What is the difference between an individual prescription and a collective prescription?
According to the practice guideline of the Collège des médecins du Québec (05/2017) entitled Les ordonnances collectives (p. 1):
“An individual prescription concerns only one person who has undergone a medical assessment by the prescriber. A collective prescription concerns a group of people or one or more clinical situations. It allows a professional or an authorized person to engage in certain medical activities, under the clinical circumstances and conditions set out in the prescription, without having to obtain an individual prescription from a physician. This means that the person concerned by the prescription does not have to be seen by a physician first. Both individual and collective prescriptions may refer to an external medical protocol.” [Translation]
To learn more about individual prescriptions, please consult the practice guideline of the Collège des médecins du Québec (10/2016) entitled Individual Prescriptions Written by a Physician.
Can an institution adapt a collective or individual prescription template and a liaison form template to suit its own practices?
Use of the collective prescription template suggested by INESSS or the Collège des médecins du Québec is not mandatory; however, an individual prescription must contain all the elements stipulated in the Regulation respecting the standards relating to prescriptions made by a physician.
The liaison form templates can also be adapted to meet the institution’s requirements. These documents are not mandatory as long as the required information about the patient is properly forwarded by the treating physician to the authorized professional who will apply the collective prescription.
The only requirement is that INESSS’s medical protocol, which is mandatory, must be used in its entirety.
Can an individual adjustment prescription completed by a physician be the initial prescription?
Yes. It can be the initial prescription because the individual adjustment prescription is a valid prescription and may therefore be sent to the pharmacist.
Do medications already prescribed at maximum dosage levels have to also be registered on the list of individual adjustment prescriptions?
Medications prescribed at maximum dosage levels must be registered on the list of individual adjustment prescriptions only if the dosage needs to be adjusted.
Is it mandatory to use INESSS’s individual adjustment prescriptions?
No. Use of INESSS’s individual adjustment prescription templates is not mandatory. These templates were developed to allow the physician to indicate the medication requiring adjustment, the maximum allowable dosage if applicable and the therapeutic target. If these templates are not used, the authorized professional must obtain the required information prior to adjusting the medication, whether using a different type of form or through another procedure.
Does the physician have to indicate on the individual adjustment prescription only those medications that are to be added or adjusted?
Yes. The physician must indicate on the individual adjustment prescription only those medications that are to be added or adjusted. In addition, the adjustment must be explained in detail in the medical protocol. For instance, in the case of the collective prescription for diabetes, the antihyperglycemic agents or insulin that are to be added or adjusted must be indicated on the individual adjustment prescription.
A physician wishing to add a medication that does not appear in the medical protocol must prepare an individual adjustment prescription that includes a medical profile section specifying the procedure that the authorized person must follow when making the adjustment.
Does an individual prescription require the approval of the Council of Physicians, Dentists and Pharmacists (CPDP)?
No. Since the individual prescription is a valid prescription, the signature of the prescribing physician constitutes approval.