Veterinary Oversight of Antimicrobial Use – A Pan-Canadian Framework for Professional Standards for Veterinarians

Executive Summary

The document, Veterinary Oversight of Antimicrobial Use – A Pan-Canadian Framework for Professional Standards for Veterinarians, was developed as a collaboration between the Canadian Veterinary Medical Association’s (CVMA) Veterinary Pharmaceutical Stewardship Advisory Group (VPSAG) and the Canadian Council of Veterinary Registrars (CCVR).

The objective of this document is to provide a template of professional standards to be used by provincial and territorial veterinary regulatory (licensing) bodies when developing their own regulations, guidelines, or bylaws relating to veterinarians professional responsibilities in providing oversight of use of antimicrobials in all circumstances. The ‘professional standards’ suggested in this document are not in themselves binding on veterinarians.

There have been calls from industry for consistency of standards relating to oversight of antimicrobial use across jurisdictions. This framework is intended to contribute to the development and implementation of uniform regulations across the country.

The Framework describes the professional obligations to be met by veterinarians as ‘suggested standards’. The Framework sets out in detail:

  1. That all antimicrobials be treated as prescription regardless of designation by Health Canada,
  2. The responsibility of the veterinarian to create and maintain appropriate medical records when prescribing drugs,
  3. The responsibilities of the veterinarian to be met when dispensing including labelling,
  4. The responsibility of the veterinarian to maintain an audit trail of dispensed medications,
  5. The responsibility of the veterinarian to provide a copy of an appropriately issued prescription to the client upon request,
  6. The responsibilities of the veterinarian to be met when prescribing Extra Label Drug Use (ELDU),
  7. That veterinarians not prescribe Active Pharmaceutical Ingredients (APIs) in dose form,
  8. The responsibilities of the veterinarian to be met when prescribing a compounded drug, and
  9. The responsibility of the veterinarian to participate in programs of surveillance of antimicrobial use once such a program is developed and implemented.

The Framework also provides a definition of the Veterinarian Client Patient Relationship (VCPR) and describes the professional obligations to be met by the veterinarian when prescribing a drug, including:

  • Establish a valid VCPR,
  • Determine the medical need of the antimicrobial,
  • Complete appropriate documentation in the medical record, and
  • Provide appropriate oversight of use, training and follow up.

In addition the Framework makes several recommendations including:

  1. That provincial and territorial regulatory (licensing) bodies undertake compliance measures involving practice inspection and verification of standards around veterinary oversight,
  2. That CVMA develops a decision cascade for prescribing in the best interest of human and animal health,
  3. That the CVMA and CCVR work with the federal, provincial and territorial governments to explore a regulatory framework for mandatory reporting of antimicrobial use on the order of veterinarians to a provincial and/or national surveillance program, and
  4. The CVMA and CCVR develop appropriate continuing education opportunities for veterinary professionals regarding antimicrobial stewardship.

 

The Framework document has been completed and distributed to all regulatory bodies and CVMA members.

A summary document “Veterinary Oversight of Antimicrobial Use – Professional Standards for Veterinary Regulatory (licensing) Bodies” has been provided to Canadian provincial and territorial regulatory bodies.

The Framework document represents a significant accomplishment of the veterinary profession in Canada to address the responsibilities that accompany the Federal Government implementation of increased veterinary oversight of antimicrobials. Outstanding issues to be addressed include surveillance of use and distribution. The veterinary profession will continue to be engaged in the important discussions at the provincial and national levels.

Further information is available from the CVMA (admin@cvma-acmv.org) and through provincial regulatory bodies.

Download document here.