From December 1, 2018 onwards, a valid prescription will be needed from a veterinarian before an individual can purchase any medically important antimicrobial, including any to be administered in animal feed.
The following considerations should be addressed by a veterinarian before prescribing a drug:
1. Establishment of a Valid Veterinarian-Client-Patient-Relationship
Veterinarians should establish a valid Veterinarian-Client-Patient-Relationship (VCPR) prior to the provision of veterinary medical services, including ordering treatment by virtue of issuing a prescription. A legitimate VCPR is considered to exist only if medical records of the practice contain sufficient evidence of relevant and timely interaction between the veterinarian, animal owner and animal patients.
The VCPR is not a signed contractual agreement but rather a working connection and interaction between veterinarian, client and specific animal patient or group of animals. The VCPR is not in and of itself an entitlement to prescribe and subsequently dispense.
Each provincial and territorial veterinary statutory body has their own definition of VCPR in provincial legislation.
2. Make an Evidence-Based Determination of Medical Need
It is the responsibility of the registered veterinarian to make an informed decision that a particular drug will be prescribed. This may require a change in the culture of use of antimicrobials where animal owners or producers may be accustomed to requesting a particular antimicrobial for prevention, control or treatment of disease.
3. Complete Appropriate Documentation in the Medical Record
Medical records created and maintained by veterinarians for all practice types shall contain sufficient information entered into the record regarding the history, consultations, laboratory investigations and physical examination findings to justify the prescription and use of the antimicrobial. A precise diagnosis or purpose for use of the antimicrobial must be recorded.
4. Provide Oversight of Use and Follow Up
The accepted definition of VCPR specifically dictates that the veterinarian who is responsible for making medical decisions with regards to an animal or group of animals must be available for follow-up or have arranged a designated alternate. This obligation extends to the prescription of any pharmaceuticals including antimicrobials.
For more information on Prescribing and Dispensing and VCPR, read Veterinary Oversight of Antimicrobial Use – A Pan-Canadian Framework for Professional Standards for Veterinarians. The document was created by the CVMA’s Veterinary Pharmaceutical Stewardship Advisory Group and the Canadian Council of Veterinary Registrars (CCVR) to help guide veterinary professionals as they assume greater responsibility.