Saskatchewan College of Pharmacy Professionals Volume 12/Issue 1 March 2020

SCOPe

100-1964 Park Street Regina, SK S4N 7M5

Tel: 306-584-2292 Fax: 306-584-9695 Email: info@saskpharm.ca

March 2020

newsletterNew Strategic Plan 2020-2024In January 2019, the Saskatchewan College of Pharmacy Professional’s (SCPP) Council embarked on the path to create a new five-year strategic plan to begin in 2020. An expert from the Institute on Governance in Ottawa was contracted to assist Council through the planning and development phases, which included many meetings with the officers of Council along with the Registrar and our consultant. Stakeholder consultation and engagement were completed through surveys in January and February, which included engagement of SCPP Councillors, staff and external stakeholders to examine the environment and direction of SCPP. In March, full two-day workshops with Council were led by our consultant where Councillors determined the path forward for SCPP over the next five years and set strategic goals and objectives. A draft strategic plan was reviewed in April and a final plan presented in May for Council approval.

SCPP has begun work on the new strategic plan for 2020 with further communication, updates and consultations planned throughout the year as we work through our objectives for 2020.

Our new Mission, Vision, Values and Goals for 2020:

MissionProtecting the public interest by building excellence in professional pharmacy practice through regulation.

VisionQuality pharmacy care for a healthier Saskatchewan.

ValuesIn delivering on its mission, the SCPP values:1. Professionalism – by maintaining the highest standards of ethical conduct

and integrity, and being accountable for our actions and their results;2. Collaboration – by engaging in a meaningful way to ensure public safety;3. Leadership – by being proactive, transparent, and innovative;4. A Culture of Excellence – by being consistent, responsive and

demonstrating a commitment to continuous improvement.

Goals1. To have functioning competency assurance and quality

improvement programs.2. To align pharmacy regulation with modern pharmacy practice.3. To empower pharmacy professionals to practice autonomously to deliver

safe patient care.4. To have enhanced transparency to stakeholders, supported by

contemporary governance and management practices.

COVID-19 Information 2PEBC Examination Dates 2MySaskHealthRecord Changes/Updates – COVID-19

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SCPP Event Cancellations due to COVID-19

3

Membership Renewals are Around the Corner

3

Farewell to Ray Joubert 4Drug Schedule Changes 4SCPP Membership & Permit Fees 2020-2021

5

NEW Process: Criminal Record Checks

6

The “Full Meal Deal” Triple Threat: Opioid-Benzodiazepine-Gabapentin

7

COMPASS Fee Breakdown 8Deadline for Compounding Compliance

8

Bylaw and Document Updates 9Discipline Matters 10From the Desk of the Dean 13Canadian Foundation for Pharmacy 75th Anniversary

14

2020 District Five Individual Study Grant

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Saskatchewan College of Pharmacy Professionals Volume 12/Issue 1 March 2020

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SCPP COUNCIL 2019-2020PRESIDENTMarilyn Younghans, Lloydminster

PRESIDENT-ELECTStephanie Scott, Weyburn

VICE PRESIDENTRod Amaya, Saskatoon

PAST PRESIDENT Justin Kosar, Saskatoon

DIVISION 1Bradley Cooper, Estevan

DIVISION 2Kyla Jackson, Hudson Bay

DIVISION 3Jashvant Patel, Prince Albert

DIVISION 4Rod Amaya, Saskatoon

DIVISION 5Scott Szabo, Regina

DIVISION 6Brandon Krahn, Swift Current

DIVISION 7Tania Horkoff, Warman

DIVISION 8Amy Wiebe, Saskatoon

EX OFFICIODr. Jane Alcorn, Saskatoon

PUBLIC REPRESENTATIVESBonnie Caven, ReginaMark Hawkins, ReginaMichael Lummerding, St. BrieuxGeorge Thomas, Regina

SENIOR STICK OBSERVERPalima Shrestha, University of Saskatchewan

PHARMACY TECHNICIAN OBSERVERSLyndsay Brakstad, TisdaleMichelle Miller, Saskatoon

The SCOPe newsletter is published by the Saskatchewan College of Pharmacy Professionals (SCPP) and is emailed to active members of the College. Decisions on matters such as regulations, drug schedule changes, etc., are published in SCOPe. All members are expected to be aware of these matters.

COVID-19 InformationTo help with finding information related to pharmacy practice amid the COVID-19 pandemic, a banner has been added to the College’s homepage to collect relevant resources in one place. In addition, updates for pharmacy professionals will be added as they are available.

A new Emergency Preparedness Tools document has also been prepared by SCPP to inform pharmacy professionals of the tools available to help them address the risks they may be identifying in their preparations to address the COVID-19 pandemic. The document can also be found within the COVID-19 banner page under Resources.

The College is working closely with the federal and provincial ministries of health, regulators and other health system partners to undertake the necessary planning to protect residents. The situation is changing rapidly and SCPP is working to keep this information source current.

The College has enacted its business continuity plan with the majority of staff working from home to reduce the possibility of spreading COVID-19. SCPP has reprioritized our work within the office to ensure the most up-to-date information for members is being providing and to ensure resources are available to respond to questions. The College is also working closely with all our federal and provincial partners on a daily, and sometimes hourly, to work through issues as they present themselves. Although the pandemic has been stressful, busy and chaotic, the Registrar would like to assure members that from a federal and provincial level, pharmacy has been top of mind for all involved. The rapid responses and changes that are occurring reflect this sentiment and further illustrate the critical role pharmacists and pharmacy technicians play within the healthcare system to ensure patients are receiving safe care.

Please continue to reach out to SCPP with questions and concerns so staff can assist with guidance or direction to help navigate this new environment.

COUNCIL HIGHLIGHTSDue to current circumstances, SCPP will provide a summary of the

February council highlights in the next edition of SCOPe.

Pharmacy Examining Board of Canada (PEBC) Examination DatesInterested candidates for the Pharmacy Examining Board of Canada (PEBC) exams are asked to check with PEBC directly in the light of COVID-19.

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SCPP STAFFDAVID CHOUPharmacy Policy and Practice Consultant

PELESHIA DUBIDADAdministrator – Member Relations, Systems and Communications Support

PAT GUILLEMINPharmacy Permits and Systems Manager

KATHLEEN HANDFORD Director of Policy and Legislation

RAY JOUBERTAssociate Registrar

FATIMA KHANField Officer

DARLENE KINGReception and Office Operations Coordinator

CHANTAL LAMBERTAssistant Registrar, Complaints Director

CHRISTINA MCPHERSONAdministrative Assistant to the Deputy Registrar

HEATHER NEIRINCKRegistration and Systems Administrator

LORI POSTNIKOFFDeputy Registrar

NATALIE REDIGER (TERM)Pharmacy Policy and Practice Consultant

KIM SAMOILAPolicy Analyst

JEANNETTE SANDIFORDAssistant Registrar – Field Operations and Quality Assurance

TAMI SCHWEBIUSComplaints Manager

BRITTANY SHARKEYCertified Compounding Inspector – Field Officer

AUDREY SOLIERegistration Administrator

MEAGHAN UNDERWOODAdministrative Coordinator for Field Operations and Quality Assurance

INGRID WAKEFIELDExecutive Assistant to the Registrar

JEANA WENDELRegistrar

CHERYL WYATTCommunications Coordinator

CAROLINE ZAREBAAdministrator - Pharmacy Relations, Systems and Communications Support

Membership Renewals are Around the CornerAll requirements for membership renewal need to be in the SCPP office by June 1, 2020.

Licences will be mailed to the address on the member’s portal. Please ensure all information in the member portal is up to date before renewing, especially

• place of employment• email address• mailing address

Updates can be made by logging into the member portal. To log in, click the “MEMBER LOGIN” link at the top right of the SCPP website.

SCPP Event Cancellations due to COVID-19In an effort to slow the spread of COVID-19 and to comply with the Public Health Order of the Saskatchewan Chief Medical Health Officer, the Saskatchewan College of Pharmacy Professional (SCPP) will be cancelling all SCPP events of the 2020 Pharmacy Association of Saskatchewan (PAS) Annual Conference. These events include the SCPP Honorees Reception, the SCPP Awards Banquet, the SCPP Annual General Meeting (AGM), and the SCPP President’s Luncheon.

SCPP continues to monitor the situation and is examining alternatives for hosting the AGM. However, the Honorees Reception, Awards Banquet, and President’s Luncheon will not take place this year. The graduates to be honored at the 2020 Awards Banquet may expect to receive their commemorative pins and Golden Anniversary Certificates in the mail. SCPP awards recipients will also receive their certificates in the mail.

The College thanks members for their understanding as we work together to slow the spread of this virus. For questions please contact info@saskpharm.ca.

MySaskHealthRecord Changes/Updates – COVID-19from eHealth, Partnership Programs and Strategic Health Initiatives

Please be aware that due to the COVID-19 outbreak, MySaskHealthRecord is temporarily providing users with the option to phone and request their PINs to complete their MySaskHealthRecord registration.

Once users receive their PIN, they will be able to start using MySaskHealthRecord right away, including access to results related to COVID-19. eHealth Saskatchewan will still mail out PINs per usual registration processes, however, the option for users to phone in for their PINs supports quicker access to health information in MySaskHealthRecord during this critical time.

To register, please click here. To phone for your PIN, call 1-844-767-8259.

Saskatchewan College of Pharmacy Professionals Volume 12/Issue 1 March 2020

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MISSION

Protecting the public interest by building excellence in professional pharmacy practice through regulation.

VISION

Quality pharmacy care for a healthier Saskatchewan.

VALUES

Professionalism

Collaboration

Leadership

A Culture of Excellence

GOALS

To have functioning competency assurance and quality improvement programs.

To align pharmacy regulation with modern pharmacy practice.

To empower pharmacy professionals to practice autonomously to deliver safe patient care.

To have enhanced transparency to stakeholders, supported by contemporary governance and management practices.

Farewell to Ray JoubertOn December 31, 2019, SCPP said goodbye to Ray Joubert as he officially headed into retirement to enjoy much deserved time to focus on family, travel and hobbies.

During 2019, Ray was instrumental in completing the vaccine preventable diseases and travel health bylaws and framework and supporting the transition of SCPP’s new Director of Policy and Legislation, Kathleen Handford. Ray was acting in this role until recruitment, onboarding and full transition was completed.

We wish Ray all the best and enjoyment in his retirement.

Drug Schedule ChangesLevonorgestrel Moves from Schedule II to Schedule III

Regulatory bylaw amendments to move Levonorgestrel (when sold in concentrations of 1.5 mg or less per oral dosage unit to be taken as a single dose of 1.5 mg, packaged and labelled for emergency contraception) from Schedule II to Schedule III have been approved by the Minister of Health. These concentrations of Levonorgestrel are listed as Schedule III according to the National Association of Pharmacy Regulatory Authorities (NAPRA) National Drug Schedules and are also Schedule III in most other Canadian provinces and territories.

Moving Levonorgestrel to Schedule III will provide optimal access to care and optimal privacy for patients, while also ensuring that pharmacists and pharmacy technicians are available and accessible to assist, provide additional information, or answer any questions that patients may have regarding this drug product.

Fluticasone Propionate

NAPRA has announced the National Drug Schedules have been revised to reflect two changes regarding fluticasone propionate nasal spray:

• Fluticasone propionate, when sold for the treatment of allergic rhinitis in a nasal spray that delivers 50 mcg/spray for those 18 years of age and older, in package sizes containing no more than 360 metered sprays, has been granted Schedule III status.

• Fluticasone propionate, when sold for the treatment of allergic rhinitis in a nasal spray that delivers 50 mcg/spray for those 18 years of age and older, in package sizes containing more than 360 metered sprays, has been granted Schedule II status.

These changes were originally recommended by the National Drug Scheduling Advisory Committee (NDSAC) on December 9, 2019. NAPRA did not receive any comments on the proposed changes during a 30-day review period. NAPRA’s Board of Directors gave final approval to the changes, effective January 20, 2020.

For more information, refer to the National Drug Schedules.

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SCPP Membership & Permit Fees 2020-2021The Fee Schedule was approved by Council and included a cost of living increase to all fees based on the November 2019 Consumer Price Index for Saskatchewan.Membership Fees – April 1, 2020Practising Membership $ 1,299.00Non-Practising Membership $ 1,182.00Associate Membership $ 209.00Retired Membership $ 102.00Practising Membership – Technicians $ 780.00Non-Practising Membership – Technicians $ 652.00Associate Membership – Technicians $ 103.00Retired Membership – Technicians $ 51.00Appraisal Training, Assessment & JP Exam Fees – April 1, 2020Appraisal Training Application Fee $ 336.00Assessment Fee $ 836.00Jurisprudence Fee $ 300.00Appraisal Training Application Fee – Technician $ 168.00Assessment Fee – Technician $ 418.00Jurisprudence Fee – Technician $ 300.00Registration & Reinstatement Fees – April 1, 2020Reinstatement Fee $ 331.00Registration – Pharmacist $ 305.00Registration – Canadian Out-of-Province and ATA Candidate $ 795.00Registration – Locum Tenens $ 305.00Registration – Dispensing Physician $ 917.00Reinstatement Fee – Technician $ 178.00Registration – Technician $ 305.00Registration – Canadian Out-of-Province Technician $ 403.00Intern Registration Fees – April 1, 2020Intern Registration Fee $ 163.00Intern Registration Fee – Technician $ 82.00Late Payment Penalty Fees – April 1, 2020Late Payment Penalty – Pharmacy $ 388.00Late Payment Penalty – Pharmacist $ 382.00Late Payment Penalty – Technician $ 234.00Pharmacy Permit Fees – April 1, 2020Pharmacy Permit Basic $ 1,870.00 COMPASS Surcharge + 500.00

Pharmacy Permit Total $ 2,370.00Satellite Pharmacy Permit $ 1,136.00Permit Amendment $ 357.00Lock & Leave Permit $ 484.00Second Pre-Opening Inspection $ 815.00Fees: Registration and Other – April 1, 2020Pre-Registration Application Fee for Non-Members $ 203.00Letter of Standing Fee $ 105.00Permit Failure to File Fee After 7 SCPP Business Days – April 1, 2020Manager Change $ 100/dayProprietor Change $ 100/dayOwnership Change $ 100/dayTrade Name Change $ 100/dayDirector Change $ 100/dayLocation Change $ 100/dayExpense Reimbursement – February 13, 2020Per Diem $ 245.00Meal Allowance $ 130.00Travel per KM $ 0.52

Fees subject to change April 1, 2021. Fees do not include applicable GST.

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NEW Process: Criminal Record ChecksBackgroundThe Saskatchewan College of Pharmacy Professionals (the “College”) recently updated the Regulatory Bylaws to require each practising and non-practising member of the pharmacy profession, as well as all new members and locums (physician), to obtain a criminal record check (CRC).

From the bylaw amendments:

“…the character and suitability to practice of the applicant, including a criminal record check or such other information from law enforcement or the applicant as may be required by the Registrar”

Due to recent events which have unfolded related to COVID-19, the College has reflected on how many processes pharmacy professionals can be expected to complete at license renewal with the increased demands from the public. Therefore, the College is asking that prior to the end of the 2020-2021 license year, that all practising and/or non-practising members obtain a CRC. This will allow members twelve months to complete the online application.

Due to the volume of CRCs that will be completed this license year, the College is requiring all members to obtain their criminal record check from Sterling Backcheck. There will be no exceptions to this requirement. The Registration and Licensing staff have been working closely with Sterling Backcheck and our database provider, OlaTech Corporation, to develop a seamless process that allows members to obtain the CRC from Sterling Backcheck’s landing page. The information from Sterling Backcheck will be provided to each member via a pdf document that the member can then upload to their member portal on the College database.

Why?The mandate of the College is the protection of the public. CRCs are required by many employers, most other Pharmacy Regulatory Authorities in Canada and most other health care profession regulators in Saskatchewan. A CRC enhances the College’s ability to ensure a member’s moral character.

Who?• Practising and non-practising pharmacists and

pharmacy technicians,• New registrants, including conditional members, and• Physicians who have a membership with the College as a

dispensing physician and any locum physician practising in Saskatchewan.

• Intern pharmacists and pharmacy technicians who have obtained a CRC for educational purposes will be covered by a memorandum of understanding between the College and the University of Saskatchewan or Saskatchewan Polytechnic and will not require the College’s CRC.

What?The College will be requiring an Enhanced Police Information Check (EPIC), which will provide information on any criminal conviction or recent charges under the criminal code. The bylaws and policies of Council also require that a member now report any criminal charges/convictions to the College that occur after the 2020-2021 CRC, but before future checks.

When?The process to obtain a CRC will become available to members at the license renewal and information will be provided by the College in the form of an individual email to each member. Please ensure the College has up-to-date email information and watch for further information via email.

How?In the near future, each member will be able to log into their member portal where they will be directed to set up a profile and obtain the CRC. The College will be notified if the CRC was “clear” (no convictions or recent charges) or if the CRC was “not clear” (showed convictions or recent charges). Members will be provided with a record of the CRC results via an emailed pdf document.

Unless there are severe/extreme conviction(s)/charge(s), which could potentiate public harm, all members will be provided a license even if the CRC is not clear. Further review and contact by the College may occur in the case of a CRC returned to the College as “not clear”.

All information collected, used, disclosed and/or destroyed by the College is done in accordance with the College’s privacy policies. Only those Registration and Licensing Unit staff and if required, the Registrar and those members of the SCPP’s Registration and Licensing Committee who need to know the details of the CRC will be viewing the results. All members of the College and all members of the Registration and Licensing Committee complete a privacy pledge. Only the information that is required (i.e. need to know) for the purposes of determining further action on a “not clear” CRC will be reviewed or provided for decision-making purposes.

If members have questions or concerns about the CRC process or the results of a specific CRC, please contact Lori Postnikoff, Deputy Registrar at the College office for more information at lori.postnikoff@saskpharm.ca.

Please see SCPP Regulatory Bylaws:• Part B section 1 for interns and section 11 for out of

province interns• Part C section 8 for pharmacists• Part D section 8 for pharmacy technicians• Part E.9 section 3• Part F.9 section 3• Part G section 1 for physicians and section 11 for locums

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The “Full Meal Deal” Triple Threat: Opioid-Benzodiazepine-GabapentinBy Nicole Bootsman, Pharmacist Manager, Prescription Review Program/Opioid Agonist Therapy Program

Reprinted with permission from the College of Physicians and Surgeons of Saskatchewan from the newsletter DocTalk, Volume 6, Issue 2 2019, pages 20 & 21.

We are all facing the devastating effects of an opioid crisis which has led to a national public health crisis1. And while we tend to focus on opioids, whether prescribed or illicit, perhaps our attention needs to broaden beyond the main course to encompass the “full meal deal” (slang for opioid + benzodiazepine + gabapentin combination).

Prescribing safeguards for potentially dangerous chronic medication cocktails.Given the multifaceted complexity of chronic pain, using a combination of medications to synergistically target the nervous system for pain management may seem quite logical2. Yet, polypharmacy – defined by the World Health Organization as “the administration of an excessive number of drugs” – with high-risk prescription medications can prompt cumulative and detrimental medication-related harms including addiction, drug interactions, motor vehicle accidents, neonatal drug withdrawal, and overdose3,4,5. Concurrent use of central nervous depressants (e.g. opioids, benzodiazepines, etc.) can potentially cause harmful and lethal respiratory effects; co-prescribing high-risk medications has even been considered “low value care”5.

A Canadian study found that an opioid-gabapentin combination increased the risk of opioid-related death by, at minimum, 49% (compared to an opioid alone) and an opioid-benzodiazepine combination increased the risk of mortality and was involved in one in five opioid poisoning hospitalizations5,6,7. Canadian data has also indicated that over 80% of opioid related deaths (between January 2016 to June 2017) involved an opioid and at least one non-opioid drug (e.g. benzodiazepine)5. While these chronic double-drug combinations are prescribed more often than we might hope, with the opioid-benzodiazepine combination contradicting the expert guidance in the 2017 Canadian Guideline for Opioids for Chronic Non-Cancer Pain8, the chronic triple-drug “full meal deal” combination is becoming alarmingly common.

Whether a prescriber has initiated a drug combination or has inherited a patient who has already been prescribed a potentially dangerous chronic medication cocktail, steps can (and often should!) be taken to ensure optimal safeguards are in place:

1. After a discussion setting expectations and boundaries from the get-go, establish a written treatment agreement (Risk Mitigation Guidance Statement 7)8, clearly outlining the risks and benefits of high-risk drug combinations.

2. Assess risk of harm at each visit (adverse effects, addiction, and overdose). Recognize and address red flags for drug-seeking behaviour (e.g. requesting brand name, reporting allergies to non-opioids/weak opioids/sustained release preparations, etc)109.

3. If additional medications are required that may have possible drug interactions, consult the patient’s pharmacist.

4. Restrict the quantity of medication dispensed as part-fills (Expert Guidance Statement 1)8.

5. Aim to prescribe for the drug’s evidence-based, labelled indications for appropriate durations. Avoid off-label use where possible.

6. Use recommended precautions (e.g. check PIP for at least every Prescription Review Program prescription).

7. If initiating a taper, obtain patient consent and reduce one drug at a time. Taper guides can be very helpful to create a plan but be flexible and pause the taper as the patient requires. If necessary, involve multidisciplinary providers (Recommendation 10)8.

8. Consider renal and hepatic function. Dosage adjustments in renal impairment are often required for gabapentin, whereas, dosage adjustments in hepatic impairment may be required for some benzodiazepines10. Without appropriate adjustments, drug accumulation may increase the risk of adverse effects.

9. Request random urine drug screens (Risk Mitigation Guidance Statement 6)8 to ensure that you have objective clinical information required for safe prescribing. If a patient is not taking a prescribed drug, a taper isn’t required (nor is a continued prescription)!

10. Limit dose escalations (Recommendation 6)8.

11. If long-term opioid therapy is indicated, prescribe controlled-release opioids for comfort and simplicity (Expert Guidance Statement 2)8. Immediate release formulations are for breakthrough pain and should ideally not exceed 20% of the total daily morphine equivalent dose9.

12. Do not abandon your patient! Often, these are challenging patients so anticipate and plan for setbacks.

13. Become an Opioid Agonist Therapy provider for your patients (contact CPSS for more information).

14. Document thoroughly.

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Credits (The “Full Meal Deal” Triple Threat: Opioid-Benzodiazepine-Gabapentin)1 Health Canada, 2017. New Federal Initiatives to Address the Opioid Crisis. Available from –

https://www.canada.ca/en/health-canada/news/2017/11/new_federal_ initiativestoaddresstheopioidcrisis.html

2 Polypharmacy and Chronic Pain: Harm Exposure Is Not All about the Opioids. Pain Med. 2015;16:472-479.

3 World Health Organization, 2004. A glossary of terms for community health care and services for older persons. Aging and Health Technical Report.

4 Indiana Center for Health Policy, 2017. Polypharmacy Among Prescription Drug Users. Available from – https://scholarworks.iupui.edu/bitstream/handle/1805/16562/polypharmacy-among-prescription-drug-users.pdf?sequence=1&isAllowed=y

5 Policies to prevent harms from the co-prescribing of opioids and central nervous system depressant drugs. Ottawa: CADTH, 2018. (Environmental scan; no. 72)

6 Gomes T, Juurlink DN, Antoniou T, Mamdani MM, Paterson JM, van den Brink W. Gabapentin, opioids, and the risk of opioid related death: A population-based nested case-control study. PLoS Med. 2017;14(10) PubMed PMID: 28972983.

7 Gaither JR, Goulet JL, Becker WC, Crystal S, Edelman EJ, Gordon K, Kerns RD, Rimland D, Skanderson M, Justice AC, Fiellin DA. The Association Between Receipt of Guideline-Concordant Long-Term Opioid Therapy and All-Cause Mortality. J Gen Intern Med. 2016 [Epub ahead of print] PubMed PMID: 26847447.

8 Busse JW, Craigie S, Juurlink DN, Buckley DN, Wang L, Couban RJ, Agoritsas T, Akl EA, Carrasco-Labra A, Cooper L, Cull C, da Costa BR, Frank JW, Grant G, Iorio A, Persaud N, Stern S, Tugwell P, Vandvik PO, Guyatt GH. Guideline for opioid therapy and chronic non-cancer pain. CMAJ. 2017;189(18):E659- E666.

9 RxFiles, 2017. Pain Mini-Book: Update on Pain Management & Opioids in CNCP.

10 Wolters Kluwer Clinical Drug Information, Inc. 2019; Lexicomp 4.6.0.

COMPASS Fee BreakdownThe COMPASS program became mandatory in all community pharmacies starting on December 1, 2017. Part of the program includes having and using a well-developed continuous quality improvement process within the pharmacy.

To fulfill this requirement, all Saskatchewan community pharmacies have subscriptions to the Community Pharmacy Incident Reporting (CPhIR) program run by the Institute for Safe Medication Practices (ISMP) Canada. This website provides access to an incident reporting tool, a medication safety self-assessment (MSSA) and a tool for recording and monitoring a quality improvement (QI) plan.

The cost of the CPhIR subscription, as well as a compliance assurance and administrative fee, is included in the overall COMPASS fee, which is broken down here:

CPhIR/MSSA subscription $ 340.00Compliance assurance and administrative fee $ 160.00Total COMPASS fee $ 500.00

Initially, the compliance assurance and administrative fee was used towards pharmacy education and development of the online reporting process for Quality Improvement Reviews (QIRs). Now, the fee is used towards maintenance of the online systems used during the QIRs, as well as ongoing updates provided to the College by ISMP Canada for tracking and monitoring of the CPhIR and MSSA statistics.

For more information, please contact the SCPP office at info@saskpharm.ca.

Deadline for Compounding ComplianceThe National Association of Pharmacy Regulatory Authorities (NAPRA) is currently in the process of developing compounding competencies which will be used to support training and education based on the identified competencies. As these competencies and education may provide additional support to members with the implementation of the compounding standards, the SCPP Council has approved the recommendation from the Compounding Inspector to extend the deadline for full compliance and implementation of the standards to December 31, 2021.

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Bylaw and Document UpdatesAdministration of Drugs by Injection and Other Routes FAQs – Revised

A new question in response to Ministry of Health feedback has been added to reinforce how pharmacists should be “familiar” with the Saskatchewan Immunization Manual (SIM) as well as minor wording changes suggested by the Ministry of Health when referencing the SIM.

Administration of Drugs by Injection and Other Routes – Revised

Revisions include a new Informed consent text box added in response to the Ministry of Health that provides clarity between the informed consent require for prescribing compared with that needed for administration. A “Notifying Primary Practitioner” form was also added to clarify the understanding of this requirement.

Long Term Care Standards – Revised

The Long Term Care Standards were reviewed and revised by a subcommittee of the Professional Practice Committee, as well as the Professional Practice Committee and the SCPP Council. The standards were modernized to reflect current best practices and extensively revises.

OAT Standards – Revised

This document is intended to give pharmacists guidance on the standards they are expected to meet and maintain regarding Opioid Agonist Therapy. It is not intended to be a clinical/best practice document. SCPP is also working on a Frequently Asked Questions document, and with Continuing Professional Development for Pharmacy Professionals (CPDPP) to provide training on harm reduction and OAT.

SCPP would like to acknowledge and express gratitude for the assistance received from CPDPP and are especially grateful for the assistance and great work of Mary Fraser. The document was also reviewed by the Professional Practice Committee and Council.

Prescription Regulations Summary and Prescription Review Program – Revised

Reference manual documents Prescription Review Program and Prescription Regulations Summary Chart have been revised to reflect the updated list of PRP medications. Prescription Review Program outlines the goals, requirements and purpose of the program. It also provides clarification on selling exempted codeine products as schedule II drugs and providing interim supplies for medications such as gabapentin and oxybutynin.

Criminal Record Check – New Requirement in Bylaws

Regulatory bylaw amendments requiring a criminal record check from all Saskatchewan College of Pharmacy Professionals (SCPP) members have been approved by the Minister of Health. Effective April 1, 2020, SCPP will require a criminal record check from all applicants by the end of the 2020-2021 registration year, existing members seeking membership renewals, interns, and medical practitioners (who are registered as Licensed Pharmacists). Criminal record checks are required by most other pharmacy regulatory authorities in Canada. These amendments will help to optimally protect the safety of the public.

SCPP Members Facebook GroupWhen there is something the College would like to get out quickly, including drug recalls, drug schedule changes, important notices, etc. the SCPP Members Facebook group is one of the avenues the College uses. It is also a place where members can ask questions and post information that will benefit the community.

Note that updates related to the COVID-19 pandemic are being posted to the SCPP website (www.saskpharm.ca).

The group is available any SCPP member who has an active member number and is a Facebook user. The Facebook Group has been set up as a “secret” group and is therefore not viewable by others.

How to JoinEmail info@saskpharm.ca with “Join SCPP Members Group” in the subject line. Please include a first and last name, licence number and the email address associated with your Facebook account in the body of the email. An invitation to join the group will be sent via Facebook. Participants can leave the group at any time.

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The Discipline Committee considers the primary purpose of a discipline proceeding to be the protection of the public and the pharmacy profession as a whole. The Discipline Committee is conscious of the fact that the public must have confidence in the profession’s ability to regulate itself in a manner that protects the public. All Decisions and Orders of the Discipline Committee are posted on the CanLII website in their entirety at www.canlii.org/en/sk/skcppdc.

Sandra DufourOn November 4, 2019, the Discipline Committee convened a hearing to hear charges and determine charges of professional incompetence and professional misconduct against registrant Sandra Dufour. The hearing proceeded via an agreed statement of facts and a joint submission on penalty.

The agreed statement of facts described the charges summarized below:• Ms. Dufour administered by injection Fluzone®

quadrivalent to her husband and two children.• Ms. Dufour administered to herself by injection Fluzone®

quadrivalent.• Ms. Dufour administered Fluzone® quadrivalent to her

husband and child in her home and outside the physical space of a licensed pharmacy.

• Ms. Dufour signed the Vaccination Consent and Record of Administration for her daughter, who was of age to sign her own consent form.

• For the period July 1, 2017 until October 14, 2019, Ms. Dufour did not hold Advanced Methods Certification. Only licensed pharmacists with Advanced Methods Certification may administer a drug by intradermal, subcutaneous or intramuscular injection.

• Ms. Dufour did prescribe and dispense Yasmin 21 3mg/0.03mg to her daughter and Yasmin 28 3mg/0.03mg to her other daughter.

• Ms. Dufour prescribed and dispensed 84 tablets and 112 tablets respectively to her daughters which is in excess of the medSask prescribing requirements of oral hormonal contraceptives, which provides for one or two months of therapy initially.

• Ms. Dufour prescribed and dispensed to her daughter Cyestra-35 which is not listed in the medSask prescribing guidelines as medication that can be prescribed by a pharmacist, and failed to prepare a Pharmacist Assessment Record as required under Part K, section 2(1) of The College Regulatory Bylaws.

• Ms. Dufour prescribed and dispensed Oracort 0.1% dental paste to her daughter and failed to prepare a Pharmacist Assessment Record as required under Part K, section 2(1) of The College Regulatory Bylaws.

• Using the pharmacy software program of Goodsoil Coop Pharmacy, Ms. Dufour created a fictitious drug file for herself, added fictitious inventory and prepared a fictitious entry in her patient profile and then cancelled those entries. The entries were for “Medical mj 1 batch 1”.

Ms. Dufour acknowledged all charges against herself and entered a guilty plea.

The Discipline Committee accepted the joint submission on penalty from Ms. Darcia Schirr, QC counsel for the College and Mr. Russell Gregory, LLP counsel for Ms. Dufour which included:• A Reprimand• Sandra Dufour may continue to practice under the

condition that, within 12 months of the date of the Discipline Committee Order, she successfully complete a course offered by PROBE Canada entitled “Ethics and Boundaries”. Ms. Dufour shall bear all costs associated with that course and provide verification to the Registrar that she has successfully completed the course by obtaining an unconditional pass.

• Pay the costs of the investigation and hearing, which costs shall be fixed in the amount of $11,000.00. The costs shall be paid on or before May 1, 2020, failing which Ms. Dufour’s license shall be suspended until payment is made.

Members are reminded of their certification obligations, which are outlined in the newsletters released by the College. The purpose of these certification requirements are to ensure that pharmacy professionals maintain the appropriate knowledge and skills to undertake specific activities. Furthermore, the public expects pharmacy professionals to treat each member of the public in a similar fashion. Cutting corners, failing to follow regulatory requirements, and providing special treatment to family members reflects poorly upon the profession and its ability to regulate itself. Conducting oneself in accordance with established standards of professional conduct is required when dealing with all clients, including family members. Such standardized behaviour is critical to upholding public confidence in the services offered by pharmacy professionals.

The entire Decision and Order is available for review on the following CanLII link:https://www.canlii.org/en/sk/skcppdc/doc/2019/2019skcppdc7/2019skcppdc7.html.

Discipline Matters

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Vipulkumar Chheta and West-Side Medical Corporation operating as West-Side Pharmacy, Saskatoon, SKOn November 4, 2019, the Discipline Committee convened a hearing to hear and determine charges of professional incompetence, professional misconduct and proprietary misconduct against Mr. Vipulkumar Chheta and West-Side Medical Corporation operating as West-side Pharmacy respectively. The hearing proceeded via an agreed statement of facts and a joint submission on penalty.

The agreed statement of facts outlined the following details:• In November 2018, a pharmacy assistant employed

at West-Side Pharmacy discarded numerous empty or apparently empty bottles of methadone in a recycling bin. Some of the bottles contained liquid residue. All the bottles contained complete labels showing the name of the patient, dispensing instructions, the name of the prescriber and the nature of the drug.

• From April 2015 until November 2018, the practice at West-Side Pharmacy was to dispose of empty methadone bottles with intact labels containing personal health information in the garbage.

• From April 2015 until November 2018, West-Side Pharmacy failed to have any or any appropriate policies, procedures and practices to destroy personal health information contained on labels for methadone bottle dispensed to patients.

Mr. Chheta admitted that the charges amounted to professional misconduct, professional incompetence, and proprietary misconduct.

Upon reviewing the evidence submitted, the Discipline Committee accepted Mr. Chheta’s plea and found him guilty of professional incompetence, misconduct and as manager of West-side Pharmacy, proprietary misconduct as defined in the Act. As a pharmacist, manager and privacy officer for West-Side Pharmacy, Mr. Chheta’s repeated failure to follow proper disposal practices of bio hazardous medications coupled with his contemporaneous privacy breaches of patient medical information fell below the standard expected for the profession and were critically in breach of The Health Information Protection Act.

The Discipline Committee accepted the joint penalty and imposed the following sanctions:• Mr. Chetta be reprimanded• Vipulkumar Chheta and West-Side Medical Corporation

shall be liable, jointly and severally, to pay a fine in the amount of $7,000.00. The fine shall be paid on or before March 15, 2020, failing which the license held by Vipulkumar Chheta and the proprietary permit held by West-Side Medical Corporation shall be suspended until payment is made.

• Vipulkumar Chheta and West-Side Medical Corporation shall be liable, jointly and severally, to pay costs in the amount of $10,515.00. The costs shall be paid on or before March 15, 2020, failing which the license held by

Vipulkumar Chheta and the proprietary permit held by West-Side Medical Corporation shall be suspended until payment is made.

The entire Decision and Order is available for review on the following CanLII link: https://www.canlii.org/en/sk/skcppdc/doc/2019/2019skcppdc6/2019skcppdc6.html.

Consensual Complaint Resolution Agreement – Summary for Newsletter – Rexall/Pharma Plus Pharmacies (Sask) Ltd.The Saskatchewan College of Pharmacy Professionals (the College) considers the primary purpose of an Alternative Dispute Resolution process to be the protection of the public and the pharmacy profession as a whole. The College is conscious of the fact that the public must have confidence in the profession’s ability to regulate itself in a manner that protects the public and has determined that a digest of Alternative Dispute Resolution processes will be published.

Consensual Complaint Resolution Agreement

Where there is evidence to support the allegation of professional incompetence, professional misconduct or proprietary misconduct the Chair of the Complaints Committee, on behalf of the Complaints Committee, shall determine whether there is an opportunity to use an Alternative Dispute Resolution to resolve the complaint. A resolution or remedy may result in a Consensual Complaint Resolution Agreement (CCRA). A Consensual Complaint Resolution process, while not a discipline hearing, will result in an agreement between the College and the signatories of the agreement which meets the public protection mandate. Should either the member, proprietor or the complainant not agree to participate in a CCRA the file is referred back to the Complaints Committee, which may result in referral to the Discipline Committee for a hearing.

The SCPP Regulatory Bylaws Part P.1 section 3(12) and (13) state the Alternative Dispute Resolution processes.

The Complaint

In 2016, the pharmacy, operated by Rexall/Pharma Plus Pharmacies (Sask) Ltd. (the Proprietor) operating as Rexall Saskatoon Eight Street at 108-3929 8th Street East in Saskatoon, was the subject of a routine practice review. At that time, several issues of concern regarding the practice were identified by the then pharmacy manager and discussed with the College Field Officer, including staff orientation and training and staff turnover. A few months later, staff of the pharmacy also called to express concerns about the operation of the pharmacy, including technology issues and the ‘auto-fill’ program instituted by the Proprietor.

In December 2016, the College received a complaint from a patient who received a medication labelled with their name

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and directions for use which had not been prescribed for them along with their intended prescription refills.

CCRA Process

At the conclusion of the investigation of the complaint the chair of the Complaints Committee concluded:

Subsequent to an investigation of the error, the Complaints Committee determined that the Proprietor orientation and/or training and supports and/or systems were not sufficient to maintain a safe practice environment for the pharmacy staff members.

The CCRA is intended to improve the practice environment of the pharmacy.

After consideration as to referral to discipline or referral to an Alternative Dispute Resolution process and discussions with the Proprietor, it was determined that a CCRA would be explored with the Proprietor.

The Proprietor has advised the College that it has already taken steps to improve the practice environment and the College has relied on those representations.

In making its decision the Committee reviewed the relevant section of The Pharmacy and Pharmacy Disciplines Act, the SCPP Regulatory Bylaws Part H - Code of Ethics and the NAPRA Model Standards of Practice, links to which are all available on the SCPP website. www.saskpharm.ca.

The Agreement

The Complaints Committee and the Proprietor were able to come to an agreement in December 2019, which, while an alternative to the discipline process, ensure the ongoing protection of the public through a commitment of the Proprietor to work with the College to ensure processes and procedures implemented by the Proprietor support the Proprietor’s pharmacy staff and the protection of the public.

In summary the agreement includes the following provisions.

1. The Proprietor will ensure an appropriate level of safe, competent and professional services are provided to the public consistent with the Act, Bylaws, Code of Ethics and Standards of Practice.

2. For a period of three years from the date of the agreement the Proprietor will cooperate with scheduled and unscheduled inspections to be conducted by the College Field Officer. The Proprietor will pay the costs of the inspection at an agreed upon fixed amount per inspection.

3. The Proprietor will rectify all deficiencies listed by the Field Officer within a reasonable time period set out by the Field Officer.

4. At six-month intervals through the three-year period, the Proprietor will provide a report to the College Registrar that

• includes information to satisfy the Registrar that the designated pharmacy manager has authority over and is responsible for the operation of the pharmacy and enjoys professional autonomy in providing pharmacy services to the public consistent with the Code of Ethics and Standards of Practice;

• provides an indication as to the number and nature of failed transaction to the Pharmaceutical Information Program (PIP) and an outline as to the steps the Proprietor is taking to rectify such problems; and,

• verifies that the Proprietor is participating in COMPASS (Community Pharmacy Professionals Advancing Safety in Saskatchewan).

5. Within 30 days of the execution of the Agreement, pays the entire costs to the College related to the investigation and steps leading to the execution of this Agreement as agreed to by the College and the proprietor.

The College will take no further action against the Proprietor if the Proprietor complies with the undertakings. A breach by the Proprietor of any of the terms and undertakings of the Agreement may be proprietary misconduct and result in further investigation.

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Dr. Jane Alcorn

College of Pharmacy and Nutrition, University of Saskatchewan

For the latest news from the College, visit our website: pharmacy-nutrition.usask.ca

UPDATE: some events listed below have now been cancelled or postponed due to COVID-19 precautions. Please check with the appropriate website or event organizer.

The College of Pharmacy and Nutrition has been a busy place and I’m proud of all the exceptional people you’ll read about below. Here are some of the remarkable moments from the last few months:

Congratulations to Dr. Holly Mansell, Nicola Rosaasen (BSP ‘92) and their team. “Solid Organ Transplantation – a Miniseries for Patients” received the Excellence in Pharmacy Practice – Leadership Award as part of the Canadian Society of Hospital Pharmacists National Awards & Fellows Recognition Ceremony. Read more.

Congratulations to nutrition student Chelsea Lussier on receiving the Leadership Award for the College of Pharmacy and Nutrition at the Indigenous Student Achievement Awards on Thursday, February 6. The Indigenous Student Achievement Awards Ceremony is a time to honour and celebrate the academic accomplishments, research endeavours, leadership and community involvement of Indigenous students at USask. Read more.

Dr. Lina Al-Sakran is our Trainee Spotlight. She is a recent PhD graduate in pharmacy who worked under the supervision of Dr. Charity Evans. For her PhD thesis, Lina studied the epidemiology and pharmacoepidemiology of multiple sclerosis in Saskatchewan. Read more.

With Indigenization a priority at both the university and college levels, Dr. Jaris Swidrovich has been working to share his findings and recommendations with colleagues and to implement new initiatives in the classroom. Read more.

Pharmacist Awareness Month and Nutrition Month have officially kicked off on campus. The students held a kick-off event at the end of February and have a number of events planned throughout March.

Thank you to everyone who joined us at our annual alumni and friends reception after the Canadian Society of Hospital Pharmacists awards ceremony on Saturday, February 1 at Reds on Adelaide.

The college will host its annual dessert and reception at the Pharmacy Association of Saskatchewan Conference on Friday, May 1. More details to follow.

The college will also host an alumni reception at the Dietitians of Canada Conference in Saskatoon on Friday, June 12. Thank you to the Saskatchewan Dietitians Association for sponsoring the event this year. Location and other details to follow.

More exciting things are coming this year and we’ll be extending invitations for you to join us at our alumni events.

Dr. Jane Alcorn Professor and Dean

From the Desk of the Dean

From the Desk of the Dean

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New Wellspring Leadership Awards for 2020

In celebration of our 75th Anniversary, the Board of the Canadian Foundation for Pharmacy (CFP) is pleased to announce our ongoing commitment to advancing the profession of pharmacy with a new grant of $10,000 for the Wellspring Pharmacy Leadership Awards.

CFP sees the value in continuing to invest in the future of pharmacy through the development of our leaders.

These annual awards recognize both demonstrated and potential leadership in individuals in the pharmacy profession. Recipients receive up to $10,000 for initiatives that further develop personal leadership through study, experiential learning, or mentorship.

Candidates can nominate themselves or be nominated by others. Click here for the criteria and application form: https://cfpnet.ca/grants-awards/details/award/36

Please send submissions for the 2020 awards to submissions@cfpnet.ca.

Canadian Foundation for Pharmacy 75th Anniversary

Important Update from CFPDue to the heavy burden that Covid-19 is placing on pharmacists across the country, we have decided to extent the deadline for applications for the Wellspring Leadership Awards and Innovation Fund Grants until further notice.

We recognize that pharmacists are relied on by patients and their own families to help everyone through this pandemic.

The portals for application are still open. We will be monitoring this over then next few weeks, to decide the right time to proceed.

We look forward to our continued support of the profession of pharmacy.

Regards, CFP Board of Directors

Innovation Fund GrantsAs we celebrate our 75th Anniversary, the Board of Director’s for the Canadian Foundation for Pharmacy is pleased to announce funding for 2020 Innovation Fund Grants.

CALL FOR APPLICATIONSThanks to our many donors and sponsors the

Canadian Foundation for Pharmacy is pleased to announce the

2020 Innovation FundUp to $100,1000 available

Focusing on Innovation in pharmacy practice

Deadline for submissions has been extended. For details and a grant application visit our website

www.cfpnet.ca

SCPP wishes to congratulate the Canadian Foundation for Pharmacy for 75 years of service to the pharmacy industry. Created in 1945, the Canadian Foundation for Pharmacy (CFP) is Canada’s National Pharmacy Charity. Through the Innovation Fund, CFP has granted more than $2 million for more than 24 projects that seek to advance the profession.

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District Five National Association of Boards of Pharmacy and American Association of Colleges of Pharmacy 931 Briar Ridge, West Des Moines, Iowa 50265-5784 Telephone: (515) 707-9118 E-Mail: LKJessen@aol.com

IOWA Board of Pharmacy ▪ MINNESOTA Board of Pharmacy ▪ NEBRASKA Board of Pharmacy ▪ NORTH DAKOTA Board of Pharmacy SOUTH DAKOTA Board of Pharmacy ▪ MANITOBA College of Pharmacists ▪ SASKATCHEWAN College of Pharmacy Professionals

DRAKE UNIVERSITY College of Pharmacy & Health Sciences ▪ UNIVERSITY OF IOWA College of Pharmacy ▪ UNIVERSITY OF MINNESOTA College of Pharmacy ▪ CREIGHTON UNIVERSITY School of

Pharmacy & Health Professions ▪ UNIVERSITY OF NEBRASKA College of Pharmacy ▪ NORTH DAKOTA STATE UNIVERSITY College of Health Professions—School of Pharmacy ▪ SOUTH DAKOTA STATE UNIVERSITY College of Pharmacy & Allied Health Professions ▪ UNIVERSITY OF MANITOBA College of Pharmacy ▪ UNIVERSITY OF SASKATCHEWAN College of Pharmacy & Nutrition

ANNOUNCEMENT 2020 District Five Individual Study Grant

Criteria: NABP/AACP District Five will make available grant money, not to exceed $3,000.00 per grant, to award two

grants within the district to study topics which benefit students, pharmacy education or pharmacy practice. Topics of interest to the boards and colleges in District Five are suggested, but researchers will not be limited to these topics. The grant recipients or designees are expected to present their report or findings at the District Five Annual Meeting in the year following the award.

Eligibility:

• Individual students with faculty or Board of Pharmacy advisor • Student organizations with faculty or Board of Pharmacy advisor • Faculty members • Board of Pharmacy members

Application: Applications should not exceed five pages in length and should include the following information:

1. Rationale (background and reason for doing the study) 2. Specific goals of study (what are you trying to achieve) 3. Names of personnel involved 4. Methods by which goals will be attained 5. Date of completion (must be prior to the August 2021 District Five NABP/AACP Annual Meeting in South

Dakota, so that the results can be presented there) 6. Justification of use for funds received (budget)

Selection of Recipient: The District Secretary/Treasurer will call for applications from Deans, department heads, and ASP advisors

at member colleges of pharmacy and from member boards of pharmacy. Applications are due to the Secretary/Treasurer (Lloyd K. Jessen) by April 30, 2020 and will then be distributed to the District Five Study Grant Committee. Selection and notification of the recipient(s) will be made by June 1, 2020.

Study Grants Awarded Since 2016:

• Use of Telepharmacy and Telehealth Technology to Prepare Pharmacy Students to Deliver Health Care to Distant Populations

• Advancing Practice for Pharmacy Technicians: A Comparison of Views • Determining the Level of Stigma About Mental Health Held by Student Pharmacists in NABP/AACP District

Five • Physical Assessment in Pharmacy Education and Practice: An Evaluation of the Value and Feasibility of

Incorporating Physical Assessment from the Care Provider and Public Perspective • Employers’ Perception of Key Variables in New Practitioners’ Success When Entering the Pharmacy

Workforce • Determining Student Preferences of and Required Financial Incentives to Work in a Rural and Medically

Underserved Area in NABP/AACP District Five • Incorporating Assessment and Prescribing for Ambulatory Ailments Skills into Practice: Training Needs of

Manitoba Pharmacists to Increase Application into Practice • Caring for Our Aging Population: Assessment of CPE in Chronic Disease Management Among Community

Pharmacists in the Upper Midwest Submit Applications to: Lloyd K. Jessen, Secretary/Treasurer, District Five NABP/AACP, 931 Briar Rdg, West Des Moines, IA 50265-5784 Or E-mail to: LKJessen@aol.com

2020 District Five Individual Study Grant