In recent decades, there have been considerable changes in the pharmacy profession. Pharmacists, whose traditional focus was mainly on drug distribution, have assumed a more direct role in providing patient care or pharmaceutical care. The major factor for this paradigm shift to patient-oriented pharmacy practice is to ensure optimal and appropriate medication use, to improve disease-state outcomes and quality of life.

In response to the rapid transition, some provinces in Canada have instituted expanded scope of practice for pharmacists. The intents of expanded scope of practice are 1) to increase access of care for patients, and 2) to promote greater interdisciplinary collaboration amongst the various health professions and enable these professions to provide more services. Currently, in Alberta, the expanded scope of practice for pharmacists includes administration of drugs by injection and prescribing.

Presently, in Alberta, the immunizations rate is still sub-optimal [1]. In 2011/2012 less than 20% of Albertans received an influenza vaccine. Pharmacists provided the second highest number of influenza vaccines Table 1.

Table 1: Number of Albertans received influenza vaccines in 2011/2012 season [2].

As of February 2012, more than 35% of pharmacists in Alberta are registered to administer drugs by injection. Increased access to immunization through pharmacists will help improve vaccine delivery system and vaccination rate and decrease mortality rates from preventable diseases.

In Alberta, pharmacists are authorized three types of prescribing:

Adapting a prescription,

Prescribing in an emergency, and

Initial access prescribing or managing ongoing therapy by prescribing based on:

The pharmacist’s own assessment of the patient,

A recommendation from a regulated health professional who is authorized to prescribe, or

Consultation with another regulated health professional.

The first two types of prescribing may be performed by any registered pharmacists, however, to prescribe for initial access prescribing or managing on going therapy, the pharmacist are required to received additional prescribing authorization by the Alberta College of Pharmacists. With additional prescribing authorization, pharmacists may prescribe Schedule I medications based on initial assessment [2].

These cognitive services are important in improving patient access of care and quality of care. The Alberta Government recognized that the cognitive services provided by pharmacists play an essential part in the delivery of quality health care to patients.

Currently in the Government of Alberta provides reimbursement for the following of cognitive services provided by pharmacists [3].

Care plan assessment – known either as a Comprehensive Annual Care Plan or a Standard Medication Management Assessment,

Administration of injections,

Assessment and modifying prescriptions based upon individual patient needs,

Prescription renewals,

Assessment of prescriptions for emergency needs,

Assessment for initiating medication therapy,

Medication assessments to ensure safe and appropriate use, such as refusal to fill a prescription or a trial prescription,

Tobacco cessation services,

Standard Medication Management Assessment for diabetics, and

Administration of publicly funded vaccines, such as seasonal influenza

While this is a tremendous step forward for pharmacists in Alberta, however, only community pharmacies are granted with a provider identification number to submit for reimbursements. This creates an egregious situation for pharmacists who do not work for a community pharmacy. At present, only pharmacies providing the above pharmaceutical services to patients by pharmacists will receive reimbursements. As for consulting pharmacists, they are unable to receive reimbursement for providing same pharmaceutical services to patients, as the Alberta Government still have not grant individual pharmacists a provider identification number.