Prevalence of medication management by community pharmacists in patients of a Newfoundland family medicine clinic

Medication management is an umbrella term that encompasses a variety of professional activities undertaken by a registered pharmacist to optimize safe and eective drug therapy outcomes for patients.5,6 Currently in Newfoundland and Labrador (NL), medication management includes providing an interim supply of medications, extending a prescription and adapting a prescription.6 The majority of Canadian pharmacists have the authority to provide these services; however, there are dierences between provinces in what is permitted and how this authority is attained.7 In NL, both providing an interim supply and extending a prescription entail dispensing additional medication for a previously prescribed chronic therapy. When an interim supply is provided, the original prescription may have been lled at another pharmacy. An interim supply allows for a small quantity to be given that is usually less than one rell, to bridge the time needed for the patient to see his or her prescriber or to return to his or her usual pharmacy. When a prescription is extended, an additional rell of a 90-day supply or less is given for a medication previously lled at that pharmacy. Adapting a prescription includes changing the dosage form, regimen or quantity, lling in missing information and making a nonformulary generic substitution. These medication management services cannot be applied to a narcotic, controlled drug or targeted substance, including benzodiazepines.6 In 2010, changes to the NL Pharmacy Regulations permitted the use of medication management under the procedure outlined in the NL Pharmacy Board (NLPB) Standards of Pharmacy Practice.6,8 To provide this service, NL pharmacists must provide NLPB with a signed declaration indicating they have thoroughly read and understand the medication management standard of practice. As part of the fundamental requirements for performing medication management, NLPB states that in most instances the original prescriber or the patients primary health provider must be notied, preferably via faxing a standard form.6 In June 2012, the NL Prescription Drug Program (NLPDP) agreed to pay pharmacists for medication management services provided to NLPDP beneciaries.9 may reect pharmacists comfort with this form of prescribing. Pharmacists practising in Alberta indicated in the study by Makowsky et al12 that this form of medication management legitimized the previous practice of lending a patient medication to prevent interruptions in therapy. In th