Interprofessional Research Support:

Ontario Health Human Resources Research Network grant, 2011 “Policy Analysis of Scope of Practice Changes in Relation to Prescribing for Optometry and Pharmacy and the Newly Regulated Health Profession of Pharmacy Technicians”

Interprofessional, regulatory, and other activities:

Assessment of Pharmacotherapy Competence for International Chiropody Graduates(2011-2013)

In 2011 I completed a comprehensive review of Chiropodists’ pharmacotherapy training in Ontario. That review captured the training and competency of most practicing Ontario Chiropodists. However, a small number of registered Chiropodists completed their studies at international Chiropody programs, primarily in the UK. Those members may choose to take pharmacotherapy continuing education courses before prescribing drugs in Ontario. Alternatively, they may submit curriculum and course information for review so that their prescribing competency can be assessed. Since 2011 I have been reviewing members’ educational credentials and recommending to the College of Chiropodists whether individual members require, or do not require, additional continuing education prior to prescribing in Ontario. This work is a crucial contribution to the College’s mandate to protect the public by ensuring competence of Chiropodists as prescribers.

Recommendations to the Board of Drugless Therapy – Naturopathy Re: Additions to the Parenteral Formulary (2012-2013)

Many Ontario Naturopathic Doctors engage in the practice of “parenteral therapy”, or the administration of substance via injection. These are often natural products, antioxidants, or nutrients that are routinely taken in oral dosage forms. Parenteral therapy substances are often non-prescription, thus there is little to no regulatory oversight of the practice. To increase the appropriateness and safety associated with parenteral therapy, the Board of Drugless Therapy – Naturopathy (serves as the “College” of Naturopathic Doctors in Ontario) has created a parenteral substances formulary. The Board considers additions to the formulary after receiving request from practicing Naturopathic Doctors. Myself, Dr. Cynthia Richard, and former Master’s student and Pharmacist Azita Kouchmeshky first modified the submission process and forms, then reviewed several sets of submissions. We performed literature searches for clinical trials and other data for each substance requested, examined the efficacy and toxicity associated with each substances, and determined whether there was sufficient reason for parenteral (vs. oral) administration. This work provides key safety and efficacy guidance to the parenteral formulary committee as they consider requests for additions to the parenteral formulary.

Recommendations for the College of Chiropodists of Ontario for Standards for the Inhalation of Substances (2012)

After the Ministry of Health and Long-term Care adopted many of the recommendations in the Critical Links report (see below), the profession of Chiropody gained the authorization to administer substances via inhalation. For Chiropodists (and Podiatrists) this new authorization involves nitrous oxide and oxygen. After performing a review of the use of nitrous oxide by Chiropodists in other jurisdictions as well as reviewing nitrous oxide-related content in Chiropody programs, I made several recommendations to the College re: additional continuing education on nitrous oxide and recommendations re: the safe use of inhaled substances.

Analysis of Pharmacotherapy Training of Ontario Chiropodists: A 25-year Review (2011)

After the HPRAC’s Critical Links report (see below) and in anticipation of a scope of practice review (ongoing) the College of Chiropodists of Ontario decided to perform a self-assessment of their member’s pharmacology and pharmacotherapy training. The goal of this assessment was to assist in determining which members should be required to take additional pharmacotherapy training prior to engaging in expanded prescribing. In addition, competency to administer injectable local anesthetics was reviewed. I assessed approximately 25 years of curricula and course syllabi from Chiropody programs at George Brown College and the Michener Institute and submitted a report to the registrar of the College. The report outlined deficiencies in both the current curriculum (at the Michener Institute) and in past curricula. After consultations with the College Board, we ultimately recommended that graduates of Ontario Chiropody programs prior to 2001 would be required to complete an approved continuing education course on pharmacology or pharmacotherapy prior to engaging in expanded prescribing.

National Biotechnology Development Agency, Biotechnology Certificate (2010)

I and other contributors, including PharmEng Technology, produced a series of one or two day seminars on several topics on biotechnology and presented these in Abuja, Nigeria. My portion involved an outline of how developments in biotechnology will impact current drug development, drug efficacy, and potential adverse effects.

Health Professions Regulatory Advisory Council (HPRAC), Critical Links Report (2008-2009)

In 2008 I began to serve as an advisor to HPRAC as they examined the prescribing authorities of all regulated health professions (with the exception of physicians) in Ontario. This included a systematic jurisdictional review, a review of professional program curricula, an assessment of needs and risks associated with expanded prescribing rights. In addition, we developed recommendations for a streamlined mechanism of modifying existing prescribing lists for all professions and developed a comprehensive emergency medications strategy for all professions that directly interact with the public. Ultimately, the Critical Links report was used as a template for Bill 179 that received Royal Assent in 2009 and changed/granted drug prescribing authorities for pharmacists and several other professions in Ontario. In addition to significantly impacting the practices of Midwifery, Optometry, Chiropody, and others, the new legislation granted pharmacists the authority to prescribe medications and administer injections including routine immunizations such as the flu shot.

Health Professions Regulatory Advisory Council, Scope of Practice Reviews for Pharmacy, Midwifery, Dieticians, and Physiotherapy: (2008)

Prior to the more comprehensive Critical Links Report (see above). I participated with HPRAC on scope of practice reviews for pharmacy and other professions. Specific reviews also impacted Bill 179 and the expanded scopes of practice for these professions, particularly for pharmacists.

Michael Beazely 2016