczynskiBonnie HauserPublic Members:Tom BaulkeGitu Parikh (Chair)Staff Resource:Connie Campbell

FITNESS TO PRACTICEElected Members:Chris LeungDoris NessimGreg Purchase (Chair)Public Members:Joinal AbdinLew LedermanGitu ParikhNCCM:Magued HannalahChris MobbsStaff Resource:Maryan Gemus

PATIENT RELATIONSElected Members:Elaine Akers (Chair)Gerry CookPublic Members:Tom BaulkeMargaret IrwinJavaid KhanNCCM:Chris AljawhiriStaff Resource:Anne Resnick

PROFESSIONAL PRACTICEElected Members:Sherif GuorguiJoseph HannaWayne HindmarshTracey Phillips (Chair)Don OrganPublic Members:Corazon dela CruzDavid HoffNCCM:Larry BoggioJill DaleyIris KrawchenkoSherry PeisterStaff Resource:Nicole Balan

QUALITY ASSURANCEElected Members:Shelley McKinneyTracey Phillips (Chair)Public Members:Joinal AbdinLew LedermanAladdin MohagheghNCCM:Christine DonaldsonGurjit HussonLilly IngStaff Resource:Sandra Winkelbauer

REGISTRATIONElected Members:Elaine Akers (Chair)Stephen ClementBonnie HauserChris LeungPublic Members:Tom BaulkeBob EbrahimzadehDavid HoffNCCM:

James ButtooDavid MalianDean:Jake ThiessenStaff Resource:Chris Schillemore

PHARMACY TECHNICIANSWORKING GROUPElected Members:Elaine AkersGerry CookBonnie Hauser (Chair)Don OrganGreg PurchasePublic Members:Andrea ChunNCCM:Bonnie BokmaMarissa CoruzziTim FlemingCatherine GrahamMark ScanlonCatherine SchusterMelody WardellStaff Resource:Susan James

STANDARDS OF PRACTICEWORKING GROUPElected Members:Chris LeungShelley McKinney (Chair)Saheed RashidPublic Members:Andrea ChunJavaid KhanNCCM:Zubin AustinZita SemeniukJeannette WangStaff Resource:Anne Resnick

NCCM=Non-Council Committee Member


council report

SEPTEMBER 2008

Council Approves 2009 Capital And Operating BudgetAt the September 2008 Council meet-ing, College Council voted in favour of approving the proposed capital and operating budget for 2009. The budget reflects the additional resources re-quired to address the needs of an ever growing and complicated membership base. These include:• Diverse streams of technicians seek-

ing regulation;• Increased scrutiny on entry to prac-

tice fairness;• HSIA (Health Systems Information

Act) and its impact on complaints and adjudication;

• Increased investigation demands;• Higher discipline case load; • Compliance costs for members’ liabil-

ity insurance requirement;• Technology support for increasingly

complex on-line services;• Call volume increases of 40%.

Although there are no increases budgeted for annual fees for pharma-cists or pharmacies or for accredit-ation or registration processes, there are some changes to the fee by-law. Ef-fective January 1, 2009, annual fees for pharmacists electing into Part B of the Register will be reduced to half that of a Part A fee. In addition, anticipating that Pharmacy Technicians will commence registration with the College in 2009, the budget provides for Technician an-nual fees to be equal to two thirds that of Part A Pharmacist fees. There is also

a new fee for Reinstatement that will support changes to proposed entry to practice regulations. The projected ex-cess of operating expenses over rev-enue of $445,000 and the IT capital spending of $150,000 is to be covered by accumulated reserves.

Council noted that over the past sev-eral years, due to growth in member-ship, the College has accumulated re-serves projected to exceed $4 million by year end 2008. As reported in previ-ous years, the excess reserves were al-located for facilities to address the an-ticipated increase in space required to accommodate growth in staffing. Con-sultations are currently underway, facili-tated by an outside Real Estate/Design firm; to determine how the current fa-cilities owned and operated by the Col-lege could be reconfigured to increase the utility and efficiency. Accordingly, Council agreed to defer approval of a capital budget for building, leaseholds and furniture to December 2008.

Council Approves Appointment Of Clarke Henning Llp As Auditors For 2008In keeping with the Finance policy that external services be tested against the market every five years, the Financial and Audit services were taken to the market in the spring of this year. Fol-lowing a comprehensive analysis, the Finance Committee recommended that the firm Clarke Henning LLP, Chartered Accountants, be appointed as Auditors for the College for the fis-cal year 2008. The firm is registered with the Canadian Public Accountabil-ity Board and will be undertaking the financial audit, the required pension audit as well as the fairness audit. As well, Council noted that the appoint-ment of Clarke Henning will result in a 30% cost saving in financial audit fees and the firm has committed to not rais-ing their fees beyond the CPI for three years.

Council Approves

Approved 2009 Budget Summary

Member Fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,223,627

Pharmacy Fees . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,741,230

Health Profession Corporation . . . . . . . . . . . . . . . .$ 31,800

Registration Fees and Income . . . . . . . . . . . . . . . . .$ 878,169

Investment Income . . . . . . . . . . . . . . . . . . . . . . . . .$ 230,000

Total Projected Revenue . . . . . . . . . . . . . . . .$10,104,826

Expenses

Council, Committee & District Meetings . . . . . . . $ 2,805,518

College Administration . . . . . . . . . . . . . . . . . . . . . $ 7,476,639

Property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ 267,459

Total Expenses . . . . . . . . . . . . . . . . . . . . . . . .$10,549,616

Excess of Revenue over Expenses . . . . . . . . . . . . . $ (444,790)

Capital Expenditures . . . . . . . . . . . . . . . . . . . . . . . $ (150,000)

Surplus (Deficit) after Capital . . . . . . . . . . $ (594,790)


Registration Regulations RatifiedAs required under subsection 95 (1.4) of the Health Professions Procedural Code, and as directed by Council at the June 2008 meeting, a consulta-tion process was initiated with stake-holders on the Proposed Registration Regulation. Feedback was requested from the members, certified pharmacy technicians, regulatory organizations, national and provincial pharmacy and pharmacy technician associations, and the Office of the Fairness Commis-sioner. The College received feedback from a small number of individuals and from those regulatory authorities and organizations most directly concerned with the Regulation (e.g. Office of the Fairness Commissioner, Pharmacy Examining Board of Canada, Canadian Council for Accreditation of Phar-macy Programs). The College care-fully considered all feedback that was received prior to the Council meet-ing and, although no material changes were made, the consultation resulted in some changes to ensure clarity of the original intent. The ratified regulations can be found on the College’s website (www.ocpinfo.com). Comments or questions about the changes are wel-come and may be directed to Susan James ([email protected])

Council Ratifies Issuance And Renewal RegulationsFollowing Council’s consideration and preliminary approval of the proposed regulation under the Drug and Phar-macies Regulation Act providing for the issuance of, suspension, revocation, expiration or renewal of Certificates of Accreditation, the regulation was circulated to members for comment.

Following receipt of responses from or-ganizations such as the Ontario Phar-macists’ Association and the Ontario branch of the Canadian Association of Chain Drug Stores as well as from cor-porations owning pharmacies in On-tario, the College held a meeting with the respondents to provide clarifica-tion of the College’s purpose and intent as well as to further understand their concerns. As a result of this meeting, several changes were made to the pro-posed regulation and Council ratified the regulations which can be found on the College’s website www.ocpinfo.com. Council noted that College pro-cesses respecting these matters have yet to be defined and that appropriate Committees will be tasked to deal with specific details.

E-Health In OntarioCouncil heard a presentation by Mr. Doug Tessier and Mr. Nick Zamora on Ontario’s e-health program. The Pro-gram objective is to help ensure that information and information technol-ogy are used to improve and modern-ize Ontario’s health care system, and to improve the quality of, and access to, health care services. Four immedi-ate priorities were highlighted in the presentation and Council was particu-larly pleased to note that members of this College are well-placed to play an active and integral role in the Ministry’s e-health initiatives as noted below:

Ontario Diabetes Registry• Comprehensive tool for diabetes

management and self-care• Accessible to providers, case man-

agers, patients and their families to support health promotion, disease prevention and better care

• Provides information to health plan-ners, LHINs and system stewards to enhance system management

Portals/Integrated Clinical View• Integrates patient information from

different clinical systems – Labs, Drugs, Diagnostic Imaging, Public Health

• Provides a single access point for to securely view a patient’s clinical results

• Builds upon current electronic med-ical record systems in physician of-fices and EHR repositories, includ-ing eCHN

e-Prescribing and Drug Systems• Provides complete drug history and

dispensing information ensuring ap-propriate prescribing and improved patient safety

• Provides drug interaction tools for providers and ensures accurate and complete information for dispensing

EMR/Computers for Physicians• Development of a program to support

the funding and distribution of com-puters to Ontario Physicians

• Multiple models to match the differ-ent needs of Ontario Physicians

• Linked to performance and outcome aligned with other health system priorities

Support For Blueprint For PharmacyFollowing the launch at the CPhA con-ference in June 2008, the Blueprint for Pharmacy – the Vision for Pharmacy document was distributed to all nation-al and provincial pharmacy organiza-tions, faculties of pharmacy and cor-porate pharmacy head offices. The

council report


Task Force invited these pharmacy stakeholders to support the Vision for Pharmacy and asked that they commit to work collaboratively with the Blue-print Task Force and working groups as they develop the implementation plan. Council endorsed the decision to sup-port the concepts and principles em-bedded in the Blueprint and the com-mitment that the document will be-come an integral part of Council’s dis-cussion as the College enters the next strategic planning cycle in 2009.

New Pharmacy Technician Observers Welcomed At Council TableCouncil welcomed Ms. Marissa Cor-uzzi and Ms. Melody Wardell to their inaugural Council meeting. Both phar-macy technicians have been appointed by the President to sit as observers at the Council table for the 2008-2009 Council term and will also serve on the Pharmacy Technicians Working Group of the College.

Office Of The Fairness Commissioner/Labour MobilityIn accordance with the Fair Access to Regulated Professions Act and the Regu-lated Health Professions Act, the Of-fice of the Fairness Commissioner re-quires certain professions to review the registration practices, submit re-ports about them and undergo compli-ance audits to ensure that registration is fair. This College will participate in the first round of audits which will be conducted as a pilot and accordingly, an audit of this College’s registration practices from July 16, 2007 to July 15, 2008 will occur between January and March 2009.

On a related matter, Council also noted the significant work currently underway by the federal/provincial/territorial agencies as well the regu-latory authorities respecting revisions to Chapter 7 (Labour Mobility) of the Agreement on Internal Trade. It is to be noted that all areas are working collab-oratively in order to meet the Premiers’ commitment that, “any worker certified for an occupation by a regulatory author-ity of one province or territory shall be recognized as qualified to practice that occupation by all other provinces and ter-ritories.” Council further noted that the College will participate in the review for the MRA for Pharmacy in Canada process that is organized through NA-PRA in late October.

Health Canada Grants A Further Extension Of S . 56 Class ExemptionHealth Canada has granted a further extension to their Section 56 Class exemption. The exemption, which permits the pharmacist to dispense methadone and to transfer custody of such doses in a secure manner to physicians or their delegates, will end December 31, 2008. Health Canada has advised that it is now in receipt of the final Evaluation Report, “Meth-adone Interim Policy Evaluation: Study Report” and that these recommenda-tions, along with all other information, will be taken into consideration dur-ing the review and analysis of this non-traditional model for the provision of methadone in Ontario.

Conference Of The Ontario Pharmacists’ Association SponsorshipCouncil endorsed the Executive

Committee’s recommendation that the College sponsor an education ses-sion at OPA’s 2008 annual conference. This year, the sponsorship, in the sum of $5,000, was provided for the ses-sion entitled “Methadone Education for Pharmacists” by Mary Nelson.

Practice Guide ProjectIn 2007, the Professional Practice Committee identified the need to begin a process of reviewing all existing poli-cies and guidelines currently available on the College’s website, in order to both facilitate access by members of the College and members of the pub-lic, and to increase understanding by members of the complex network of legislation, regulations, by-laws, stan-dards, policies and guidelines by which they are expected to practice. Council noted the progress made with respect to this project and was advised that a legal review will also be conducted to ensure that by categorizing as stan-dards, policies or guidelines, the intent of each document will be clear with re-spect to providing guidance to mem-bers and for purposes of enforceabil-ity. It is anticipated that over the next few Council meetings, the Professional Practice Committee will bring forward recommendations (i.e. reaffirmation or deletion) for Council’s consideration.

Council Meeting Dates 2008 -2009 Term• Thursday 11th and Friday 12th De-

cember, 2008• Sunday 8th, Monday 9th and Tuesday

10th March, 2009• Monday 8th and Tuesday 9th June,

2009• Monday 14th and Tuesday 15th Sep-

tember 2009


liability insurance

It has been almost a year since the College introduced the require-ment for all Part A pharmacists to maintain personal professional liability insurance. The first year was full of questions. The ques-

tions came from insurance underwriters, brokers, pharmacy corpora-tions and professional groups – both community and institutional, and of course, from individual members.

What we learned in this first year is that words can be interpreted differently no matter how clearly we believe they are stated. The in-surance requirement was put in place to ensure that members of the public who are harmed as a result of a medical misadventure involving a practising pharmacist or an intern can make a claim that could be cov-ered through insurance.

To ensure that happened, the College explored models of mandat-ed coverage ranging from simply stating a minimum limit of coverage to developing a compulsory, coordinated program through the Col-lege. Given the model for services in Ontario, the College believed a more prescribed approach was appropriate. However, despite pre-scribing very specific criteria, there was quite a range of products and options out there. In some cases, what was intended was not exact-ly being delivered. Insurance brokers were marketing products that, while on the surface appeared compliant, were not fully meeting the expectations.

To even the playing field and ensure that the public has protection if and when they need it, we have worked closely with our insurance con-sultant, the broker community and insurance companies to determine which policies can and will meet the intention of the College’s registra-tion requirement, while assuring costs to the pharmacist associated with the appropriate coverage is reflective of the insurance marketplace.

Presently there are still a large range of products available and at the suggestion of our insurance consultants we will be streamlining the pro-cess and product availability to ensure consistency.

At this time, we can confirm that the insurance products and broker organizations listed on this page satisfy the criteria prescribed in Col-lege by-law.

We urge members to be cautious if considering any other insurance products. We also caution members who are relying on their employer to arrange insurance on your behalf. Any policy that terminates if your employment terminates DOES NOT meet the College’s requirement. It is the member’s responsibility to ensure that they have compliant in-surance and that the insurance is fully portable regardless of their em-ployment status.

Ontario Pharmacists’ AssociationBroker: AON Reed Stenhouse

Contact: Eija Kanniainen, OPA

Phone: 416-441-0788 ext 4226

Toll Free: 1-866-903-3780

www .opatoday .com

Canadian Society of Hospital PharmacistsBroker: The Insurers Financial Group

Contact: Dianne Leibold

Phone: 905-707-5141 ext 1202

Toll Free: 1-800-563-7283 ext 1202

dianne .leibold@ifgcanada .com

Aviva CanadaThis product is available through multiple insurance

brokers across Ontario and through specific

agreements with various pharmacy groups/networks.

Pharmaguard Individual MalPractice LiabilityBroker: Gary McCaslin

McCaslin Horne Insurance Brokers Inc .

Phone: 905-877-8738

Toll Free: 1-800-668-4830

mchorne@bellnet .ca

www .pharmaguardins .com

Gellatly Insurance LimitedBroker: Ben Malik

Phone: 416-236-2321, ext 121

Toll Free: 1-800-381-4092 ext 121

bmalik@gellatlyinsurance .com

www .gellatlyinsurance .com

Pottruff and SmithBroker: Leo Adragna

Toll Free: 1-800-263-2369 x 309

ladragna@pottruffsmith .com

www .pottruffsmith .com

Update on Professional Liability Insurance


MedsCheck Consult – An expansion of the MedsCheck program As a result of conducting the MedsCheck Annual or MedsCheck Follow-Up medication review many pharma-cists are identifying drug related problems (DRP) and medi-cation-related issues that require the collaboration with the patient’s prescriber; hence the reason we are expanding to the MedsCheck Consult program.

What is the difference between the MedsCheck Annual or the MedsCheck Follow-Up and the MedsCheck Consult?Whereas the MedsCheck Annual and MedsCheck Follow-Up medication review program focused on the relationship between the pharmacist and the patient or caregiver, the MedsCheck Consult is a program that promotes collabora-tion and follow-up between the pharmacist, patient and pa-tient’s prescriber towards the goal of optimizing a patient’s drug therapy.

The main objectives of the MedsCheck Consult are to promote healthier patient outcomes; and improve and opti-mize drug therapy by promoting inter-professional collab-oration in patient care.

How does the MedsCheck Consult work?The MedsCheck Consult builds on the MedsCheck medi-cation review process. Should a pharmacist identify a DRP, he/she will communicate with the patient’s prescriber using a standardized form and outline the DRP or medication con-cern including the nature of the drug related problem, the desired outcome, a recommended option(s) to the physician and possible follow-up action.

The physician and pharmacist, together, agree on the

collaborative action that is best for the patient. The stan-dardized form, signed and dated by both practitioners is re-turned to the pharmacist as the agreement to proceed with one of the following responses: no further action required; a change to a patient’s medication therapy; or a request by the prescriber that additional information or further analysis of the possible recommended option be considered.

PILOT implementation of MedsCheck Consult programThe MedsCheck Consult program will be piloted to identify strengths and weaknesses of the program and to test the use of the standardized form that will be required for purposes of documentation and communication of the process.

The MedsCheck Consult pilot study will include a min-imum of 30 pharmacy practice sites from across the prov-ince including urban, rural and remote; and from differ-ent pharmacy practice sites such as independent owner, chain, banner, mass merchandiser, medical clinic pharmacy, family health team, hospital out-patient and walk-in clinic operations.

Interested pharmacists will receive a one-time honour-arium for their participation in the pilot study and are asked to complete an application that includes a commitment to approximately 3 months of activity and one month of fol-low-up communication and assessment with the ministry. In selecting pharmacists, inherently, the physicians in their vicinity will also be selected and included in the plans.

For more information on the MedsCheck Consult pro-

gram please refer to: www.medscheck.ca

The MedsCheck™ Consult Pilot Project


opiATE

The OpiATE (Awareness, Treatment and Educa-tion) Project was created after a 2007 provincial

task force made recommendations on how to improve methadone maintenance treatment.

Methadone is an effective and legal substitute for opioid drugs such as heroin, codeine, morphine, Dilau-did®, and Percodan®. People who are dependent on opioid drugs can take methadone to help stabilize their lives. The dose is usually mixed with orange juice and taken daily. It has been used in treatment programs since the early 1960s.

The use of methadone maintenance treatment has increased substantially over the past decade in On-tario, and the provincial task force noted three main challenges: • Access to services in a timely and equitable manner • Ensuring methadone maintenance treatment servi-

ces are safe and effective • Responding to concerns of local communities

where methadone maintenance treatment is provided

The OpiATE project, which received $2 million in provincial funding, has three strategies: a) raising

awareness b) community engagement and c) train-ing/professional supports. Partners include the Col-lege of Physicians and Surgeons of Ontario, Ontario Pharmacists Association, Registered Nurses Asso-ciation of Ontario, and the Centre for Addiction and Mental Health.

Four jurisdictions - Ottawa, Thunder Bay, Halton, and Chatham – were chosen to play a key role in the project. The aim is to create a strong community co-alition, and encourage physicians, pharmacists, and other health and social service professionals to get in-volved. An important objective is to reduce the mar-ginalization of clients with addictions.

On July 23, 2008, the Centre for Addiction and Mental Health held a meeting with 15 health profes-sionals at the Champlain LHIN office to share infor-mation about the OpiATE project. Attendees dis-cussed new mentoring and training opportunities in opioid dependence assessment and treatment for nurses, physicians, pharmacists, case managers and counsellors.

The group also spoke about awareness strategies for allied professionals and the community.

Ottawa Participating in Provincial OpiATE Project

Reprinted (modified) from CHAMPLAIN LHIN - with permission.

FOCUS ON METHADONE MAINTENANCE TREATMENT

Ottawa Area Pharmacists: There will be a C.E. workshop

on this topic coordinated by the Ottawa Carleton

Pharmacists’ Association on Wednesday, January 21, 2009

from 6:30 to 9 pm at the Hampton Inn.


pharmacy technician regulation

Pharmacy Technicians Demonstrate Tremendous

Commitment for Regulation

W hile the degree of early commitment is ex-citing and confirming, it has also created an unexpected situation. Technicians are

ready and waiting to complete the steps for registra-tion, even before the process is fully developed and widely available. Some technicians have reported frus-tration, as they find themselves competing to gain entry to programs that presently, have limited capacity.

On the bright side, the transition plan is on track and allows ample time for those wishing to pursue registra-tion to complete the process. In the next while, access to education programs will increase as on-line courses are developed and classroom delivery becomes avail-able in local communities and even some workplaces. Examinations will also expand to accommodate more people in more places, once fully implemented. So, al-though many of the activities are under development and will have limited availability through 2009, by the end of the year, full implementation will allow those technicians in transition to complete the process over the next five years.

Although momentum is growing and many phar-macy technicians are keen to move through the re-quired steps as soon as possible, there are many others who feel uncertain and undecided about what regula-tion will mean to them; this is understandable. In these early days, many questions are yet to be answered; about the process, the cost, the time and the effort that will be involved. Even as these details emerge, an inability to predict the future impact of regulation on individual technicians and workplaces continues to make the decision a difficult one. The College would like to reassure pharmacy technicians, pharmacists and employers that there is no need to feel pressured to act immediately. There is plenty of time to consid-er the issues and plan for the transition. Whether you choose to move forward now, wait for increased avail-ability of programs, extend the costs over a few years, or see how the marketplace responds… the choice is yours. Take your time, consider all of the aspects of regulation, and make the choice that is right for you and your career.

In the last couple of months there have been strong indicators

that pharmacy technicians in Ontario are not only engaged, but ready and

eager to pursue registration with the College.

The enthusiasm for regulation is remarkable; in fact it far exceeds

expectations – and capacity!

16 pharmacyconnection • November/December 2008 1717pharmacyconnection • November/December 2008

pharmacy technician regulation


health canada advisories & notices

Oct 29, 2008

Oct 28, 2008

Oct 28, 2008

Oct 17, 2008

Oct 17, 2008

Oct 15, 2008

Oct 8, 2008

Sept 23, 2008

Sept 22, 2008

Sept 3, 2008

Aug 22, 2008

Aug 22, 2008

Do not use Eros Fire, a product promoted to enhance sexual performance, as this product may pose serious health risks. The product was found to contain xanthoanthrafil (also known as benzamidenafil), which is not indicated on the label.

Published retrospective studies have reported that venlafaxine overdosage may be associated with an increased risk of fatal outcome compared to that observed with Selective Serotonin Reuptake Inhibitor (SSRI) antidepressants, but lower than that for tricyclic antidepressants.

Health Canada is warning Canadians, especially expectant mothers, not to use two vitamin C products sold under the brand names New Roots Herbal Vitamin C8 and Vitazan Professional Vitamin C Advanced Ascorbate. These products were improperly manufactured using vitamin A instead of vitamin C, exposing consumers to potential risks of adverse events.

Swissmedic warned consumers not to buy or use the product Powertabs because it was found to contain an unauthorised substance with a structure similar to sildenafil. Sildenafil is a prescription drug used in the treatment of erectile dysfunction and should only be used under the supervision of a health care practitioner. The Hong Kong Department of Health warned consumers not to buy or use the product Sweet Energizer Vitality Candy because it was found to contain an unauthorised substance with a structure similar to tadalafil (aminotadalafil). Tadalafil is a prescription drug used in the treatment of erectile dysfunction, and should only be used under the supervision of a health care practitioner.

Physio-Control, Incorporated, a division of Medtronic, Incorporated is notifying customers of a recall for LIFEPAK CR Plus and/or LIFEPAK EXPRESS automated external defibrillators (AED) manufactured between November 2006 and March 2008. These AEDs contain a specific internal flex cable that may be susceptible to failure and could cause a short, preventing the AED from powering on. Failure to power on will prevent delivery of therapy to a patient.

Teleflex Medical has issued a voluntary recall for Weck brand ligating clips including Hem-O-Lok, Horizon, Hemoclip Traditional and Hemoclip Plus products because holes were detected in the thermoformed tray of certain sterile packaged units meaning the sterile integrity cannot be guaranteed.

Health Canada is advising the public, especially nursing mothers, about the very rare but serious health risk to breastfed babies posed by codeine use in mothers. Once ingested, codeine is converted by the body into morphine. Some people convert codeine into morphine more rapidly and completely than others. The babies of nursing mothers who rapidly metabolize codeine may be at increased risk for morphine overdose due to higher-than-expected morphine levels in breast milk.

Health Canada is advising consumers not to use 6 foreign health products due to concerns about possible side-effects: Dr. Life, Chong Cao Ju Wang, Hanguo shoushen yihao (meiti xing), One Korean Slimmer (Body Enhancer Brand), Liquimax Complete Nutrition, Multivitamin Formula, ARMA - sin Gang San and New ARMA - Sin Gang San.

The Hong Kong Department of Health warned consumers not to buy or use Lover Liquid Nutriment Herbal Supplement and Onyo because they were found to contain undeclared pharmaceutical ingredients. Lover Liquid Nutriment Herbal Supplement was found to contain sildenafil while Onyo was found to contain sildenafil, as well as unapproved substances with structures similar to sildenafil and vardenafil. The U.S. Food and Drug Administration warned consumers not to use the product Rose 4 Her because it was found to contain an undeclared ingredient similar to the prescription drug sildenafil. The product has been voluntarily recalled by the manufacturer in the U.S.

Health Canada is advising consumers not to use any unauthorized health products sold under the brand names Life Choice, Healthy Choice, Doctor’s Choice and Your Choice as well as other products without a brand name. All of these unauthorized health products have the same identifying image on their label.

Health Canada is advising consumers not to use 8 foreign products due to concerns about possible side-effects. Natural (Xin Yi Dai) and Lasmi, AA Qu Feng Shu Jin Wan, Energy II, Apisate, Obat Asam Urat and Asam Urat, Slim 3in1 (Xiao Nan zhi Bao)

Health Canada is warning consumers not to use the two unauthorized natural health products, Life Choice Ephedrine HCL and Life Choice Kava Kava because they are not approved by Health Canada, and may cause serious adverse health effects including death.


Aug 21, 2008

Aug 20, 2008

Aug 19, 2008

Aug 18, 2008

Aug 14, 2008

Aug 12, 2008

Aug 11, 2008

Aug 11, 2008

Aug 8, 2008

Aug 7, 2008

Aug 7, 2008

Aug 1, 2008

For complete information & electronic mailing of the Health Canada Advisories/Warnings/Notices subscribe online at: http://www.hc-sc.gc.ca/dhp-mps/medeff/index_e.html

MedEffect e-Notice is the new name which replaces Health Canada’s Health_Prod_Info mailing list. The content of the e-notices you receive will remain the same and are now part of MedEffect, a new Health Canada Web site dedicated to adverse reaction information. MedEffect can be visited at www.hc-sc.gc.ca/dhp-mps/medeff/index_e.html

Health Canada Notices are also linked under “Notices” on the OCP website: www.ocpinfo.com

Health Canada would like to assure Canadians that the Viracept product now available on the Canadian market has the acceptable ethyl methanesulfonate limits so that the precautions relating to its use in non-pregnant HIV infected adults and children no longer apply.

Liko issued a safety notice for the Universal SlingBar. An unanticipated fatigue may lead to the sling bar to detach from the patient lift resulting in the patient falling. The letter contains important safety information regarding the inspection of the SlingBar to detect any problem.

Precipitate formation has been observed in Accusol 35 haemodialysis solutions for acute renal therapy when used for treatment modes other than haemodialysis. SOL35K0 and SOL35K4 solutions are only to be used for haemodialysis and should not be used for haemofiltration and haemodiafiltration

Health Canada is advising consumers not to use 9 foreign health products due to concerns about possible side-effects: Dan Bai Shou Shen Su, Karntien, Karntien Easy to Slim, Armstrong Natural Herbal Supplement, Enhanix New Extra Men’s Formula, Power 58 Extra, and Platinum Power 58 Extra, More Slim and Soloslim.

Further to a communication issued August 8, 2008, Health Canada is advising Canadians with milk allergies of two additional acidophilus-containing health products labeled as “non-dairy” that have been found to contain trace amounts of milk protein from dairy ingredients used in the production process.

Health Canada Recalled damaged Curlin infusion pumps. Curlin Medical, Inc. issued a safety notice for specific ambulatory infusion pumps. The affected pumps may exhibit over-delivery medication when physically damaged. The letter contains important safety information regarding testing the pump and updates of the User’s Manual instructions.

Health Canada is advising consumers that serious hypersensitivity/infusion adverse events have occurred in patients treated with TORISEL (temsirolimus).

Health Canada is advising consumers not to use 5 foreign health products due to concerns about possible side-effects: Oyster Extract Caps, Xiadafil VIP Tabs, Herb Vigour, Natural Vigour and China Vigour.

Health Canada is warning Canadians with milk allergies not to use several brands of unauthorized acidophilus-containing health products labeled as “non-dairy” because they contain trace amounts of milk protein from dairy ingredients used in the production process.

Desmopressin nasal sprays (including Apo-Desmopressin Spray) are associated with an increased risk of serious side effects involving water retention and decreased blood sodium levels (hyponatremia). Canadian healthcare professionals, patients and hospitals are advised that intranasal formulations of desmopressin (including Apo-Desmopressin Spray) are contraindicated for treatment of Primary Nocturnal Enuresis (bedwetting) due to increased risk of hyponatremia.

Health Canada is warning consumers not to use Rize 2, The Occasion capsules (Rize2), an unauthorized product promoted for the treatment of erectile dysfunction, because it may pose serious health risks. Rize 2 contains an undeclared pharmaceutical ingredient similar to the prescription drug sildenafil which should only be used under the supervision of a health care professional. The product may pose serious health risks, especially for patients with pre-existing medical conditions such as heart problems, those who may be taking heart medications, or those who may be at risk for strokes.

Health Canada is advising consumers that Ceftriaxone monographs are being updated to address the risk of fatal interaction of ceftriaxone with calcium.

moving forward with technology


Step 1: Renewing and updating your informationThe online process will guide you through the information requiring verification and/or updating. Information that appears with an asterisk (*) is mandatory and these fields must be completed. You will be able to review the infor-mation you have entered, save changes, and come back to complete your renewal at a later time.

Once you fully complete and submit this first step of your renewal, you will receive a confirmation that your updated information has been recorded on your file.

Step 2: Payment of the annual renewal feeYou may pay your renewal two ways; by online payment, or by mailing your payment to the College with a printed copy of the confirmation . If you pay online you will re-ceive a pop-up confirmation indicating successful payment and a confirmation number. OCP recommends that you print the payment notice to retain for your records.

Your annual renewal is considered complete once BOTH steps have been completed. Your receipt and wal-let card will be mailed to your “preferred mailing address”.

Step One

1. Getting started…you’ll need your OCP number (User ID) and your eService password. Forgot your password? Your password was originally set to the last 6 digits of

your Social Insurance Number. If you have changed your password and forgotten it, you can request a new password online using eService provided the College has your current email address. If we do not have your current email address on file, please email [email protected] so that we can update your record.

2. Go to www.ocpinfo.com, click on Member Login. Enter your User ID (your OCP number) and your password.

3. Once you have successfully logged in, click on Pharma-cist Renewal on the left hand side of the screen.

4. Because of different fees and insurance requirements, the initial page will require you to confirm that you are in Part A or Part B of the register. To elect to Part B of the College register please send an email to [email protected] indicating your desire to move to Part B of the register. To elect to Part A of the College register please contact Continuing Competency at (416) 962-4861 ext. 273 for more information.

5. You will be asked to verify and/or provide information as you move through the tabs. Information that ap-pears with an asterisk (*) is mandatory and must be confirmed or changed.

Personal Information• OCP number (display only)• Part – A or B(display only) • Status (display only)

New Online Pharmacist Annual Renewal Process

Fast , easy , convenient !

Completing your renewal is a 2-step process ... here’s how it works


New Online Pharmacist Annual Renewal Process• Last Name (display only)• First Name (display only) • Preferred First Name *• Title (Mr. Mrs., etc) *• Home address *• Residential Telephone Number * (at least one [resi-

dential or cell phone] must be entered)• Cell Phone Number

Practice Information • Your current practice sites will be displayed• Please remove any practice sites that no longer apply• Your current declared place of practice for voting pur-

poses will be indicated by a ●•• Please update your weekly practice hours, employment

category and employment status. **

Contact Information• Preferred Email• Preferred Mailing address (defaults to Home address)• Preferred Fax• Preferred Language (this is for demographic and statis-

tical information (English or French) Note: The Col-lege corresponds to members in English,

Education Information • OCP Qualifying Degree (display only) • Additional Education information. ** Insurance Information (required for Part A pharmacists only)• Your current policy information on file will be displayed. • If you are with the same insurance company and have

renewed your policy, please update the term start and end dates.

• If you have a new insurance policy please update all requisite fields.

Declaration• Please read the Criminal and Drug Related Offences

question and Declaration carefully to understand what is required, so that you do not inadvertently provide an incorrect response!

Once you fully complete and submit this first step of your renewal, you will receive confirmation that your informa-tion has been updated and recorded on your file.

Step TwoPayment

• Pay online by Credit Card or Interac (Debit card). You will receive a pop-up confirmation indicating successful payment and a confirmation number. OCP recommends that you print the payment notice to retain for your records.

Or• Mail your cheque to the College with a printed copy of

your confirmation from step one.

Your annual renewal is considered complete and your receipt and wallet card will be sent to you once BOTH STEPS have been completed.

** This information is collected and reported to the Can-adian Institute for Health Information (CIHI). CIHI is an independent, not-for-profit organization that pro-vides essential data and analysis on Canada’s health system and the health of Canadians.

Watch for this new process to be launched online

mid-January, 2009


registration Q&A

Chris Schillemore, R.Ph., B.Sc.Phm. M.Ed.

Manager, Registration Programs

QMy fluency score will expire before I am licensed . What should I do?

The Registration Committee has approved a policy allowing registration advisors to extend the validity of language pro-ficiency test scores if you are currently enrolled in the Inter-national Pharmacy Graduate program at the Leslie Dan Fac-ulty of Pharmacy, University of Toronto, or are completing your Structured Practical Training at the student or intern level in Ontario. If your fluency scores expired before you started training at the student level, or if there are any con-cerns about your fluency, your request will be referred to a panel of the Registration Committee. The panel will con-sider current use of the language and decide whether it will extend the validity of your test score or require you to com-plete another test. Panels will consider any evidence you may wish to provide in support of your request; however, they make their decisions on a case-by-case basis.

For information on the language proficiency tests and scores that meet OCP’s language requirements, go to www.ocpinfo.com > Licensing > Training & Assessments > Fluency.

Q I am making a request for an exemption from a registration requirement . When will my request go to a registration panel?

The deadline for submitting your request to a specific panel is the first day of the month before the panel is to meet; for example, all documents for the February panel must be re-ceived by January 1. The Regulated Health Professions Act (RHPA) Procedural Code requires the College to give ap-plicants notice of their right to provide any documentation to support a request within 30 days.

Client Services cannot forward your file to the Registra-tion Programs department to make a request to a panel until they receive the following: • all documents required to complete your pre-registration

file

• the Pre-Registration form [available at www.ocpinfo.com > Licensing > Forms > Pre-Registration Form (Filing Fee Form)]

• the student or intern application form • the appropriate fees • a letter explaining your request, along with documentation

to support your request for an exemption.

Since it may take more than the 30 days given in the no-tice for you to obtain documents from other jurisdictions, incomplete files will not be forwarded to the Registration Programs department until the outstanding documenta-tion is received.

Client Services staff must confirm your identity, phar-macy education, status in Canada, licensure and good stand-ing in other jurisdictions, good character, examination re-sults, and language proficiency before sending your request to the Registration Programs department. It is important to respond to requests from Client Services for outstanding in-formation as quickly as possible so that your application can be referred to a panel.

Once your pre-registration is complete, the Registra-tion Programs Assistant will review your request and docu-ments. You will receive a formal referral letter from the Registrar, as required by the RHPA Procedural Code, listing the reasons for your referral to a panel as well as the date of the meeting. The letter also states that you have 30 days to submit additional material to support your request. The Registration Programs Assistant may contact you to sug-gest specific documents that you submit to support your request to the panel.

While OCP staff make every effort to forward your file to the next available panel, missing documentation can cause delays. For more information, please go to www.oc-pinfo.com > Licensing > Member Registration > Registra-tion Panel Requests.


practice Q&A

QWhat must a pharmacist report to Health Canada regarding controlled substances, specifically

narcotics and controlled drugs?Both the Narcotic Control Regulations (NCR section 42) and the Regulations to the Food and Drugs Act (s.G.03.013) requires a pharmacist to report any loss or theft of these drugs within 10 days of discovering the loss.

QHow do I report a loss? Are there forms to fill out?

Forms can be found on the Health Canada website at: http://www.hc-sc.gc.ca/dhp-mps/substancontrol/sub-stan/compli-conform/loss-perte/index-eng.php

In addition, pharmacists can access the forms through the OCP website by clicking on the menu tab “College Forms” at the bottom of the OCP homepage, and clicking on the link “Reporting narcotic and controlled drug loss…”

QWhat would be considered a loss of controlled substances?

A loss can take many forms. Simply stated, a loss is anything that results in a shortage in your inventory of controlled sub-stances. Some examples are theft or robbery, diversion or unexplained loss, spillage or wastage, damage or contam-ination of products, etc.

QWhat about forgeries? Are they reported together with other losses?

No. Although forgery is a form of loss, forgeries are reported on a separate Health Canada form. Pharmacists should download and keep copies of both the loss report and the forgery report forms with their narcotic records.

QWhat if I discover a forgery that was filled in the past? Do I still need to report that?

Yes. Any loss, theft or forgery must be reported within 10 days of discovery.

Greg Ujiye, R.Ph., B.Sc.Phm.

Professional Practice Advisor QWhy is it necessary to print and review the Narcotic Sales Report?

The Narcotic Sales Report is an important management tool in curbing diversion and theft, when properly reviewed. Owners and managers should use the report with the nar-cotic prescriptions dispensed to ensure that• all reportable narcotics and controlled drugs are properly

recorded, i.e., their software is up to date,• all prescriptions are accounted for, i.e., no prescription

numbers are missing,• all narcotics and controlled drugs requiring a written pre-

scription are present,• unusual patterns of drug usage are monitored or

identified.

QWhy is it necessary to do a narcotic inventory regularly?

Narcotic inventories are necessary to provide a starting point or baseline to perform narcotic reconciliations. Nar-cotic inventories should be done on a regular basis, in con-junction with random reconciliations on specific narcotics. This will help to identify any shortages, possible diversion, or theft. The introduction of perpetual inventory manage-ment by software providers is a useful tool for facilitating the reconciliation process.

QWho do I contact to receive permission to destroy narcotics or controlled drugs in my inventory?

All requests for permission to destroy narcotics must be for-warded to the Compliance, Monitoring and Liaison Division of Health Canada. No specific form is required, however all requests must be legible and include:• name of the pharmacy• name and signature of the pharmacist making the

request• date of the request• detailed list with name of product, strength, dosage form

and quantity as well as reason for destructionFax your request for destruction to the Compli-

ance, Monitoring and Liaison Division at 1-613-957-0110. For more information the office can be contacted by tele-phone at 1-613-954-1541


My summer exp erience at the OCP

summer student

This summer, I had the wonder-ful opportunity of working at the Ontario College of Phar-

macists from May to August. I feel that my experience at the College has helped me bring together all the differ-ent pieces of my pharmacy education thus far, and has provided me with a clearer picture of the profession in our province.

After a short time, my initial sim-plistic definition of the College as the licensing and regulating body of phar-macists in Ontario was slowly replaced by a much broader and comprehensive understanding of the roles and respon-sibilities of all those who encompass the College; the staff, the members of Council, and the pharmacist Mem-bers in Ontario. I learned a lot about the internal structure of the College;

the different departments and their respective roles, and how they are all fundamentally interconnected. I had the opportunity to attend various com-mittee meetings and a Council meet-ing. At these meetings I observed how OCP staff supports committee mem-bers who come together and dedicate their time and knowledge to regulate the profession and protect the public.

I had the opportunity to work on a few different projects this summer for various departments. The majority of my time was dedicated to a project in-itiated by the Professional Practice Pro-gram. The goal of this ongoing pro-ject is to create a Practice Guide for pharmacists in Ontario. I found this work to be very educational as it in-volved researching the origins of num-erous policies and guidelines which have been written by the College over the years, with some documents dat-ing back to the seventies. Through this process, I got a glimpse into the past, and learned about the history of many elements in pharmacy practice today, and how they came to be and why. I learned that although it is important to have governing policies and guidelines in place to maintain standards across the province, it is also equally import-ant for pharmacists to be able to apply their own knowledge and experience in their practice, as clear cut answers are not always within reach.

With guidance from the Registration

Program, I had the opportunity to learn more about the entry to practice re-quirements for pharmacists who have graduated outside Ontario. I have also gained a better understanding of the requirements for maintaining licensure as a pharmacist in Ontario, and how this varies across the country. Learn-ing about these registration require-ments and the reasons for their exist-ence has given me a greater apprecia-tion for the impact that they have on the public.

My experience at the College has helped me further understand the context of why the College and phar-macists are important in our prov-ince. The OCP is important because it serves to protect the public, and en-sure that all patients receive the same standard of care when they walk into a pharmacy, or receive care from a phar-macist anywhere in Ontario. Pharma-cists and other health care providers are important because they take on the responsibility of providing this care to their patients, building relationships based on mutual trust and respect, and helping to improve the health and qual-ity of life of their patients. One of the most interesting happenings over the summer would have to be the College’s submission to HPRAC on the scope of practice review for Pharmacy. While working at OCP and since starting school, I have found myself explaining this topic to peers, friends, and family,

Laura Narducci

GTA Public Health Departments have

launched a new falls prevention campaign

entitled, “Make a Splash!” that encourages

older adults to be active and use medication

wisely . Pharmacists can order free posters

and brochures by calling Toronto Health

Connection at 416-338-7600 or visit

www.toronto.ca/health for additional falls

prevention information and fact sheets.

Make a Splash!


My summer exp erience at the OCPclarifying how pharmacists may soon have an expanded role in “medication management”.

Looking back, one of the most signifi-cant observations that I made while at the College was the importance of ex-cellent communication, good relation-ships and camaraderie. I saw first hand

how excellent communication and good relationships not only facilitate good teamwork, but also promote and en-courage more great work to develop. As I enter into my third year of phar-macy, I am excited to be able to apply these skills in my own work and inter-actions with my peers as we take on

many educational challenges this year.In closing, I was very fortunate to

have had the opportunity to meet and work with so many inspiring and experienced individuals this summer and I am very grateful to the College for making this student position pos-sible.




preceptor workshops

Are you looking for a way to recapture the excitement of practising pharmacy? Consider becoming a

preceptor in 2009. Should you decide to become a preceptor, you will be required to attend one of the

Orientation Workshops that the College will be giving in Ontario during 2009. The workshop schedule, which

also lists Advanced Workshops for current preceptors, appears below. For more information about becoming

a preceptor, please visit www.ocpinfo.com > Licensing > Training & Assessments > SPT.

Any pharmacist actively serving as a preceptor for students or interns who has not attended a workshop in the

last three years is required to attend an Advanced Workshop.

To arrange a workshop in your community, please have your CE Coordinator contact

Vicky Gardner at 416-962-4861 x 297 or at [email protected].

Please visit our website for regular updates.

DATE LOCATION WORKSHOP & TOPIC

Wednesday, January 7th Toronto Orientation

Thursday, February 12th Toronto Orientation

Wednesday, February 18th Toronto Advanced

Conflict Analysis & Resolution

Thursday, March 12th Toronto Orientation

Wednesday, March 25th Burlington Orientation

Thursday, March 26th Burlington Advanced

Conflict Analysis & Resolution

Wednesday, April 8th Toronto Orientation

Tuesday, April 21st Ottawa Orientation

Wednesday, April 22nd Ottawa Advanced

TBA

Tuesday, May 5th Toronto Orientation

Wednesday, May 13th London Advanced

TBA

Thursday, May 14th London Orientation

Wednesday, May 27th Toronto Orientation

Thursday, May 28th Toronto Advanced

TBA

Tuesday, June 16th Toronto Orientation

Thursday, July 9th Toronto Orientation

* Other dates for September through December will be posted later in the year.

CALL FOR PRECEPTORS


Non-physician Prescribers Project

The Health Professions Regulatory Advisory Council (HPRAC) has recently invited several health profes-

sions, including pharmacy, to make submissions regarding non-physician prescribing. The Minster of Health and Long Term Care has asked HPRAC to review the following:1. Examine the authority given to non-physician health pro-

fessions to prescribe and/or use drugs in the course of their practice under the Regulated Health Professions Act, 1991 (RHPA) and the Health Profession Acts.

2. Provide advice specific to each of these professions re-specting whether lists, categories or classes of drugs should be prescribed by regulation for the profession, or whether restrictions on prescribing of drugs should be placed in regulation under the respective health profes-sion Act.

3. Provide advice on a framework and process for the on-going evaluation of requests by Colleges for changes to regulations in this regard to ensure that such regulations

reflect efficiency, best practices of the profession and provide maximum public protection.

The College recently made a submission to HPRAC to expand the role of the pharmacist as part of a Scope of Prac-tice Review. The activities of adapting, changing and re-newing prescriptions (dispensing without authorization) and administering drugs by inhalation and injection were dis-cussed in that report. A new submission is being prepared to address those activities for the Non-physician Prescribing Project. HPRAC has a very tight timeline for the submission of November 12, 2008. The submissions from pharmacy and other health professions will be posted on the HPRAC web-site, and once again pharmacists will have an opportunity to respond to the submission.

Watch for the submission to be posted on the website at www. hprac.org in the later half of November.

HPRAC launches Non-physician

Prescribers Project


Case 1

Falsification of records following a

dispensing error

Member: Antonio Colavecchia

Pharmacy: St. Clair Pharmacy,

Toronto

Hearing Date: September 10, 2008

FactsThis case proceeded by way of an Agreed Statement of Facts and Joint Submission on Penalty con-cerning the dispensing of 30 Phyllo-contin 225mg for the patient on or about March 27, 2007, when only Divalproex 125mg and Adalat 60mg had been prescribed for her.

The prescription in question was written as follows:

Divalproex 125 mg 125 mg qam.Pt will continue in 250 mg qpm30Adalat XL60mg O.D.30

On March 27, 2007 Mr. Colavec-chia, based on his reading of the prescription, dispensed the follow-ing for the patient:

• 30 APO-DIVALPROEX 125MG TAB 1 TABLET EVERY MORNING

• 30 ADALAT XL 60MG TAB TAKE 1 TABLET DAILY

• 30 PHYLLOCONTIN 225MG TAB 1 TABLET IN THE EVENING

In the letter of complaint

initiating the investigation in this matter, the prescribing physician indicated that the intention of the prescription had been to decrease the patient’s usual dose of Dival-proex 250mg twice daily to 125 qam and 250 qpm, or 125 mg in the morning, with the usual 250 mg in the evening, as specif ied in the prescription.

If he were to testify, Mr. Colavec-chia would say that on or about March 27, 2007, the patient called him to obtain the pharmacy’s fax number. At that time she advised him that a new medication had been prescribed to her by her doctor. The patient then faxed the prescription to the pharmacy, and the medica-tion was delivered to the patient at her home by the pharmacy.

If he were to testify, Mr. Colavecchia would say that, in read-ing the prescription, he noted that the dosage of Divalproex was being changed from the previous dosage. He would testify that he read the words “Pt will continue in 250mg” as “Phyllocontin, which he believed to be the new medication referred to by the patient in her phone call.

If he were to testify, Mr. Colavec-chia would say that he knew that Phyllocontin did not come in 250mg dosage strength, and that he there-fore called the doctor’s office. He would testify that it was confirmed to him by the secretary that the dos-age for Phyllocontin was for 225mg. Mr. Colavecchia would testify that he made a note of this call to the doctor’s office on the prescription, in which he wrote: “225 mg ok called Dr”.

However, the prescribing phys-ician’s off ice has no record of any telephone call concerning the pre-scription from Mr. Colavecchia or anyone else at the pharmacy on or about March 27, 2007, or at any other time, which gave rise to an al-legation that Mr. Colavecchia had falsif ied a record.

Admission of Professional MisconductIn response to the allegations in the Notice of Hearing (at paragraphs 1, 3, 5, 6), Mr. Colavecchia acknow-ledged that he failed to maintain the standards of practice of the profes-sion, falsif ied a record relating to his practice, breached sections 155 and 156 of the Drug and Pharma-cies Regulation Act, and engaged in conduct that would reasonably be regarded by members of the profes-sion as disgraceful, dishonourable, and unprofessional, with respect to the dispensing of the Phyllocontin to the patient when Divalproex 125mg had been prescribed.

Decision and ReasonsFrom the Agreed Statement of Facts, it is clear that there is agree-ment that a dispensing error oc-curred and that Mr. Colavecchia took steps to conceal this.

Mr Colavecchia’s admission of the latter fact shows a blatant dis-regard of his obligation as a phar-macist to the public and to fellow members of the profession.

Similar violations of this nature have been dealt with by past pan-els of the Discipline Committee, and

deciding on discipline


the Panel in this case was provided with ample precedents which dem-onstrate that the Joint Submission on Penalty falls well within the par-ameters of a reasonable disposition. The Panel saw no reason to deviate from precedent.

Order1. A reprimand;2. Specif ied terms, conditions, or

limitations on Mr. Colavecchia’s Certif icate of Registration, re-quiring him to complete success-fully, at his own expense and within 12 months of the date of the Order, remedial training, as follows:

a. Applied Ethics in Pharmacy Practice, offered by Professor Zubin Austin, Leslie Dan Fac-ulty of Pharmacy at the Uni-versity of Toronto;

b. the Pharmaceutical Jurispru-dence seminar and examina-tion, offered by the College;

c. the Confronting Medica-tion Errors workshop, offered by the Ontario Pharmacists’ Association;

d. Canadian Pharmacy Skills 1, Module 4 – Patient Counselling Skills;

e. Law Lesson 2 (The Regulation of Pharmacy Practice);

f. Law Lesson 4 (Standards of Practice); and

g. Law Lesson 7 (Professional Liability) from the Canadian Pharmacy Skills Program, of-fered through the Leslie Dan Faculty of Pharmacy at the University of Toronto.

3. A suspension of Mr. Colavec-chia’s Certif icate of Registration for a period of two months, with one month of the suspension to be remitted on condition that the Member complete the remedial training program specif ied above.

4. Costs to the College in the amount of $4,000.00.

ReprimandThis case resulted from a dispens-ing error, This type of error gener-ally occurs due to some type of neg-ligence, but can be minimized if ap-propriate checks and balances are in place to ensure the right drug is given to the right patient in the right dose. As a standard of practice, pa-tient counselling is required when a new prescription is dispensed to any patient.

Although the Agreed State-ment of Facts makes no mention of the quality of patient counsel-ling, the Panel felt the dispensing error could have been prevented by proper dialogue with the patient. The pharmacists on the Panel were at a loss to understand why a bron-chodilator was dispensed when there was no documentation of asthma in the patient’s medication history.

The most troublesome part of this case was Mr. Colavecchia’s deliberate falsif ication of the rec-ord in an attempt to avoid respon-sibility for his actions. Members of the College are professionals in whom the public places its trust, and Mr. Colavecchia’s miscon-duct has undermined that trust.

The Panel hopes this was an isolat-ed incident and that Mr. Colavec-chia has learned from the experi-ence. Mr. Colavecchia has been or-dered to take remedial courses, and the Panel has asked him to use the knowledge he gains to practise at a higher level than his actions demon-strated in this case.

Case 2

Appeal of Discipline Penalty

Member: Mr . Roshdy Boshara

Pharmacy: Bay-Wellesley Pharmacy,

Toronto

Appeal Hearing Date: Sept. 12, 2008

FactsThe facts of the discipline hear-ing are summarized in the January/February 2007 Pharmacy Connec-tion. Mr. Boshara appealed one of the penalty terms imposed by the Discipline Committee. This term prohibits Mr. Boshara from having any proprietary interest in a phar-macy, and from working at a phar-macy in which a family member has a proprietary interest for a period of three years.

Mr. Boshara’s appeal was heard by the Ontario Superior Court of Justice Divisional Court on Septem-ber 12, 2008. The Court dismissed his appeal.

The Court noted that the deci-sion of the Discipline Committee was based upon an Agreed Statement of Facts and a guilty plea by Mr. Boshara to allegations of misconduct related to


deciding on discipline

fraudulent billing practices in respect of one patient. By agreement, the de-cision also imposed five other penalty terms on Mr. Boshara. These aspects of the Order were not challenged. Mr. Boshara sought to have the sixth penalty term of the Order regarding the three-year ban set aside or, al-ternatively, to have the sixth penal-ty term substituted with a spot audit requirement.

The Court rejected Mr. Boshara’s submission that the Discipline Com-mittee considered the lateness of his acknowledgement of guilt to be an aggravating factor when it imposed its sanctions stating that Counsel for the College had made this clear in his submissions at the discipline hearing, and nowhere in the Disci-pline Committee’s Reasons for De-cision could the Court f ind anything from which to infer that the Com-mittee punished Mr. Boshara for the

lateness of his plea.The Court also rejected Mr.

Boshara’s submission that the min-or dollar amount of the fraud in-volved made the Discipline Com-mittee’s sanction unduly harsh and disproportionate.

The Court concluded that the Discipline Committee was moved by the number of individual false claims, together with Mr. Boshara’s efforts to conceal his wrongdoing by falsifying records, even while the in-vestigation was ongoing.

Further, the Court rejected Mr. Boshara’s submission that the Com-mittee’s decision punishes his wife, who owns a pharmacy. The Court noted that the proscription against the appellant working for his wife was consistent with the Disci-pline Committee’s concerns. In view of the sustained level of mis-information in the form of falsif ied

prescriptions, the Committee de-termined that protection of the public was required, and that Mr. Boshara’s access to a pharmacy as an owner was not in the public interest.

The Court concluded it was rea-sonable to ensure that Mr. Boshara not benefit indirectly from his in-volvement in his wife’s business. The Court noted that the character of Mr. Boshara’s wife was not an issue but that Mr. Boshara’s character was.

In sum, the Court found the Discipline Committee’s decision to be reasonable, in that nineteen sep-arate acts of dishonesty were fol-lowed by ongoing attempts to con-ceal them, right up to the time of the hearing.

In dismissing Mr. Boshara’s ap-peal, the Court ordered him to pay costs of $15,000 to the College.

bulletin board

Eric Bruce joined the College at the beginning of Septem-ber as the Acting Decisions Coordinator in the Investiga-tions and Resolutions department to fill a maternity leave. Eric was called to the Bar this year and has been awarded many honours of distinction that include the Justice M.J. Moldaver/Carswell Prize in 2007and the James Jefferson Prize in Health Law in 2007. He has also served in the Of-fice of the Chief Justice, Superior Court of Justice.

Jocelyn Dipaling, who has been providing services on a temporary basis, has recently joined the College in a permanent staff position in the Client Services depart-ment. Jocelyn had previously covered a maternity leave at the College and brings many years of administrative experi-ence.


Many drugs widely used in infants and children are not commercially available in oral liquid dosage forms. Since infants and young children are un-

able to swallow solid dosage forms, pharmacists are often challenged to provide a suitable extemporaneous oral liquid for these patients.

Information on the formulation and stability of many ex-temporaneous preparations is often lacking. In some instan-ces, the pharmacist may not have access to the information, may lack a required ingredient, or lack the experience and confidence in preparing a suitable final product. As a result, the pharmacist may choose to dispense the adult solid dos-age form with the instructions to split the tablet into smaller pieces to obtain the required pediatric dose. This practice can introduce the potential for error as the following case illustrates.

Case:A nine-year-old patient was admitted to hospital with heart and renal failure. She was treated with a regimen of ACE inhibitors, beta-blockers and diuretics. The beta-blocker carvedilol was started at a dose of 0.1mg/kg/day in two divided doses. Since the child weighed 20kg, a daily dose of 1mg twice daily was required. An oral suspension was ex-temporaneously compounded in the hospital pharmacy and the appropriate dose administered.

Upon discharge, a prescription for carvedilol 1mg BID was given to the child’s parent. The prescription was subsequent-ly taken to a local community pharmacy for processing. On reading the prescription, the pharmacist decided to dispense the 3.125mg tablet with the label instruction to give one-third of a tablet twice daily. The parent either misunderstood the instructions or encountered difficulty in cutting the tablets into thirds. As a result, the child was given one whole tablet twice daily or more than three times the prescribed dose.

focus on error prevention

Ian Stewart, R.Ph., B.Sc.Phm

Toronto Community Pharmacist

Pediatric dosages

A few days later, the child returned to the Heart Failure clinic with her medication for a follow up. The error in dos-ing was therefore discovered. Fortunately, the child did not experience any long-term ill effects.

Possible Contributing Factors:• Lack of a commercially available oral dosage form appro-

priate for pediatric patients.• The dispensing of tablets which required cutting into thirds.

The tablets dispensed are small and not scored making it difficult to accurately cut into three equal parts.

• Possible miscommunication between the pharmacist and parent.

Recommendations:• Whenever possible, avoid the need to spilt tablets into

smaller segments to obtain a specific pediatric dose. This practice can lead to the administration of an incorrect dose due to the difficulty in splitting tablets accurately.1 Uneven breaking of tablets can result in fluctuations in the admin-istered dose. This can be clinically significant in the pedi-atric population.

• Avoid rounding off dosages whenever possible as this can lead to the administration of an incorrect dose with the po-tential for harm in the pediatric population. In the above example, even if the tablets were split precisely into thirds, the dose would still be incorrect.

• Whenever a prescription is received for a unique pediatric dosage not available commercially, seek out and access an appropriate resource for published formulas. This may in-clude The Hospital for Sick Children Department of Phar-macy website at www.sickkids.ca/pharmacy .

• Adhere to the published formula for which there is ad-equate stability data.

• If unable to extemporaneously prepare the product, con-sider referring the patient to another pharmacy with the expertise or contact the hospital pharmacy from which the patient was discharged for guidance.

• Take steps to confirm that the parent understands and will administer the correct dose to pediatric patients.

References:1. Marriott JL, Nation RL, Splitting tablets. Australian Pre-

scriber, 25(6): 133-135, 2002.


ONTARIOJanuary 21, 2009Pharmacists Role in Methadone Maintenance Treatment Ottawa, ONCenter for Addiction and Mental HealthContact: Peter WilliamsTel: (613) 569-6024Email: [email protected]

GTANov 5-7Thrombosis ManagementLeslie Dan Faculty of PharmacyUniversity of TorontoContact: [email protected]

November 15, 2008Canadian Society of Hospital Pharmacists OntarioBranch Annual General Meeting and Educational SessionsEducational Sessions & Awards EveningUniversity of TorontoContact: Susan KorporalEmail: [email protected]

November 15, 2008Obesity Certificate ProgramOntario Pharmacists AssociationContact: [email protected] 24-25, 2008

November 15, 2008Caring for Children after a Heart Transplant: A Symposium for HealthProfessionalsThe Hospital for Sick ChildrenContact: Anne DipchandEmail: [email protected]

November 24 - 25, 2008E-Health and Medical Records150 King St West, TorontoContact: www.insightinfo.com1 888 777-1707

December 3, 2008-09-25Root Cause Analysis Workshop - Intermediate LevelOntario Hospital AssociationContact: [email protected](416) 205-1398

ON-LINE CEhttp://www.rxcertified.caOnline fee-based certificate courses developed by theDrug Information and Research Centre (DIRC) and rx-BriefCase.com. Currently offering:- Diabetes Patient Care Level 1- Obesity Program

http://www.camh.net/education/Online_courses_webinars/safe_baby_webinars.htmlWebinar series continuation: Exposure to psychotropicmedications and other substances during pregnancy andlactation: Mid-late November 2008: alcohol, antipsychotics,tobacco, anti-epileptic drugsRegister: onlineContact: Robyn Steidman (416) 535-8501, extension 6640.

http://209.200.99.173/CTI2/de-fault.aspOnline Clinical Tobacco Interventions for Health Care Professionals

CE FOR PHARMACY TECHNICIANSFebruary 200927th Pharmacy Technicians ConferenceHumber College North Campus, TorontoRegister online @ pharmacy.humber.caContact: Irene Van Vliet(416) 675 6622 ext. 4691

Visit the College’s website: www.ocpinfo.com for a complete listing of upcoming events and/or available

resources. A number of the programs listed below are also suitable for pharmacy technicians.

CE resources


laws & regulations

Drug and Pharmacies Regulation Act (DPRA) * sAmended June 4, 2008 Regulations to the DPRA:DPRA R.R.O. 1990, Regulation 545 – Child Resistant PackagesDPRA Ontario Regulation 297/96 Amended to O.Reg. 173/08 – GeneralDPRA R.R.O. 1990, Regulation 551 Amended to O.Reg. 172/08 – General

Drug Schedules **Summary of Laws Governing Prescription Requirements, Transfers, Refills, Prescription Drug Ordering and RecordsJune 2007 OCPCanada’s National Drug Scheduling System – August 27, 2008 NAPRA (or later)

Regulated Health Professions Act (RHPA) * sAmended 2007 Regulations to the RHPA:Ontario Regulation 39/02 -Certificates of Authorization Amended to O.Reg. 666/05Ontario Regulation 107/96 – Controlled Acts Amended to O.Reg. 296/04Ontario Regulation 59/94 – Funding for Therapy or Counseling for Patients Sexually Abused by Members

Pharmacy Act (PA) & Regulations * sAmended 2007 Regulations to the PA:Ontario Regulation 202/94 Amended to O.Reg. 270/04 – GeneralOntario Regulation 681/93 Amended to O.Reg. 122/97 – Professional Misconduct

Standards of Practice sStandards of Practice, January 1, 2003 OCPStandards of Practice for Pharmacy Managers, July 1, 2005

Drug Interchangeability and Dispensing Fee Act (DIDFA) & Regulations * sAmended 2007 Regulations to the DIDFA:R.R.O. 1990 Regulation 935 Amended to O.Reg. 321/07 – GeneralR.R.O. 1990 Regulation 936 Amended to O.Reg. 205/96 – Notice to Patients

Ontario Drug Benefit Act (ODBA) & Regulations * sAmended 2007 Regulations to the ODBA:Ontario Regulation 201/96 Amended to O.Reg. 264/18 – General

Food and Drugs Act (FDA) & Regulations ** 'Updated as of December 31, 2006Amendment 1478 & 1491 – Addition of two medicinal ingredients to Part I of Schedule F. Reg. SOR/2007-224, Oct 25/07Amendment 1476, 1502, 1511 and 1512 – Addition of nine medicinal ingredients to Part I of Schedule F. Reg SOR/2007-234, Oct 25/07Regulations Amending the Food and Drug Regulations (Project 1551- Lanthanum salts) (February 7, 2008)

Controlled Drugs and Substances Act (CDSA) **Current as of July 27, 2008

Regulations to the Controlled Drugs and Substances Act (CDSA) **All regulations updated August 13, 2008Benzodiazepines & Other Targeted Substances RegulationsMarihuana Medical Access RegulationsPrecursor Control RegulationsRegulations Exempting Certain Precursors and Controlled Substances from the Application of the Controlled Drugs and Substances ActNarcotic Control Regulations **

OCP By-Laws By-Law No . 1 – December 2007 sSchedule A - Code of Ethics for Members of the Ontario College of Pharmacists - December 2006Schedule B - “Code of Conduct” and Procedures for Council and Committee Members - December 2006Schedule C - Member Fees - Effective January 1, 2007Schedule D - Pharmacy Fees - Effective January 1, 2007Schedule E – Certificate of Authorization – Jan. 2005Schedule F - Privacy Code - Dec. 2003

Reference sOCP Required Reference Guide for Pharmacies in Ontario, August, 2008

* Information available at Publications Ontario (416) 326-5300 or 1-800-668-9938 www.e-laws.gov.on.ca ** Information available at www.napra.org ' Information available at Federal Publications Inc. Ottawa: 1-888-4FEDPUB (1-888-433-3782)

Toronto: Tel: (416) 860-1611 • Fax: (416) 860-1608 • e-mail: [email protected] s Information available at www.ocpinfo.com

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2008/2009

Left to Right: President Tracy Wiersema,

Registrar Deanna Williams,

and Vice President Stephen Clement

Documents

PC November/December 2008.pdf