British Columbia
Prescription
Adaptation
Program
British Columbia Prescription Adaptation Program
Contents
Description of Services ........................................................................................ 1
Preparing Kroll System for Prescription Adaptation ............................................ 1
Step 1: Update your system to the Kroll Adaptation compliant version ................................... 1
Performing Updates in Kroll ................................................................................................... 2
Step 2: Doctor Card Maintenance .............................................................................................. 2
Prescription Adaptation Procedure ........................................................................................ 3
Entering the SIG ...................................................................................................................... 3
Prescription Adaptation Report .......................................................................... 5
Comments Report ............................................................................................. 10
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British Columbia Prescription Adaptation Program
British Columbia Prescription
Adaptation Program
Recent legislature has come into effect that gives pharmacists prescriptive authority, in some
situations, to renew and adapt prescriptions. The Pharmacist Prescription Adaptation Report in
Kroll has been created to accommodate the documentation requirements for this program.
This user guide explains how the Prescription Adaptation Program works, how to prepare your
Kroll system for prescription adaptation, and how to run the Prescription Adaptation and
Comment reports.
Description of Services
Pharmacists can now perform the following in specific situations:

Renew a prescription that does not have any authorized refills remaining;

Change the details of a new prescription to better suit the needs of a patient;

Substitute one drug for another, within the same class of drugs, to better suit the needs
of a patient (this is called a "therapeutic substitution").
Preparing Kroll System for Prescription Adaptation
In order to prepare your Kroll system for performing Prescription Adaptation, you need to
perform a few maintenance tasks as follows:
Step 1: Update your system to the Kroll Adaptation compliant
version

The latest Kroll version for BC is Version 10 2014-Aug-27.kcu. Ensure your system is
running this version of Kroll or higher.

If you are already on Kroll version 10, this will be a small maintenance update.
NOTE: If you are on any of the prior Kroll versions, the update must be performed after
hours from the main station when no one else is logged on.
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British Columbia Prescription Adaptation Program

If you are unsure about the current Kroll version that you have, please call the Kroll
Helpdesk in advance of the update procedure so that they will connect to your system
and inform you about the current version that you are using.

Ensure you have a good backup.
Performing Updates in Kroll
1. From the Alt-X Start screen, go to File > List Program Updates. The Update Information
window will appear.
2. Click on Check Kroll to access all the updates posted on the Kroll server.
3. Place a checkmark next to the update and click Download.
4. Once the update is downloaded into the Current Updates tab, highlight the update and click
Run Update.
Step 2: Doctor Card Maintenance
For each dispensing Pharmacist in your system, you need to ensure that the salutation is
configured correctly. This will change how the Pharmacist appears in the report sent to Doctors.
1. From the Alt-X Start screen, click F7 – Doctor.
2. Bring up each Pharmacist and check/modify the Salutation fields.
3. Ensure that the Salutation field is blank by pressing spacebar (defaults to Dr.).
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British Columbia Prescription Adaptation Program
4. Make sure that all the phone and address information is correct as it prints on the form.
NOTE: You may notice when printing the adaptation form, the salutation is changed to the
format: PH pharmacist name.
Prescription Adaptation Procedure
In order to adopt a prescription, copy it from an existing prescription using the pharmacist as
the doctor and a new prescription number, or fill it as a new prescription. When making
changes to a prescription that has not been previously filled, the Rx would be entered as new,
with the adaptation mode on the first fill, using the pharmacist as the doctor.
Entering the SIG
When you perform the adaptation, you will need to enter the word ‘adapted’ in the first part of
the sig to identify it on the Rx label. To do this, you can manually enter the word adapted
before sig or sig codes, or you can add a sig code for adapted to the system.
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British Columbia Prescription Adaptation Program
Adding a Sig Code
Follow the below steps to add a Sig Code:
1. From the Alt-X Start screen, go to Edit > Sig Codes. The Sig Code List Form appears.
2. Click Ins to create a new Sig Code. The Edit Sig Code form appears. Enter the code you
would like to use and the expansion you want it to display.
NOTE: For users in British Columbia, any Adapted prescription must be submitted with one
of the following intervention codes:

NI = Dosage Change

NJ = Formulation Change

NK = Directions for Use Modified

NL = Renewal of Prescription

NM = Therapeutic Substitution
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British Columbia Prescription Adaptation Program
NOTE: Two additional intervention codes below have been added for emergency supply and
emergency contraception; these prescriptions are not subject to adaptation fees.

NN = Emergency Supply of Medication

NO = Emergency Contraceptive
Adding an Intervention code
1. From the F12 – Fill Rx screen, select View > Plan Information. The Rx Plan Information
screen will appear.
2. Click F2 and select ‘NI – Dosage Change’ from the Intervention Code 1 menu.
Prescription Adaptation Report
Select Reports > Pharmacist Prescription Adaptation from the F12 screen.
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British Columbia Prescription Adaptation Program
The report will appear with the Original Rx Information tab displayed first. You will be required
to manually enter the original prescribing doctor of this specific prescription in order to fax the
adaptation form to them. The drug and sig will be prepopulated in this form according to the
information in the Fill screen.
NOTE: The adapted prescription information will be automatically populated into the report
from the Fill screen.
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British Columbia Prescription Adaptation Program
The Comments tab of the report is the area of the report where the pharmacist is to provide an
explanation to the doctor as to why the prescription adaptation was required, as well as
instructions to the patient and a follow up plan.
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British Columbia Prescription Adaptation Program
The Options tab allows you to select certain information to print on the report. The Pharmacist
field will be prepopulated based on the Pharmacist that is selected as the doctor in the
prescription.
Once all the required information is selected, you can choose to print or preview the report and
then it must be faxed off to the doctor.
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British Columbia Prescription Adaptation Program
Sample Pharmacist Prescription Adaptation Report:
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British Columbia Prescription Adaptation Program
Comments Report
The Comments Report is a useful tool for determining what prescriptions have been adapted
by the pharmacist in a specified time period.
1. From the Alt-X Start screen, go to Reports > Other > Comments Report. The Comments
Report form appears.
NOTE: When running the Comments Report, make ensure that you select only Rx
Adaptation from the Topic dropdown menu; otherwise you will get comments from all the
Rxs.
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British Columbia Prescription Adaptation Program
Sample Rx Comments Report:
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