A review of state pharmacist collaborative practice laws

Hill, Joanna M.; Hill, Joseph M.; Gentile, Nicholas

doi:10.2146/ajhp160269

Cited by 24 publications

(19 citation statements)

References 2 publications

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“…4 According to the ASHP Guidelines on the Pharmacist's Role in Palliative and Hospice Care, pharmacists should ideally be practicing at the top of their license; engaging in the direct care of patients with regard to symptom assessment, management and monitoring, and prescribing in states that allow prescriptive authority through collaborative practice agreements (CPAs). 2,[5][6][7][8][9][10][11][12] Practicing under a CPA with the physician is an opportunity to act as a uniquely qualified physician extender. This collaboration can help offset the known PC physician workforce shortage and aids in alleviating the present access, quality, and safety challenges of care delivery.…”

Section: Introductionmentioning

confidence: 99%

Pharmacists Providing Palliative Care Services: Demonstrating a Positive Return on Investment

Lehn

Gerkin

Kisiel

et al. 2019

Journal of Palliative Medicine

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Objective: To establish a return on investment (ROI) for a pharmacist position on a hospital-based palliative care (PC) team. Background: Utilizing a pharmacist to provide PC services is often overlooked as a solution to physician shortages. Integration of a pharmacist into PC teams yields a favorable ROI. Methods: A 16-month retrospective review comparing PC patients at two hospitals with consultative PC teams. The PC teams at the two facilities had identical full-time equivalent team members, except for a PC pharmacist at Facility 1. The PC pharmacist's ROI was calculated based on cost savings created by utilizing the PC pharmacist as a physician extender and costs attributable to preventable adverse drug events (pADEs) identified by the PC pharmacist. Results: An annual ROI of 1.2 to 2.9 million dollars was calculated, $125,760 from physician time saved and $1.1-2.8 million dollars from pADEs. A statistically significant difference in rates of pADEs was realized between the PC pharmacist and non-PC pharmacists at Facility 1 as well as between pharmacists at Facility 1 (PC pharmacist and non-PC pharmacists) and pharmacists at Facility 2 (non-PC pharmacists). Conclusion: A PC pharmacist's unique qualifications and perspective contribute to the value of care provided to PC patients. A favorable ROI that exceeds a pharmacist's annual salary was demonstrated in this analysis.

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Section: Introductionmentioning

confidence: 99%

Pharmacists Providing Palliative Care Services: Demonstrating a Positive Return on Investment

Lehn

Gerkin

Kisiel

et al. 2019

Journal of Palliative Medicine

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“…Statewide legislation allowing pharmacists to prescribe contraceptive medications does not currently exist in Indiana or in the majority of other states, however there is a broader form of pharmacist prescribing through collaborative drug therapy management (CDTM) that provides the framework for creating a similar model. CDTM is defined as “a collaborative practice agreement between one or more physicians and pharmacists wherein qualified pharmacists working within the context of a defined protocol are permitted to assume professional responsibility for a variety of functions, including patient assessment, ordering drug therapy‐related laboratory tests, and selecting, initiating, monitoring, continuing, and adjusting drug regimens.” As of 2016, 48 states including Indiana allow creation of CDTMs for the management of a variety of disease states (eg, diabetes or hypertension), making pharmacist prescribing of hormonal contraceptives possible . As a first step towards exploring this potential for an expanded role, the objective of this study was to identify how women at risk for unintended pregnancy in central Indiana perceive pharmacist prescribing as a method for obtaining contraception.…”

Section: Introductionmentioning

confidence: 99%

“…16,17 As of 2016, 48 states including Indiana allow creation of CDTMs for the management of a variety of disease states (eg, diabetes or hypertension), making pharmacist prescribing of hormonal contraceptives possible. 18 As a first step towards exploring this potential for an expanded role, the objective of this study was to identify how women at risk for unintended pregnancy in central Indiana perceive pharmacist prescribing as a method for obtaining contraception.…”

mentioning

confidence: 99%

Women's perceptions of pharmacist‐prescribed hormonal contraception

Meredith

Olenik

Farris

et al. 2019

J Am Coll Clin Pharm

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Introduction Unintended pregnancy is a public health issue, with young women in their late teens and early 20s at highest risk. Multiple approaches to increasing contraception access have been implemented, including adoption of statewide pharmacist prescribing legislation in multiple states. Indiana does not currently have such legislation in place. The objective of this study was to identify how women at risk for unintended pregnancy in central Indiana perceive pharmacist prescribing of contraception. Study Design Qualitative, one‐on‐one semi‐structured interviews. Methods Purposive, convenience sampling of eligible women 18 to 29‐years‐old who live in Indiana was used. Recruitment occurred via printed flyers placed in public locations that were not focused on health care, free classified online advertisements, and electronic flyers within Facebook social groups relevant to the study population. Interviews were conducted via telephone until thematic saturation was achieved. Participant demographics, baseline characteristics, current and past barriers to obtaining contraception, and perception of a pharmacist contraception prescribing model were collected. Interview transcripts were coded in an iterative manner with qualitative data analysis software (MAXQDA, Version 12) until consensus was achieved. Results Fourteen women completed the study. Four primary themes emerged encompassing accessibility, communication, pharmacist attributes, and payment. Thirteen participants would personally utilize a pharmacist prescribing contraceptive service and all stated that this service would be beneficial for other women. Of those women expressing a preference (n = 7), a female pharmacist would be preferred for service delivery. Participants expressed concerns related to access by minors, skills and training of the pharmacist, and environment within the pharmacy. Conclusions Women in Indiana desire broader access to contraception. Efforts should be made at the individual pharmacist‐provider level and statewide to explore strategies to increase access. Resources should be allocated to the creation of protocols for pharmacist prescribing within Indiana and other states.

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“…The scope of pharmacist practice is expanding across the world. Pharmacist prescribing has taken root in the United States 1 , United Kingdom (UK) 2 , and Canada. 3 Each jurisdiction has a unique model and pharmacists may not have a shared understanding of what constitutes prescribing.…”

Section: Introductionmentioning

confidence: 99%

“…Albertan pharmacists do not require a written agreement with a physician to prescribe as in the US model. 1 Furthermore, pharmacists do not require additional training with a physician partner as in the UK model. 2 …”

Section: Introductionmentioning

confidence: 99%

Development and validation of a survey instrument to measure factors that influence pharmacist adoption of prescribing in Alberta, Canada

Guirguis¹,

Hughes²,

Makowsky³

et al. 2018

Pharm Pract (Granada)

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Objective:Study objectives were to develop a questionnaire to assess factors influencing pharmacists’ adoption of prescribing (i.e., continuing, adapting or initiating therapy), describe use of pre-incentive and mixed mode survey, and establish survey psychometric properties.Methods:Questions were developed based on prior qualitative research and Diffusion of Innovation theory. Expert review, cognitive testing, survey pilot, and main survey were used to test the questionnaire. Six content experts reviewed the questionnaire to establish face and content validity. Ten pharmacists from diverse practice settings were purposefully recruited for a cognitive interview to verify question readability. Content analysis was used to analyze the results. A pre-survey introduction letter with a monetary incentive was mailed via post to 100 (i.e. pilot) and 700 (i.e., main survey) randomly selected pharmacists. This was followed by an e-mail with a personalized link to the online questionnaire, e-mail reminders, and a telephone reminder if required. The psychometric properties of scales were evaluated with an exploratory factor analysis and Cronbach’s alpha. Scale responses were described.Results:Engagement of six experts and ten pharmacists clarified definitions (e.g., prescribing), terminology, recall periods, and response options for the 34-item response scale. Fifty-six pharmacists completed the online pilot survey. Based on this data, ambiguous questions and routing issues were addressed. Three hundred and seventy-eight pharmacists completed the online main survey for a response rate of 54.6%. The factors analysis resulted in 27 questions in eight scales: (1) self-efficacy, (2) support from practice environment, (3) support from interprofessional relationship, (4) impact on professionalism, (5) impact on patient care), (6) prescribing beliefs, (7) technical use of electronic health record (EHR) and (8) patient care use of the EHR. Prescribing beliefs and technical use of the EHR scales had low reliability while the remaining six scales had strong evidence for reliability and validity.Conclusion:Through a multi-stage process, a survey instrument was developed to capture pharmacists’ perceptions of prescribing influences. This questionnaire may support future research to develop interventions to enhance adoption of prescribing and enhance direct patient care by pharmacists.

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A review of state pharmacist collaborative practice laws

Cited by 24 publications

References 2 publications

Pharmacists Providing Palliative Care Services: Demonstrating a Positive Return on Investment

Pharmacists Providing Palliative Care Services: Demonstrating a Positive Return on Investment

Women's perceptions of pharmacist‐prescribed hormonal contraception

Development and validation of a survey instrument to measure factors that influence pharmacist adoption of prescribing in Alberta, Canada

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