- The diagnosis must come from an authorized professional, such as a physician or nurse practitioner.
- The regulations set no list of chronic diseases.
- They cannot prescribe a designated substance under this framework.
In what situations can they act?
According to the guide, they may notably prescribe independently if the patient is not reaching therapeutic targets, or to treat or relieve a manifestation linked to a treatment prescribed for a chronic disease.
What does low risk of deterioration mean?
The guide considers this risk low notably when there are no red flags or unusual signs, and no deterioration or risk of rapid decline, including hemodynamic, respiratory or neurological.
Which diseases are covered?
There is no regulatory list. As non-exhaustive examples, the guide cites diabetes, hypertension, dyslipidemia, hypothyroidism, chronic obstructive pulmonary disease, asthma, migraine, pain, certain mental health problems and heart failure. The length of treatment is a matter for the pharmacist’s judgment.
What steps does the guide suggest?
- Confirm the nature of the disease already diagnosed and, if in doubt, contact the prescriber or the professional responsible for follow-up.
- Check whether another professional is actively adjusting drugs for this disease, and learn the follow-up plan.
- Prescribe based on evidence, in shared decision-making, aiming for recognized targets.
- Record, follow up and refer if the situation worsens.
Will the physician be informed?
Current regulations do not require communication, but the Ordre asks pharmacists to send information that may influence future decisions. The guide gives the example of a new drug for a chronic disease: communication there ensures better continuity of care. See also the impact on physicians and nurse practitioners.
Sources: OPQ, summary of what is new (in French) · OPQ, summary of what is new (in French) · OPQ, practice guide on professional activities (in French) · OPQ, practice guide on professional activities (in French) · OPQ, practice guide on professional activities (in French) · OPQ, practice guide on professional activities (in French)
General information based on the publications cited. This text does not replace professional or legal advice, or the Ordre’s guides.