Scope of Practice Round-up: September 2025

MedSask Updates

The Medsask Guideline on Dandruff has been updated as follows: 

• Ciclopirox olamine 1.5% Shampoo was discontinued in January 2024. It has been removed from this guideline and the associated documents. There ceases to be any Schedule I option for prescribing. 
• There is now a column in the guideline for ‘dosage form’ in Table 1: Dandruff Pharmacological Treatment Options to help with clarity about treatment options. 
• In the guideline, minimization of impact to mental health and self-image has been added as a Goal of Therapy. 

Have you accessed medSask guidelines and PARs recently? If not, here are some of the recent changes to further align with B.C. Minor Ailments and Contraception Services (MACS) scope:

• Guideline added for Atopic Dermatitis (March 2025)
• Guideline, algorithm and PAR for Acne have been updated to include information on all topical therapies (April 2025)
• Guideline update for Vulvovaginal Candidiasis (June 2025)
• Guideline update for Dandruff (August 2025)

Updates are currently in progress for the guidelines on Contraception (expected later in 2025)

Access medSask

Ministry of Health shares survey data from MACS patients

Between May 7 and Oct. 14, 2024, the Ministry of Health surveyed 2,825 British Columbians who received a Minor Ailment and Contraception Service (MACS) at a community pharmacy. The results are now available.

The survey identified demographic profiles of patients, patients' personal ratings of their health, reasons for visiting a pharmacist, an assessment of their experience as a MACS patient, and summaries of patient feedback.

Overall, 93 per cent of patients indicated they would see a pharmacist for this service again, and 85 per cent (excluding contraception and nicotine dependence) reported that their condition improved or resolved completely. The full survey results are available here.

B.C. government publishes report on increasing primary care access

The B.C. government has published a report on the province's Primary Care Strategy, which was launched in 2018 with the goal of increasing patient attachment to care providers and increasing access to care. The report details the government's work to open new Urgent Primary Care Centres, Community Health Centres, and tracks individual professions that make up the primary care provider workforce, including pharmacists who are providing MACS.

Among other details, the report also charts the percentage of patients attached to a longitudinal health provider in each of British Columbia's Primary Care Network regions. The completion of the report, the first of two, was announced by the Ministry of Health in early August.

Updated adaptations, drug administration numbers from PharmaCare

PharmaCare has published updated numbers for adaptations and drug administrations.

The available numbers show the quantity of publicly funded flu and COVID-19 vaccines pharmacists administered and a breakdown of the types of prescription adaptations being made from 2023 to March 2025.

Adaptations and emergency fills by pharmacists

Drug administrations and publicly funded vaccines by pharmacists

Two-year data report for MACS

PharmaCare has published its two-year overview of the MACS program, which includes data from June 1, 2023 to May 31, 2025. The full two-year overview document is available here.

The publication includes information on the outcome of MACS visits at pharmacies, whether patients received a prescription, were directed to another health professional with or without a prescription, did not receive a prescription at all, or visited the pharmacy with a non-covered minor ailment.

There are also updated client demographics, information on the average number of medications MACS patients are taking, the types of pharmacies providing MACS services, and the impact of MACS on hospital and physician services.

Information on adapting prescriptions for controlled substances during drug shortages

In August, the College of Pharmacists of British Columbia published information on pharmacists adjusting medications containing controlled substances during drug shortages.

According to Health Canada, dispensing the constituent components oxycodone and acetaminophen when the combination product (for example, oxycodone/acetaminophen 5 mg/325 mg, brand name Percocet®) has been prescribed would not be considered “substitution”. Instead, this activity is considered a change in dosage form/formulation as per Health Canada’s guidance document Prescription management by pharmacists with controlled substances under the Controlled Drugs and Substances Act and its regulations.

In accordance with the College’s Professional Practice Policy 58 – Adapting a Prescription (PPP-58), Section 13, a pharmacist may change the dose, formulation, and/or regimen of a prescription for a narcotic, controlled drug, or targeted substance only if all principles and requirements in PPP-58 are met.

This includes, but is not limited to:

• The quantity dispensed does not exceed the amount originally authorized in the prescription, and
• The change meets one of the criteria outlined in PPP-58 (e.g., strength not commercially available)

Limitations:

• Changing from one substance to another (e.g., oxycodone to hydromorphone) is not permitted.
• Pharmacists cannot adapt a prescription for a combination product that is not classified as Schedule 1A into a single-entity product that is classified as Schedule 1A, as this would require a Controlled Prescription Program (CPP) form.

More information is available on the College website. A resource is also available from the Canadian Pharmacists Association on shortages of acetaminophen with oxycodone or codeine.

College publishes new details on medication incident reporting

The College of Pharmacists of British Columbia has issued a new requirement that pharmacies must have access to a reporting platform for medication incident reporting by June 1, 2026. The reporting system must support mandatory data fields, de-identifies data, and integrates with national databases (National Incident Data Repository (NIDR) for community pharmacies.

The College has a list of commercially available reporting platforms that it has posted online. The College is calling the new program Continuous Improvement, Reporting, Collaborating and Learning (CIRCL). More details about CIRCL are available here.

The College will also be hosting a series of webinars to help pharmacists prepare for CIRCL. The first webinar is at 6 p.m. Pacific on Sept. 18, 2025.

College identifies pharmacies not in compliance with "expectations of care" poster

In September 2024, the College of Pharmacists of British Columbia introduced bylaws requiring pharmacies to display a "What You Can Expect from Your Pharmacy Visit" poster, with requirements that the poster must be displayed:

• Clearly, within the pharmacy, and at all times when clients or the public may be present in the pharmacy.
• In a manner and location that makes the poster clearly visible and readable to members of the public from every consultation area or counter where a member of the public can obtain a full pharmacist's advice.
• In a manner that makes it visually distinctive from other signage that may be displayed at the pharmacy.

In 2025, the College conducted inspections at pharmacies across the province and found 83 per cent of those inspected had some form of non-compliance with the requirements. The College found 17 per cent of pharmacies had no poster at all, 59 per cent needed more posters for their pharmacy to ensure the poster is visible and readable from consultation areas/counters. Some pharmacies displayed posters in black and white instead of the original colour-version, and others had modified the poster.

Information about the display requirements of this poster can be found at: https://www.bcpharmacists.org/whattoexpect