Pharmacy Regulatory Innovation Index: Benchmarking the regulatory environment in 10 western states

Adams, Alex J.; Frost, Tim P.; Weaver, Krystalyn K.

doi:10.1016/j.japh.2021.05.003

Cited by 12 publications

(9 citation statements)

References 14 publications

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“…With additional training, pharmacy technicians were authorized to administer COVID-19 vaccines and certain therapeutics (Office of the Assistant Secretary for Health, 2020c). A limited number of states allowed pharmacy technicians to administer vaccines prior to the pandemic (Adams, Frost, & Weaver, 2021). Interviewees emphasized that community pharmacies were able to take on the increased workload from new COVID-19 services due in large part to the expanded role of the pharmacy technician.…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on the Community Pharmacy Workforce

Bacci,

Pollack,

Skillman

et al. 2023

Med Care Res Rev

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This study sought to describe the impact of the COVID-19 pandemic on community pharmacy practice and its workforce. Interviews were conducted with 18 key informants from pharmacy associations and community pharmacists representing chain and independent pharmacy organizations across the United States from January to May 2022. Interview notes were analyzed using a rapid content analysis approach. Four themes resulted: (a) patient care at community pharmacies focused on fulfilling COVID-19 response needs; (b) pharmacists’ history as immunizers and scope of practice expansions facilitated COVID-19 response efforts; (c) workforce supply shortages impeded COVID-19 response efforts and contributed to burnout; and (d) maintaining community pharmacy workforce’s readiness will be critical to future emergency preparedness and response efforts. Formalizing scope of practice expansion policies and reimbursement pathways deployed during the COVID-19 pandemic could facilitate the community pharmacy workforce’s ability to address ongoing public health needs and respond to future public health emergencies.

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Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on the Community Pharmacy Workforce

Bacci,

Pollack,

Skillman

et al. 2023

Med Care Res Rev

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“…46 Idaho was the first state to adopt a standard of care approach to pharmacist service regulation. 47,48 In so doing, the Idaho Of note, other federal forays into pharmacist prescribing have suffered from the same over-regulation observed at the state level. [54][55][56][57] Thus, federal action to override state laws is not a panacea, and OTC access is not appropriate for all medications.…”

Section: Regulating Pharmacist Services: a " Standard Of Care" Regula...mentioning

confidence: 99%

“…Idaho was the first state to adopt a standard of care approach to pharmacist service regulation 47,48 . In so doing, the Idaho Board of Pharmacy reduced its volume of regulations from approximately 100 pages to 25, removing the minutia that bogs down other state pharmacy laws.…”

Section: Regulating Pharmacist Services: a “Standard Of Care” Regulat...mentioning

confidence: 99%

The over‐regulation of pharmacist services: Why over‐the‐counter naloxone should spark conversation about a “standard of care” regulatory approach

Adams

Frost

2023

J Am Coll Clin Pharm

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In March 2023, the U.S. Food and Drug Administration approved the first naloxone nasal spray to be available over-the-counter without a prescription. Naloxone nasal spray will become much more accessible nationwide, and a lot of current state regulations will become obsolete. Current state naloxone regulations for pharmacists are poorly calibrated to the medication's safety profile and may impede access to this critical opioid overdose reversal agent. State policymakers should reflect on the unnecessary regulations that were imposed on pharmacist prescribing of naloxone and consider moving to a "standard of care approach" to better enable pharmacists to engage in future public health initiatives.naloxone, pharmacist prescriptive authority, scope of practice, standard of care In March 2023, the U.S. Food and Drug Administration (FDA) approved the first naloxone nasal spray to be available over-thecounter (OTC) without a prescription. 1 Naloxone rapidly reverses an opioid overdose and restores a patient's breathing. 2 Naloxone is safe, has few side effects, and no absolute contraindications. 2,3 Following the FDA action, naloxone nasal spray will likely soon be sold anywhere that nonprescription drugs are available, including gas stations, convenience stores, and vending machines. 4 OTC status will increase the accessibility of naloxone. This follows years of efforts by states to increase access to the medication through community pharmacies. By 2016, 42 states allowed naloxone to be dispensed to patients through either collaborative practice agreements or statewide protocols, and at least five states allowed pharmacists to prescribe naloxone. 5,6 Today, all states have increased access to naloxone through community pharmacies in some fashion, though such laws are often riddled with restrictions that are poorly calibrated to the safety profile of naloxone and its public health potential.We believe that OTC naloxone presents an important case study to rethink how states regulate pharmacist services. Namely, states should seek to transition from hyper-specific, prescriptive regulations to a flexible "standard of care" regulatory framework so that pharmacists can flexibly meet public health needs in a changing patient care environment.

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“…10 There is additional variation in scope of practice across states that affects the patient care that community pharmacists can provide, such as their ability to initiate, modify, or discontinue drug therapy; administer vaccines or other medications; order, administer, and interpret laboratory tests; and delegate activities to pharmacy technicians. 12 Community pharmacists are often siloed from the rest of the health care team by both physical location and connectivity with limited to no bidirectional flow of patient health information. 11,13 Further, there is limited patient demand because many patients do not understand or are not aware of the expanding role of the community pharmacist.…”

Section: Introductionmentioning

confidence: 99%

“…Reimbursement opportunities for patient care services are limited and vary state‐to‐state, thus community pharmacy workflow and staffing remain centered around medication dispensing 10 . There is additional variation in scope of practice across states that affects the patient care that community pharmacists can provide, such as their ability to initiate, modify, or discontinue drug therapy; administer vaccines or other medications; order, administer, and interpret laboratory tests; and delegate activities to pharmacy technicians 12 . Community pharmacists are often siloed from the rest of the health care team by both physical location and connectivity with limited to no bidirectional flow of patient health information 11,13 .…”

Section: Introductionmentioning

confidence: 99%

Qualitative analysis of a community pharmacy practice transformation initiative

Bacci

Ferreri

Coley

et al. 2022

J Am Coll Clin Pharm

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Objective To evaluate practice transformation team (PTT) members' perceptions of the Flip the Pharmacy (FtP) initiative as a strategy for implementing and improving community pharmacy‐based patient care. Methods FtP is a national 2‐year practice transformation initiative for implementing enhanced patient care and medication optimization services at community pharmacies, launched in 2019 with 28 PTTs including over 500 pharmacy locations. Key informant interviews were conducted with team leads, coaches, and pharmacy champions from four PTTs that participated in the first FtP cohort. The interviews were conducted using semistructured interview guides based on the RE‐AIM framework and focused on participants' experiences in the first year of FtP. Interviews were audio‐recorded, transcribed, and analyzed using a rapid content analysis approach. Results Four leads, 8 coaches, and 8 pharmacy champions were interviewed from 4 PTTs from May to October 2021 and resulted in 10 themes: (1) community pharmacy practice experience is important when selecting coaches; (2) team readiness supports successful pharmacy practice transformation; (3) measures of patient care quality are needed; (4) payment and practice transformation opportunities happen in parallel; (5) successful practice transformation requires strategic involvement of the entire pharmacy team; (6) FtP practice transformation domains are synergistic; (7) change packages, coaching, and performance monitoring are core practice transformation supports; (8) pharmacy teams value opportunities to share and learn from each other; (9) sustaining patient care services is continuous; and (10) COVID‐19 accelerated practice transformation while creating new stress points. Conclusion Participants in this study perceived the FtP initiative as a helpful strategy implementing and improving community pharmacy‐based patient care. Future research should explore the sustainability of the FtP initiative and similar community pharmacy practice transformation efforts.

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Pharmacy Regulatory Innovation Index: Benchmarking the regulatory environment in 10 western states

Cited by 12 publications

References 14 publications

Impact of the COVID-19 Pandemic on the Community Pharmacy Workforce

Impact of the COVID-19 Pandemic on the Community Pharmacy Workforce

The over‐regulation of pharmacist services: Why over‐the‐counter naloxone should spark conversation about a “standard of care” regulatory approach

Qualitative analysis of a community pharmacy practice transformation initiative

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