(A) A managing pharmacist shall prescribe in
accordance with a valid prescriber-patient relationship. This includes, but is
not limited to, the following:
(1) Reviewing a
thorough history of the patient;
(2) Except as provided in
paragraphs
(F) and (G)(2) of this rule, conducting an initial consultation with the
patient via in-person meeting, video conference,
or by telephone;
(3) Ordering
tests and evaluation of test results in accordance with section
4729.39
of the Revised Code;
(4)
Prescribing medication in accordance this division of the Administrative Code,
ruling out the existence of any recognized contraindications;
(5) Consulting with the authorizing
practitioner on the consult agreement when necessary;
and
(6) Documenting these steps in
the patient's medical record.
(B) The pharmacist's prescriptive authority
shall not exceed what is specified in the consult agreement.
(C) A managing pharmacist shall comply with
the same requirements for the prescribing dangerous
drugs
pursuant to
agency 4731 of the Administrative
Code.
(D) A pharmacist, as part of
an opioid treatment program licensed by the state, may administer controlled
substance narcotics pursuant to a consult agreement in accordance with this
division of the Administrative Code for the maintenance or detoxification
treatment of opioid addiction.
(E)
Except as provided in paragraphs (F) and (G)(1) of this rule, a managing
pharmacist shall, at a minimum, conduct a follow-up consultation with the
patient on an annual basis. The review shall be conducted via in-person
meeting, video conference or by telephone and shall be documented in the
patient's medical record.
(F)
Paragraphs (A)(2) and (E) of this rule do not apply to the inpatient management
a patient's drug therapy pursuant to a consult agreement in an institutional
facility.
(G) A hospital, clinic or
other healthcare facility that utilizes managing pharmacists for the purposes
of authorizing prescriptions that were originally issued by a consulting
practitioner shall comply with the following:
(1)
(a) A
managing pharmacist, consulting practitioner, or agent of the consulting
practitioner shall, at a minimum, conduct a follow-up
consultation with the patient on an annual basis. The review shall be conducted
via in-person meeting, video conference or by telephone and shall be documented
in the patient's medical record.
(b) The required follow-up consultation with
patients pursuant to paragraph (G)(1)(a) of this rule does not apply if the
patient, or an individual authorized to act on behalf of a patient, elects to
opt-out of the follow-up consultation.
(2) The initial consultation requirement by a
managing pharmacist is not required if the managing pharmacist is only engaged
in the authorization of prescriptions.
(3) In addition to the communication
requirements in paragraph (C) of rule
4729:1-6-01
of the Administrative Code, the hospital, clinic or healthcare facility shall:
(a) Obtain patient consent specifically
authorizing the use of managing pharmacists to authorize prescriptions pursuant
to a consult agreement.
(b) Provide
contact information, either electronically or in writing, of the person or
persons at the hospital, clinic or other healthcare facility who are
responsible for answering questions regarding the patient's drug
therapy.
(4)
Notwithstanding any other provision of the Administrative Code, all
prescriptions authorized pursuant to this paragraph shall include the name of
the managing pharmacist authorizing the prescription and the telephone number
where the managing pharmacist can be personally contacted during normal
business hours.
(5) Managing
pharmacists authorizing prescription refills in accordance with this paragraph
shall utilize an electronic health records system that complies with the
following:
(a) The system shall provide
managing pharmacists and consulting practitioner with real-time access to the patient's
complete medical record maintained by the consulting practitioner, including patient lab results and
prescriber and pharmacist notes.
(b) The electronic health records system
shall have the capability to allow communication between managing pharmacists
and consulting practitioner.
(6) The consult agreement shall include an
algorithm that is specific to refill authorizations. The algorithm must
include, but is not limited to, the following decision criteria for managing
pharmacists to follow when conducting prescription refill authorizations:
(a) Required lab results;
(b) Any restrictions or limitations;
and
(c) The maximum amount of time
between prescriber visits a refill may be authorized based upon prevailing
standards of care.
