Manitoba Pharmaceutical Association

187 St. Mary's Road   Winnipeg, MB   R2H 1J2 
tel: (204) 233-1411   fax: (204) 237-3468   e-mail: info@mpha.mb.ca

JOINT STATEMENT BETWEEN:

The  Manitoba Pharmaceutical Association

187 St. Mary's Road, Winnipeg, Manitoba  R2H 1J2 

Telephone: (204)233-1411

and

The College of Physicians and Surgeons

1000 - 1661 Portage Ave., Winnipeg, MB  R3J 3T7

Telephone: (204)774-4344

CONTINUED CARE PRESCRIPTIONS

Situations may arise where a patient requires a renewal or refill of a prescribed medication
yet is unable to contact the prescribing physician. In such a situation, the pharmacist may
be asked to provide a renewal or refill of the prescription (“continued care prescription”).
Pharmacists who are asked to provide a continued care prescriptions should consider the
following principles:

1.                   Continued care prescriptions cannot and do not take the place of ongoing
medical care.

2.                   Each request for a continued care prescription must be judged on the
individual nature of the patient's need and that patient's history.

Pharmacists may provide a continued care prescription only where the following conditions are met:

            1.                   The pharmacist must be satisfied that the physician would in all likelihood provide
             the authorization were the pharmacist able to contact the physician.

            2.                   The medication to be continued must be for a chronic or long-term condition.

            3.                   The patient must have an established stable history (no recent changes to dosages
             or drug therapy) with that medication.

            4.                   The original prescription must have been filled at that particular pharmacy,

                        and the patient must be within the care of the pharmacist.

            5.                   Narcotics or controlled substances must not be provided by a continued
            care prescription.

            6.                   Benzodiazepines must not be provided by a continued care prescription unless:

             a.       the medication is being used for management of convulsive disorders or

             b.       there is a legitimate risk of seizure due to sudden withdrawal.

7.                   The amount of medication provided must be determined by the pharmacist
             based upon the circumstances of the particular patient, but must not exceed
             the previous amount filled.

            8.                   All medication dispensed pursuant to a continued care prescription must be:

             a.                  recorded by the pharmacist at the time of dispensing,

             b.                  reported no later than the next business day by telephone or
            facsimile to the original prescribing physician and to the
            primary care physician if different from the original prescribing physician,

             c.                  entered into the Drug Program Information Network, and,

             d.                  documented in the patient record.

Provided these conditions are met, the continued care prescription will be viewed as a
"collaborative practice agreement" between the pharmacist and the physician,
i.e. a temporary delegation of function where an urgent need for patient drug therapy management
has arisen and the prescribing physician is unavailable to provide refill authorization.

First Print    04/02

A statement is a formal position of the College with which members shall comply.