NURSE PRACTITIONER PRESCRIBING DURING COVID-19
8 April 2020
Sending prescriptions to pharmacists by email
- Unsecured email, texting and other digital platforms are generally not acceptable ways to send prescriptions.
- Whenever feasible, NPs should use appropriate channels, such as phone, fax or secure e-prescribing systems.
- We understand this is an unusual time and if these methods of communication are not an option, work with the pharmacist to identify the best way to meet patient needs, such as unsecured email. The pharmacist needs to assure any prescription is valid. Unsecured email cannot be used for drugs listed under the Narcotic Control Regulations.
- Work with your patients to meet their needs and to get informed consent before using unsecured email to send a prescription. If the patient consents to sending this unsecured prescription email, ensure you are only sending it to the pharmacy of the patient’s choosing. For guidance, consult with the Department of Health Prescribing methadone and buprenorphine
- For NPs who treat opioid addiction, the Centre for Addiction and Mental Health has new guidelines for prescribing and managing treatment with methadone and buprenorphine while adhering to social distancing and self-isolation measures. These guidelines “address office visits, remote visits, carry doses and frequency of urine drug testing.”
- We encourage NPs to work with pharmacists and others on the care team who may be impacted by changes to a patient’s treatment regime.
Hydroxychloroquine and azithromycin prescriptions
- All drugs, including hydroxychloroquine and azithromycin, should only be prescribed in alignment with current evidence.
- Until there is supporting evidence, do not prescribe hydroxychloroquine and azithromycin to prevent or treat COVID-19 as this is leading to drug shortages and may compromise care for other patients.
- Nurses have an obligation to ensure that their practice and any treatment they prescribe is evidence-informed.
Health Canada exemptions for prescribing controlled substances
- As part of its response to the containment of COVID-19, Health Canada is issuing exemptions for prescriptions of controlled substances under the Controlled Drugs and Substances Act.
- NPs can now temporarily issue verbal orders (for example, over the phone) to extend or refill a prescription to a patient under your treatment.