Current through Register Vol. XLI, No. 38, September 20, 2024
4.1.
Collaborative pharmacy practice agreements are voluntarily implemented by
practitioners who seek to serve patients with active pharmacist participation
in drug therapy management and other related protocols.
4.2. Collaborative pharmacy practice is a
collaborative, physician-directed approach which may be utilized after informed
consent is received from the patient and recorded in the patient medical
record.
4.3. A collaborative
pharmacy practice agreement shall establish the pharmacist's scope of practice
for purposes of the agreement.
4.4.
A pharmacist may not diagnose patients.
4.5. Collaborative pharmacy practice
agreements shall be in writing. All pharmacists and physicians who are parties
to the agreement shall sign the agreement, and copies of the agreement shall be
made available to all individuals collaborating thereunder.
4.6. Collaborating pharmacists shall maintain
a copy of the collaborative practice agreement at their place of
practice.
4.7. Collaborative
practice agreements shall incorporate protocols containing detailed direction
concerning the services that collaborating pharmacists may perform for patients
and the role of collaborating physicians. The protocols shall, at a minimum,
include:
4.7.1. The specific drug or drugs to
be managed by the collaborating pharmacist, and the terms and conditions under
which drug therapy may be implemented, modified, or discontinued, including:
4.7.1.a. The protocols may authorize
implementation or modification of drug dosages based on symptoms or laboratory
or patient evaluations defined in the protocol;
4.7.1.b. The protocol shall include
information specific to the drugs authorized by the collaborating
physician;
4.7.1.c. In instances
where drug therapy is discontinued, the pharmacist shall notify the treating
physician of the discontinuance within seventy-two hours unless the protocol
incorporates a shorter time period for notice;
4.7.1.d. Specific protocols for patients
identified by the collaborating physician as having complex medical conditions
or comorbidities, one or more of which are under treatment by another medical
provider or specialist;
4.7.1.e.
The protocol may not authorize the pharmacist to change a controlled substance
or to initiate a drug not included in the established protocol.
4.7.2. The conditions and events
upon which the pharmacist is required to notify the physician, including but
not limited to the need for new prescription orders and reports of the
patient's therapeutic response or adverse reaction. All evaluation notes shall
be in the patient's medical record within one week of the evaluation and/or
drug management change. If there are no drug therapy changes the information
shall be provided to the physician within 30 days unless the protocol
incorporates a shorter time period for such notice;
4.7.3. The laboratory tests that may be
ordered in accordance with drug therapy management, including:
4.7.3.a. Authorization of the collaborating
pharmacist to obtain or to conduct specific laboratory tests related to the
drug therapy management;
4.7.3.b.
The collaborating pharmacist may only obtain the laboratory tests specified in
the collaborative pharmacy practice agreement;
4.7.3.c. Laboratories utilized by the
pharmacist may be in a pharmacy or pharmacy center; and
4.7.3.d. All laboratory results obtained are
to be sent to the physician within forty-eight hours, except that any severely
abnormal or critical values shall be sent by the pharmacist to the physician
immediately;
4.7.4. The
mutually agreed upon patient evaluations the pharmacist may conduct;
4.7.5. The protocol may authorize the
pharmacist to monitor specific patient activities;
4.7.6. Procedures for documenting patient
informed consent in the patient's medical record;
4.7.7. A provision for the collaborative drug
therapy management protocol to be reviewed, updated, and re-executed or
discontinued at least every two years;
4.7.8. A description of the method the
pharmacist shall use to document the pharmacist's decisions or recommendations
for the physician;
4.7.9.
Procedures for record keeping, record sharing, and long-term record
storage.
4.7.10. Procedures to
follow in emergency situations.
4.7.11. A description of the mechanism for
the pharmacist and the physician to communicate with each other and for
documentation by the pharmacist of the implementation of collaborative drug
therapy. Pharmacist visits may not be substituted for physician
visits.
4.8. A copy of
the protocols set forth in the collaborative pharmacy practice agreement shall
be filed in the patient's medical record.
4.9. A collaborating pharmacist may not
delegate drug therapy management to anyone other than another collaborating
pharmacist that has signed the applicable protocol.
4.10 A collaborating physician may not
delegate collaborative drug therapy management to any unlicensed person or
licensed person other than another physician, a collaborating physician
assistant or a collaborating pharmacist.
