+ When a patient picks up a TPP-type 1 medication sent through an e-prescribing platform (e.g., PrescribeIT), do both the pharmacist and patient need to sign the printed PrescribeIT paper copy?

As per TPP policies, the dispensing pharmacist who is responsible for assessing the prescription for appropriateness must sign the prescription, either on paper or electronically.

The signature of the patient or their agent must also be captured when they receive the prescription, either on paper or via an e-signature.

+ For compounded TPP medications, or for office or veterinary use, a copy of the TPP prescription must be kept. If the pharmacy has electronic record keeping, is an electronic copy sufficient or is a physical paper copy required?

An electronic copy of the TPP prescription is sufficient for compounded medications, and veterinary or office-use prescriptions. The signature of the patient, their agent or the prescriber (in the case of office-use prescriptions) must be captured upon receipt of the prescription, either on paper or via an e-signature. Additionally, a copy of the prescription, including the completed bottom portion of the prescription, must be sent to the TPP Alberta.

+ Where should I send the completed TPP prescription copy after dispensing?

After ensuring the pharmacy section has been completed accurately, TPP prescriptions can be grouped and mailed to:

TPP Alberta

2700-10020 100 Street NW

Edmonton, AB T5J 0N3

Pharmacists can request pre-printed return envelopes for TPP forms from the Alberta College of Pharmacy office:

Phone: 1-877-227-3838 / 780-990-0321
Fax: 780-990-0328
Email: acpinfo@abpharmacy.ca
TPP Alberta

+ Do I need to fill out the Pharmacy Use Only portion of the TPP prescription if it does not fall under one of the criteria that is required to be returned to CPSA?

If TPP Alberta does not require a copy of the prescription, the pharmacist does not need to complete the “Pharmacy Use Only” section for information duplicated on the transaction record (a signature is still required for the “Medication Received by” line).

The pharmacy transaction record which includes required information (i.e., dispense date, prescription number, Drug Identification Number (DIN), quantity, and dispensing pharmacist name and registration number) must be filed with the secure form and be available for review upon request by TPP Alberta. Please see the TPP Alberta Program Guide for additional information.

+ Where can I find a list of medications requiring a TPP form?

You can find the monitored medications list here: [TPP Alberta | Medication Lists — TPP Alberta | Tracked Prescription Program Alberta][1]

+ What if the TPP prescription has expired (past 72 hours)?

Prescriptions issued on a secure form are only valid for 72 hours. Day 1 is the date the prescription is written. The prescription cannot be filled after midnight on the third day. At their discretion, dispensers may contact the prescriber for approval to use an expired prescription written on a TPP form.

Both the prescriber and dispenser should document such authorizations on their respective secure form copies (or in the patient record if the prescriber copy has been electronically saved).

+ Can I accept a faxed TPP prescription?

Faxing secure forms directly from the prescriber’s office is acceptable. The TPP prescription must be legible for pharmacy and TPP Alberta use.

• The prescriber faxes the PHARMACY/TPP copy of the secure form to the pharmacy.
• Following successful fax transmission, the prescriber must mark the PHARMACY/TPP copy FAXED. This must not be given to the patient/patient’s agent.
• The prescriber retains the PRESCRIBER COPY of the secure form.
• The dispenser must confirm the prescription is current, authentic, complete, and verify the source of the fax per Alberta College of Pharmacy standards of practice.
• The dispenser must upload the received prescription into the patient’s electronic record and/or maintain it in a paper file and send a completed copy of the form to TPP Alberta for compounded, office use, out-of-province (i.e., prescriptions filled in Alberta pharmacies for out-of-province (OOP) patients written by Alberta prescribers) and veterinary use prescriptions.

+ What DIN do I write on the Pharmacy Use Only portion for compounds?

If the prescription is a compound, the DIN of the TPP medication component must be identified. If the compounding agent does not have a DIN, the name of the agent should be indicated. DO NOT use a pseudo-DIN.

The quantity of drug dispensed, route of administration, directions for use and medical indication must be included in the information sent to TPP Alberta. Inclusion of the prescription label in the fax to TPP Alberta may satisfy these information requirements.

+ What if a TPP prescription is placed on hold or unfilled?

If a medication is saved on file or placed on hold, the pharmacist may write “deferred” or “logged” in the “Received by” section.

+ What if a TPP prescription is placed on hold or unfilled?

Pharmacists may fill out-of-province narcotic or controlled drug prescriptions, sending a prescription copy to the respective Canadian prescription monitoring program as applicable. Be sure to note their Health Care Number and province of origin if not already on the TPP form [1]: https://www.tppalberta.ca/medication-lists

+ What is a prescription forgery?

Forging a prescription is defined as illegally acquiring pharmaceuticals for either personal use or for trafficking (illegitimate sale or distribution). Creating a prescription (on a blank prescription form or electronically), or altering a legitimate prescription, (e.g. by increasing the quantity of a medication or adding another medication to the prescription) are all examples of a forgery.

Prescription forgery and trafficking of Controlled Drugs are contraventions of the Controlled Drugs and Substances Act with serious legal penalties (particularly for trafficking).

+ What steps should be taken by a prescriber if a forged prescription has been dispensed?

Confirm the forgery:

1. Get a copy of the forged prescription(s) for TPP Alberta-monitored drugs from the pharmacy.

2. Determine as many details about the forgery as possible, for example: • Date & time of forgery presentation to/receipt by the pharmacy • Patient information

3. Identify any discrepancies from legitimate prescriptions under your name.

4. Document the forgery in your records.

Collaborate with the pharmacy that received and/or filled the forged prescription(s):

1. Share applicable details with the pharmacy staff so that they can identify possible future forgeries under your name.

2. Provide direction to the pharmacy staff on the steps you would like taken for suspected forgeries received under your name. For example, how best to contact you for verification.

3. Confirm who will complete notifications, as appropriate, to: • Law enforcement • The Alberta College of Pharmacy (ACP) • Health Canada Notify TPP Alberta of the forgery:

Provide a copy of the forged prescription to TPP.Info@cpsa.ab.ca, including details gathered and shared with the pharmacy. TPP Alberta will complete appropriate documentation.

+ What steps should a pharmacist take when a forgery is suspected or confirmed?

1. Pharmacists should follow the guidance provided on the ACP forgeries webpage.
2. Pharmacists should collaborate with the prescriber and/or other healthcare professionals.
3. All confirmed forgeries for TPP-monitored drugs should be reported to TPP Alberta.
4. If the forgery has been dispensed, notify Health Canada, local law enforcement and contact Netcare (Pharmaceutical Information Network) for dispense record corrections, as appropriate.

+ To what organizations should a forgery of a controlled drug and substance be reported?

Health Canada requires that all those working with controlled substances and precursor chemicals must take proper security measures. If a theft, loss or forgery of a controlled drug or substance occurs it must be reported to the local police and to the [Office of Controlled Substances. ]

In Alberta, forgeries for TPP Alberta-monitored drugs should be reported to TPP Alberta on the "Forgeries" page on this website.

Additionally, it is recommended that pharmacists notify the Alberta College of Pharmacy.

Alberta Law Enforcement Agencies Contact Information:

Edmonton Police Service (EPS)

• Non-Emergency Line: 780-423-4567

Calgary Police Service (CPS)

• 403-266-1234

RCMP Non-Emergency Lines

• Red Deer: 403-406-2300
• Grande Prairie: 780-830-5701
• Wood Buffalo: 780-788-4040
• Other detachments: https://www.rcmp-grc.gc.ca/detach/en/find/AB

Alberta Health

Note: If a person suspects that someone is using a card that is not theirs or misusing their Alberta Health Care Insurance Plan card, they may call the confidential Alberta Health tips line at 1-866-278-5104.