By: Julie Therou Zechel, Deputy Registrar
This article appeared in issue 108 of the Eighth Line Newsletter, and has been edited for easier viewing on the web. Some of the information in this article may be out of date. Refer to our current static website pages for correct information.
You Asked, We Answer
One of the most common questions we receive in our office, from Opticians and members of the public, is; do prescriptions expire? This seems like a question that should be answered with a simple yes or no, but there is more to this question than meets the eye.
Why do prescriptions have an expiry date on them?
Most of the prescriptions you see in your office will have been issued by an Optometrist. According to the Alberta College of Optometrist’s Evidence-Based Clinical Practice Guidelines (supplemental documents to their Standards of Practice) all spectacle prescriptions and contact lens specifications must include an expiry date.
Can an office refuse to release a prescription if it is past the expiry date?
According to the Health Information Act (HIA), “an individual has a right of access to any record containing health information about the individual that is in the custody or under the control of a custodian.” (Province of Alberta – HIA(1) Prescription Expiry Dates Julie Therou Zechel, Deputy Registrar 16 2017, Part 2, 7(1)) This means a patient has a right to a copy of any information contained in their file including current and historical prescriptions.
Under specific circumstances, as per the HIA, a custodian may refuse to release information to a patient. Examples of when a patient may be refused access would most commonly occur if the disclosure could reasonably be expected:
• to result in immediate and grave harm to the applicant’s mental or physical health or safety,
• to threaten the mental or physical health or safety of another individual, or
• to pose a threat to public safety (Province of Alberta – HIA(2) 2017, Part 2, 11(1)-11(2))
A good rule of thumb is to contact the prescriber’s office if they refuse to release a prescription and ask why. If the answer is just because it is past the expiry date, that is not a sufficient explanation. If the answer is that the prescriber has advised to hold the prescription(s) due to a reasonable explanation as noted above, you then have an opportunity to work with them to make sure your patient gets the best possible care and that you are not filling a prescription
that might cause them harm. If you feel a patient has been refused access to their information without a sufficient explanation you may direct them to the prescriber’s regulatory body or to the Office of the Privacy Commissioner to lodge an inquiry or complaint.
Can an Optician use a prescription that is past the expiry date?
Alberta Opticians Profession Regulations state that “a regulated member who dispenses corrective lenses for the purpose of dispensing eyeglasses may do so only
(a) in accordance with a prescription from a person who is authorized to prescribe corrective lenses, or
(b) when the lenses are being duplicated with no change in refractive value.” (Province of Alberta – Opticians Regulation 2011, Section 10(2))
Further, our Standards of Practice state that “prescriptions for eyeglasses, contact lenses or subnormal vision devices do not expire; however, an Optician must inform their patient of the importance of regular eye health assessments and recommend that patients have their eyes tested regularly.” (ACAO – Standards 2009, Standard 6). It is up to each regulated health professional to use their professional judgement to decide whether or not to use a prescription that is past the documented expiry date.
When should an Optician refuse to use a prescription that is past the expiry date?
When a patient asks an Optician to fill a prescription, it is the Optician’s professional responsibility to determine whether the prescription may need to be updated, to explain this to the patient and to provide recommendations using his or her professional judgment. Opticians are advised to record these recommendations in the patient’s file. You should refuse to use a prescription that is past the documented expiry date when your professional judgement tells you it is not in the patient’s best interest. At no time is an Optician required or expected to use a prescription unless he or she has decided it is in the best interests of the patient to do so. The primary consideration should always be the best interests of the patient.