The objectives of the pharmacy smoking cessation program are:
The program includes nine points of contact between the patient and the pharmacist. The first point of contact is the completion of a readiness assessment where the patient agrees to the program’s enrollment requirements. Once enrolled, the patient attends a consultation meeting and a total of seven follow-up sessions that take place over the course of one year.
ODB recipients who smoke are eligible to enroll in the program once per year from the date of the first consultation meeting. If a patient withdraws from the program either by notice or by continued absence, the patient must wait 1 year from the date of the first consultation before re-enrolling in the program. There is no limit on how many times a patient may enroll in the smoking cessation program.
Yes. The program is designed as nine points of contact, all of which require full documentation for reimbursement and program evaluation. While the pharmacist and the patient may agree to meet more often, pharmacists are provided billable professional services for the nine sessions.
Should the patient withdraw from the program or the patient cannot be reached, the pharmacist is required to indicate this circumstance through the health network system for purposes of program evaluation.
The first three or primary follow-up counseling sessions should take place within 3 weeks of the first consultation and the four or secondary follow-up sessions are expected to take place at intervals as agreed by the pharmacist and the patient between one to two months; between three to four months; between six to seven months and between eight to 12 months.
Suggested timelines for follow-up counseling sessions:
Primary Follow-up Sessions
Secondary Follow-up Sessions
The smoking cessation meetings should take place in the community pharmacy with the patient, in-person where possible.
Each point of contact and between the pharmacist and the patient must be documented to ensure program continuity and to support counselling, data analysis, evaluation and claims adjudication. Any additional sessions between the pharmacist / patient should be documented to ensure continuity of care.
The ministry will provide standardized template forms to assist pharmacists in the documentation at each patient point of contact. While pharmacists may develop their own forms, it is important that the standardized templates are adapted to maintain a consistency of the program protocol.
Should the patient decide that he / she needs to withdraw from the program, the pharmacist is required to document this situation using the standardized template. All documentation forms and pharmacy records submitted through the ODB Health Network System PIN mechanism are subject to audit and must be maintained in a readily retrievable format for a minimum of 2 years for the purposes of audit under the ODB program; and for a minimum of 10 years as part of the patient health record.
If there is no documentation or incomplete documentation regarding a billable professional service, the claim is subject to recovery.
The first consultation is designed to establish a dialogue between pharmacist and patient about their smoking history, and to ensure the patient understands the goals, objectives and their responsibilities. The first consultation occurs after the pharmacist has conducted the readiness assessment, obtained patient consent for program enrolment and sharing of health information.
The consultation also focuses on his / her tobacco use, medication history, health risks, triggers / strategies, establishes a quit date and any pharmacotherapy the patient may require.
The secondary follow-up sessions continue to build on the patient’s successes and review any incidents and / or drug therapy issues and biological incidents that prevented the patient from reaching his / her goal.
The primary follow-up sessions are approximately 10 minutes each in length, and the secondary follow-up sessions are between 3-5 minutes.
The follow-up counselling sessions may occur in person, by telephone or an alternative means of communication as agreed to by the patient. The location and method of communication must be included in the documentation.
Yes, however if a patient prefers to attend the meeting in person, every effort should be made to accommodate the patient’s request.
Smoking cessation program sessions are conducted in a variety of ways. It is recommended that an in-person appointment be scheduled for the first consultation within the community pharmacy to ensure adequate time to discuss history and pharmacotherapy options. The follow-up counselling sessions may occur in person, by telephone or an alternative means of communication as agreed to by the patient. The location and method of communication must be included in the documentation.
It is recommended the patient have the option to appear in person to the first consultation meeting. If this is not possible, the pharmacist may provide the first meeting and subsequent sessions through alternate means (including online) provided the patient agrees to the chosen program delivery method and the pharmacist can provide appropriate counseling with this approach.
Yes. Pharmacists that are registered as Part A with the Ontario College of Pharmacists are qualified to provide the smoking cessation program provided they have also taken a smoking cessation training program that includes motivational interviewing strategies, the 5A’s algorithm and provides knowledge of smoking cessation counselling and quit smoking planning strategies.
Smoking cessation programs are obtainable in Ontario through the Ontario Pharmacists' Association, the Canadian Pharmacists' Association and the Centre for Addiction and Mental Health. Training programs from other organization are acceptable provided the training meets the required program criteria.
Information including multi-lingual fact sheets, quit smoking tips and on-line group forums are available for patients and health professionals on the Ontario Government’s Smoke Free Ontario Strategy website.
Pharmacists may wish to provide additional quit smoking resources by directing patients to the Canadian Cancer Society, Ontario Lung Association and / or the Centre for Addiction and Mental Health. A variety of resources are available through these organization’s websites.
Further information and assistance is available through the following telephone help lines: Smoke-Free Ontario Smokers Helpline; Canadian Cancer Society Smokers’ Helpline; Ontario Lung Association; and the Centre for Addiction and Mental Health Information Centre.
Each point of contact and / or meetings between the pharmacist and the patient must be documented to ensure program continuity and for the purposes of counselling, support, data analysis, evaluation and claims adjudication.
Using the ministry template forms as a minimum standard, full documentation is required of all pharmacist / patient engagement including patient readiness, patient consent and agreement terms, first consultation meeting, follow-up counselling sessions and any incidence of program withdrawal.
Follow-up meetings may be in person, telephone, electronic messaging or other agreed upon method of communication. The method and location of these meetings must be included in the documentation.
All records relating to the smoking cessation claim and smoking cessation program forms must be maintained on site at the pharmacy in a readily retrievable format for a minimum of 2 years for the purposes of audit under the Ontario Drug Benefit program.
All patient health records must be retained by the pharmacist in a readily retrievable format and kept on file at the pharmacy for a minimum period of ten years or as per O. Reg. 58/11 of the Drug and Pharmacies Regulation Act. Patients are entitled to a copy of their readiness assessment, consent forms and any documentation from the first consultation and follow-up counselling sessions.
At his time, smoking cessation program claims for payment may only be submitted for Ontario Drug Benefit recipients.
Claims are submitted using the same method as a pharmacist would use to submit a claim for the MedsCheck program. Claims use a special product identification number (PIN).
Claims for pharmacy payment are in accordance with the following schedule:
|93899941||First Consultation (once per year): Readiness assessment is complete including willingness to set a quit date; patient has enrolled in the program and provided signed consent to the pharmacist for purposes sharing health information within the circle of care and for program data collection.||40.00|
|93899942||Primary Follow-up counselling sessions 1-3 (max. 3 times per year = $45 total)||15.00|
|93899943||Secondary Follow-up counselling sessions 4-7 (max. 4 times per year = $40 total)||10.00|
|93899944*||Successful Quit (once per year, if applicable)||0.00|
|93899945*||Un-Successful Quit (once per year, if applicable)||0.00|
|93899946*||Unknown Quit Status (once per year, if applicable)||0.00|
*PINs are used for program evaluation data collection.
By documenting the different stages of the smoking cessation program, including submitting the appropriate PIN, pharmacists are assisting in data collection for the Smoke Free Ontario Strategy.
Output measures that indicate how Ontario is meeting its smoking cessation goals may include the following:
This data is invaluable for monitoring the success of smoking cessation programs. The ministry will use this data to determine if the program is successful in the current design or if modifications are necessary to improve the program. The ministry requests that pharmacists are diligent in their efforts to document their interactions with patients to assist in obtaining relevant data for program evaluation.
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