In some instances, a pharmacist in New Brunswick may renew a prescription for Schedule 1 prescription drugs, insulin, epinephrine or nitroglycerin.
For a prescription to be renewed by a pharmacist, the patient must:
- have a valid Medicare card,
- not reside in a nursing home or a correctional facility,
- be without a primary care provider or have barriers to accessing their current provider.
Another situation that may apply is when a patient or their pharmacist is unable to obtain a prescription from the patient's primary care provider due to absence such as a leave, an illness, or a vacation. The program is intended to help patients avoid a visit to a walk-in clinic or emergency room for their prescription renewal, not to replace an appointment with their primary care provider.
If the conditions are met, the patient may have up to four prescription renewal services covered under the New Brunswick Medicare plan each year. The program does not cover costs associated with dispensing the medications, or the cost of the drugs.
When renewing the prescription, it is the pharmacist's responsibility to assess the patient's other prescriptions that may be due for renewal, and use their clinical judgment to determine whether it is appropriate to renew those prescriptions at the same time. It is a tremendous privilege and responsibility for a pharmacist to prescribe a medication renewal and one that we take very seriously. You can expect the pharmacist to speak with you in person in most cases when determining to put a prescription renewal in his or her name.
Let me give an example: A patient calls for a refill on his blood pressure medication. He recently received notification that he no longer has a nurse practitioner. Although he is on the list for a new primary care provider, he is now out of pills and has not taken his medication in two days.
This is a situation in which it is in the interest of the health and safety of the patient for the pharmacist to renew a prescription. Lack of timely access to blood pressure medication may have serious consequences for the patient.
A pharmacist in this situation would look at the patient's health record to ensure that the patient has been taking a consistent dose for an appropriate length of time. They would ask questions to ensure that the patient is not experiencing any serious side effects that would make it dangerous to renew the medication. The pharmacist would also want to take the patient's blood pressure measurement, and document it on the patient's pharmacy record.
If the pharmacist's assessment satisfied their professional judgment about the safety and appropriateness of renewing the patient's prescription, they could then prescribe a quantity of medication based on the patient's usual duration of therapy.
However, if the pharmacist saw any indication that the patient had dangerously high blood pressure, or determined that further medical assessment was required, the pharmacist would not renew the prescription. Instead, they would refer the patient.
New Brunswick pharmacists are working hard to continue the care of your medication therapy in collaboration with your primary care prescriber. We want to keep you safe and living healthy, happy, lives.
Dr. Kevin McLaughlin (PharmD, BScPharm, BSc, ACPR) practices at Kennebecasis Drugs, in Rothesay N.B. His opinions expressed in this column are published for educational and informational purposes only, and are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis or treatment.