Reminder to Prescribers: Prescribing Requirement Changes Effective June 1

The new Standard of Practice Prescribing Requirements and the accompanying Practice Direction for Electronic Transmission of Prescriptions are effective June 1, 2024. Registrants should be informed about how this may impact their practice. 

It is important to note that all prescriptions written on or after June 1, 2024, must meet the requirements outlined in these documents.

Most notably, CPSM and the College of Pharmacists of Manitoba (CPhM) have authorized operational changes related to the M3P Program. (See Must-Have Information for M3P Prescriptions below.)

The following M3P Program changes may have an immediate impact on your practice:

  1. M3P Prescription Booklets (duplicate pads) will be phased out. 

    The M3P prescription booklets (also known as triplicate or duplicate pads) that physicians order from CPhM will be phased out. Registrants may continue to use the M3P pads they already have in their possession. However, when a registrant's current supply of M3P pads is depleted, they are encouraged to transition to the new prescription templates available in the CPSM Portal.

    M3P prescriptions containing all required information may be either electronically generated or handwritten. They may be handed to a patient (and signed in ink) or electronically transmitted (via fax or secure e-prescribing) directly to a specific pharmacy in accordance with the Practice Direction for Electronic Transmission of Prescriptions (electronic signature permissible). See below for details of prescription content requirements (as outlined in the SOP Prescribing Requirements Section 3).

  2. CPSM strongly recommends physicians use M3P Prescription Templates in their practice.

    CPSM strongly recommends using M3P prescription templates to ensure all required information is present on a prescription. This ultimately minimizes the need for pharmacist-prescriber correspondence to clarify prescriptions and prevents delays in patient care. Further guidance and templates are available for all registrants by logging into their CPSM Portal. As with any prescription pads, please ensure these templates (in electronic or hard-copy format) are stored securely to minimize the risk of prescription forgery. However, using these specific M3P prescription templates is NOT a requirement. Pharmacists should not require prescribers to use a specific template. The substance of the prescription (the required content) is prioritized over specific forms/templates.

     

  3. The CPSM Practice Directions for the a) Facsimile and b) Electronic Transmission of Prescriptions are consolidated into one document.

    Prescribers are reminded that electronically generated or handwritten prescriptions can be transmitted:

    • From the prescriber directly to a specific pharmacy via fax,
    • From the prescriber sent via a closed e-prescribing system to a specific pharmacy, or
    • Be handed to a patient to take to a pharmacy of their choice.

Again, all prescriptions handed to patients must be signed in ink. For prescriptions transmitted by fax or by an e-prescribing system, an electronic signature is sufficient.

Please note that prescriptions cannot be emailed, nor may images of prescriptions be transmitted via text message, or emailed to a patient or a pharmacy. Prescriptions should never be posted to a patient portal by clinics who maintain such platforms to communicate with their patients.

It is critical that patient autonomy and choice of pharmacy be respected at all times. Prescribers must NOT influence patients to fill their prescriptions at a specific pharmacy in any way, directly or indirectly. This is especially important when closed e-prescribing systems are utilized for prescription transmission.

If the patient's pharmacy of choice is not part of an e-prescribing system, the prescription must be transmitted to the patient's pharmacy of choice by fax or handed to the patient to take to their preferred pharmacy.

Rare exceptions may exist when the medication or service the patient requires (e.g. opioid agonist therapy) is not available from the patient's pharmacy of choice. In such situations, the prescriber must work with the patient to identify pharmacies that can meet the patient's needs. The patient can then choose from the available options.

Further Information 

  • NEW! Frequently Asked Questions about the new Prescribing Standard and Practice Direction. 
  • NEW! M3P Prescription Guidance: Requirements & Recommended Templates are now available in the CPSM Portal

User tip: Look for the new Important Message from CPSM notification when you log into the CPSM portal for quick access to the guidance and templates. Prescribers may download and customize the templates with their clinic logo, address, and prescriber contact information. The original or customized templates may also be imported into the prescriber’s EMR software. As with any prescription pads, please ensure these templates (in electronic or hard-copy format) are stored securely to minimize the risk of prescription forgery.

  • CPSM registrants may contact the Prescribing Practices Program at 204-774-4344 with questions or for further information. 

 

Must-Have Information for all M3P Prescriptions

Prescribers must continue to ensure all required information is present on the M3P prescriptions, including:

  • Patient demographics (name, address, PHIN, DOB)
  • Name, strength, and dosage form of the drug
  • Total quantity of the drug to be dispensed (in numbers and words)
  • The interval (# of days) at which each quantity (# of tablets) is to be dispensed (part fill instructions)
  • Therapeutic indication (required for all M3P prescriptions)
  • Directions for use
  • Date prescribed
  • Prescriber signature

Verbal prescriptions and refills are still not permitted for M3P medications. Only part fills are allowed if the total quantity and specified time interval between part-fills is clearly indicated.

As of June 1, 2024, prescription transfers are permitted for all narcotic and controlled medications between pharmacies, including those on the M3P drug list. Benzodiazepine and z-drug prescriptions can now also be transferred more than once. This includes transfers between pharmacies within Manitoba and to out-of-province pharmacies within Canada. See the Frequently Asked Questions for more information about what to consider when your patient requests an out-of-province transfer of their M3P prescription.