Pharmacies across Canada have seen a significant increase in prescriptions, including “for office use” orders, for drugs such as hydroxychloroquine and azithromycin, which have not yet been proven to be beneficial for preventing or treating COVID-19. Registrants should use their professional judgment to assess these prescriptions, and decline to dispense if the prescription is inappropriate. 

Physicians have been reminded by the College of Physicians and Surgeons of Ontario (CPSO) that prescribing for any inappropriate use is contrary to their professional obligations as medical professionals. CPSO has also advised physicians that prescribing these drugs as a precautionary measure has led to drug shortages and compromised care for patients who need these medications for their intended use. 

Please also see the joint statement from the Ontario Pharmacists Association, the Ontario Medical Association and the Registered Nurses Association of Ontario.
 

The CPSO has advised its registrants that patients who are in self-isolation or isolation due to a confirmed or potential positive COVID-19 test should be told to stay home rather than enter a pharmacy to fill a prescription, which would put the health of other patients and pharmacy professionals at risk. 

Physicians have also been advised to send the prescription to the patient’s pharmacy of choice and explain the patient’s situation. The patient and pharmacy can then arrange for delivery of the medication or for it to be picked up by a designate, such as a friend, who does not live in the same household. 

Whenever possible, prescribers should use phone, fax, or secure e-prescribing systems to send prescriptions to a pharmacy. The CPSO has also communicated this to physicians. However, you may receive prescriptions via unsecured email as prescribers may not have access to these established channels.

Given the exceptional circumstances of this global pandemic, we recommend that you facilitate the dispensing process once you have validated, in your professional judgment, that the source is authentic and that the content is appropriate. 
 

As you know, on March 19, the Chief Medical Officer of Health (CMOH) issued a directive that health care providers (regulated health professionals or persons who operate a group practice of regulated health professionals) cease or reduce to minimal levels all non-essential and elective services. On March 23, the provincial government mandated closure of all non-essential workplaces effective March 24 at 11:59 p.m. Businesses providing pharmaceuticals and pharmaceutical services, including pharmacies and dispensaries, are considered an essential service.

Given these important directives designed to minimize the risk to the public and healthcare professionals, the College is supportive of pharmacies exploring ways to safely maintain patient access to prescription medication and clinical care while limiting access into the physical location. Some examples were discussed in a recent webinar by the Canadian Pharmacists Association. Please refer to the March 20 edition of e-Connect for further information.