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首页> 外文期刊>The Canadian journal of hospital pharmacy. >Provincial Comparison of Pharmacist Prescribing in Canada Using Alberta's Model as the Reference Point
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Provincial Comparison of Pharmacist Prescribing in Canada Using Alberta's Model as the Reference Point

机译：使用Alberta模型作为参考点使用Alberta模型在加拿大处方的省级比较

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Background: In the past decade, pharmacist practice has evolved tremendously in Canada, but the scope of practice varies substantially from one province to another. Objective: To describe pharmacists' scopes of practice relevant to prescribing within various jurisdictions of Canada, using the prescribing model in Alberta (authors' province) as the reference point. Methods: This cross-sectional survey consisted of clinical scenarios for emergency prescribing, adapting or renewing a prescription, and initial-access prescribing for a chronic disease. Pharmacists were asked about their ability to administer injections and to order or access the results of laboratory tests, as well as certification and training requirements and reimbursement models. Results: Thirteen pharmacists representing Canadian provinces other than Alberta were surveyed in late 2015, for comparison with Alberta. With specific reference to the scenarios presented, pharmacists were able to prescribe in an emergency in 9 of the 10 provinces, renew prescriptions in all provinces, and adapt prescriptions in 6 provinces. Three provinces required that pharmacists have collaborative practice agreements identifying a specific practice area in order to initiate a prescription for a chronic disease (with 6—12 pharmacists per province having such agreements) . Alberta required pharmacists to have authorization, based on a detailed application, in order to initiate any provincially regulated drug (with about 1150 pharmacists having this authorization). Pharmacists were allowed to administer vaccines in 9 provinces, and 5 provinces allowed pharmacists to administer drugs by injection. Three provinces had systems in place for pharmacists to access laboratory test results, and 2 allowed pharmacists to order laboratory tests. Five provinces had government-reimbursed programs in place for select prescribing services; however, all 9 provinces with public vaccination programs reimbursed pharmacists for this service. Conclusions: Pharmacist prescribing differs among Canadian provinces. Although most provinces allow emergency prescribing and renewal or adaptation of prescriptions by pharmacists, only 4 provinces allow prescription initiation, with variable criteria and scope. Despite some progress to enhance patient flow through the health care system (e.g., by allowing pharmacists to extend prescriptions), further work should be pursued to harmonize clinical practices across Canada and to enable pharmacists to initiate and manage drug therapy.
机译：背景：在过去的十年中，加拿大的药剂师执业经历了巨大的发展，但执业范围因省份而异。目的：以阿尔伯塔省（作者所在省）的处方模式为参考点，描述加拿大不同管辖区内药剂师与处方相关的执业范围。方法：这项横断面调查包括紧急处方、调整或更新处方以及慢性病初始处方的临床场景。药剂师被问及他们管理注射、订购或获取实验室检测结果的能力，以及认证和培训要求和报销模式。结果：2015年末，对加拿大除艾伯塔省以外的13个省份的药剂师进行了调查，以与艾伯塔省进行比较。根据所述情景，药剂师能够在10个省份中的9个省份紧急开处方，在所有省份更新处方，并在6个省份调整处方。三个省份要求药剂师签订合作执业协议，确定具体的执业领域，以便为慢性病开出处方（每个省份有6-12名药剂师签订此类协议）。艾伯塔省要求药剂师根据详细申请获得授权，以便开始使用任何省级管制药物（约1150名药剂师拥有该授权）。9个省允许药剂师接种疫苗，5个省允许药剂师注射药物。有三个省份建立了药剂师获取实验室检测结果的系统，有两个省份允许药剂师下令进行实验室检测。五个省份为部分处方服务制定了政府报销计划；然而，拥有公共疫苗接种计划的9个省份都向药剂师报销了这项服务的费用。结论：加拿大各省药剂师的处方不同。尽管大多数省份允许药剂师紧急开处方、更新或调整处方，但只有4个省份允许开处方，标准和范围各不相同。尽管在促进医疗系统中的患者流动方面取得了一些进展（例如，允许药剂师延长处方），但仍应继续开展进一步的工作，以协调加拿大各地的临床实践，并使药剂师能够启动和管理药物治疗。

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