- Individual or collective prescription: a named patient, or an identified group.
- Consultation request: one patient, at the request of a professional authorized to prescribe.
- EPAP: a written agreement for a team that shares patients and files.
What is an individual or collective prescription?
An individual prescription authorizes one or more pharmacists to prescribe or change a treatment for a named patient. A collective prescription allows them to start or change a treatment for an identified population or group. According to the guide, this type of prescription is likely to be used much less as the right to prescribe expands.
How does a consultation request work?
It comes from a professional authorized to prescribe and concerns a patient’s therapy, such as reaching a target or managing an adverse effect. It may be verbal or written. The pharmacist replies in writing before prescribing, then makes the changes with the requester’s agreement and agrees on follow-up. If the requester specified it in the request, they may apply their recommendations and inform the requester afterwards. They cannot prescribe what the requester could not prescribe themselves.
What is an EPAP?
An advanced partnership practice agreement (EPAP) allows the pharmacist to prescribe for an identified group of patients, in situations they could not manage independently. It is concluded between a pharmacist and a physician or nurse practitioner, or between groups of these professionals, within a team that shares the same patients and file, for example in a family medicine group or long-term care centre. It must be in writing.
What must an EPAP specify?
- The names of the parties and the patients covered.
- The cases, conditions and terms of prescribing, including exclusions.
- The procedure for consulting the partner professional or asking for their help.
- How the prescribing activity will be evaluated.
- The means of communication, the term of the agreement and the procedure to review or end it.
What limits do the three frameworks share?
None of them authorizes the pharmacist to prescribe or start treatment with a designated substance, or to make a diagnosis. Under an EPAP, their professional responsibility is the same as when prescribing independently. They must report their participation in an agreement in their annual renewal with the Ordre and keep a copy.
Sources: 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.