Current through February 27, 2024
1. The protocol prescribed pursuant to
section 2.5 of Senate Bill No. 190, chapter 504, Statutes of Nevada 2021, at
page 3268 (NRS 639.28077) , consists of compliance with subsections 2 to 8,
inclusive.
2. Before initially
dispensing a self-administered hormonal contraceptive to a patient under the
protocol, a pharmacist must:
(a) Provide the
patient with the risk assessment questionnaire prescribed in section 5 in
accordance with subsection 2 of section 3 of Senate Bill No. 190, chapter 504,
Statutes of Nevada 2021, at page 3269 (NRS 639.28078) , and, if the patient
completes the questionnaire, discuss the results of the questionnaire with the
patient; and
(b) Utilize a
treatment algorithm to determine whether it is safe to dispense a
selfadministered hormonal contraceptive to the patient. The treatment algorithm
must include, without limitation:
(1) Training
and education of the patient concerning the self-administered hormonal
contraceptive and possible alternatives to the self-administered hormonal
contraceptive;
(2) Assessing any
risks to the patient posed by the self-administered hormonal
contraceptive;
(3) Evaluating the
patient using the criteria adopted by reference in section 3;
(4) Conducting a health and history screening
of the patient;
(5) Screening to
determine whether the patient is or may be pregnant;
(6) Screening the patient for
disease;
(7) Determining whether
the patient is taking other medications and, if so, evaluating the potential
interaction between the self-administered hormonal contraceptive and the other
medications;
(8) Evaluating the
blood pressure of the patient;
(9)
Soliciting and considering the preferences of the patient concerning treatment;
and
(10) Formulating a plan for
treatment of the patient and discussing the plan with the patient.
3. If, after satisfying
the requirements of subsection 2, a pharmacist determines that it is unsafe to
dispense a self-administered hormonal contraceptive to the patient, the
pharmacist must not dispense the self-administered hormonal contraceptive and
must:
(a) Refer the patient to his or her
attending provider of health care or another qualified provider of health care
for further consultation and treatment; and
(b) Provide the patient with a copy of the
record required by subsection 4 of section 3 of Senate Bill No. 190, chapter
504, Statutes of Nevada 2021, at page 3269 (NRS 639.28078) .
4. If, after satisfying the
requirements of subsection 2, a pharmacist determines that it is safe to
dispense a self-administered hormonal contraceptive to the patient, the
pharmacist must:
(a) Provide the patient with
information concerning the self-administered hormonal contraceptive being
dispensed, which must include, without limitation, the information described in
paragraph (b) of subsection 3 of section 3 of Senate Bill No. 190, chapter 504,
Statutes of Nevada 2021, at page 3269 (NRS 639.28078) , and information
concerning:
(1) Proper dosage of the
self-administered hormonal contraceptive;
(2) The effectiveness of the
self-administered hormonal contraceptive;
(3) The importance of obtaining recommended
tests and screening from the attending provider of health care of the patient
or another qualified provider of health care who specializes in women's
health;
(4) The effectiveness of
long-acting, reversible contraceptives as an alternative to selfadministered
hormonal contraceptives;
(5) When
to seek emergency medical services as a result of administering a
selfadministered hormonal contraceptive; and
(6) The risk of acquiring a sexually
transmitted infection and ways to reduce that risk;
(b) Provide the patient with a copy of the
record required by subsection 4 of section 3 of Senate Bill No. 190, chapter
504, Statutes of Nevada 2021, at page 3269 (NRS 639.28078) ; and
(c) Dispense an appropriate self-administered
hormonal contraceptive to the patient in a container with a label that clearly
shows:
(1) The date on which the
self-administered hormonal contraceptive was dispensed;
(2) The name and address of the
patient;
(3) The serial number
assigned to the record of the self-administered hormonal contraceptive in
accordance with paragraph (a) of subsection 8;
(4) The number of recommended doses of the
self-administered hormonal contraceptive that are being dispensed in the
container;
(5) Specific directions
for use of the self-administered hormonal contraceptive;
(6) The proprietary or generic name of the
self-administered hormonal contraceptive;
(7) The strength of the self-administered
hormonal contraceptive; and
(8) The
expiration date of the self-administered hormonal contraceptive.
5. A pharmacy that
initially dispenses self-administered hormonal contraceptives under the
protocol shall maintain:
(a) A written or
electronic record of each risk assessment questionnaire completed by a patient
of the pharmacy pursuant to paragraph (a) of subsection 2 for at least 2 years
after the date of completion; and
(b) The written or electronic record required
by subsection 8.
6. A
pharmacist who dispenses a self-administered hormonal contraceptive under the
protocol shall not dispense to a patient more than a 12-month supply of the
self-administered hormonal contraceptive. If the pharmacist initially dispenses
to the patient less than a 12-month supply, the pharmacist may refill the
self-administered hormonal contraceptive under the protocol until the patient
has received a 12-month supply. If the patient requests a refill after the
patient has received a 12-month supply, the pharmacist must comply with the
requirements of the protocol set forth in subsections 2, 3 and 4.
7. Subject to the limitations set forth in
subsection 6, a pharmacist who has not complied with the requirements of
section 2 may refill the supply of a selfadministered hormonal contraceptive
initially dispensed under the protocol if the pharmacist has access to an
electronic record of the risk assessment questionnaire completed pursuant to
paragraph (a) of subsection 2. When dispensing the refill, such a pharmacist
shall:
(a) Review and discuss the results of
the risk assessment questionnaire with the patient;
(b) Answer any questions that the patient may
have concerning the self-administered hormonal contraceptive; and
(c) Take the actions described in paragraphs
(a) and (c) of subsection 4.
8. A pharmacy that dispenses a
self-administered hormonal contraceptive under the protocol, including, without
limitation, a pharmacy that refills the supply of a selfadministered hormonal
contraceptive pursuant to subsection 7, shall maintain a written or electronic
record of each self-administered hormonal contraceptive dispensed by the
pharmacy for at least 2 years after the date on which the self-administered
hormonal contraceptive was dispensed. The record must:
(a) Be assigned a serial number;
(b) Include, without limitation, the
information required by paragraph (a) of subsection 3 of section 3 of Senate
Bill No. 190, chapter 504, Statutes of Nevada 2021, at page 3269 (NRS
639.28078) ; and
(c) Be maintained
in the same manner as other records of prescriptions dispensed by the
pharmacy.
Added
to NAC by Bd. of Pharmacy by
R036-21A,
eff. 2/28/2022
NRS
639.070 and section 2.5 of Senate Bill No.
190, chapter 504, Statutes of Nevada 2021, at page 3268 (NRS 639.28077)
.
