what states allow pharmacists to practice under protocol

Nosotros know there'south a growing shortage of and reduced access to physicians in the U.S. Just when we thought the pandemic was easing, new COVID-nineteen variants are emerging that will probable crusade the physician access situation to worsen again. Fortunately, in an increasing number of states, pharmacists have been granted say-so to prescribe some medications, as discussed in our recent web log on clinical protocol evolution and prescriptive authority.

As noted, pharmacists are highly accessible and are reported to be visited by patients 12 times more oft than the patient's principal care physician. Growing recognition that pharmacists can help make full unmet public health needs through their accessibility and medication knowledge has led to the adoption of statewide protocols for contained pharmacist prescriptive say-so expanding the scope of pharmacy do. Statewide protocols permit pharmacists with qualifying criteria to prescribe specific medications or medication categories.

And then, we know the why and the who. There's a shortage of physicians which reduces access to providers and medications.  And, pharmacists, guided by scope-of-practice laws and standardized protocols established past land legislatures and regulated by appropriate boards, are in a unique position to help accost that shortage.

At present, let's wait at the how, what and where.

How statewide protocols are created

Statewide prescribing protocols and standing orders are designed to increase access to healthcare and medications by utilizing pharmacists' extensive medication knowledge, community accessibility, and the public's trust of the profession. They accost known public health problems that don't require a diagnosis or for which a diagnosis requiring depression-risk medications already exists. They are predictable and consistent,  helping provide greater continuity of intendance and utilize of standardized practices.

Statewide protocols don't crave collaborative practice agreements between a pharmacist and healthcare provider. Their authorization is ratified by the land, and protocols are established by Boards of Pharmacy. Pharmacists may take to obtain additional licensure, complete specific continuing pedagogy, and/or notify primary care physicians following treatment.

These statewide protocols help create continuity of care within a land. Simply, in an endeavour to create standardization between states, the National Alliance of Country Pharmacy Clan's ( NASPA ) and the National Clan of Boards of Pharmacy ( NABP ) take assembled the Statewide Protocol Workgroup. Their goal is to typhoon policy recommendations and develop templates for creating standardized statewide protocols for chemist prescriptive authority.

Similar protocols, statewide continuing orders are some other means of permitting pharmacists with autonomous prescribing abilities. Statewide standing orders item various actions for pharmacists to follow when treating specific patient conditions. They're signed by a state's public wellness officer; however, unlike a protocol, they must be reimplemented and re-signed should a new public wellness officer assume the role in a given state.

Types of statewide protocols

Statewide pharmacist prescriptive authorisation is continually growing as U.S. states innovate legislation and prefer protocols. Statewide protocols are the to the lowest degree restrictive, granting access to all qualified pharmacists within a state.

In addition to statewide protocols, pharmacists accept prescribing capabilities under collaborative practice agreements (CPA) or advanced certification as allowed by state laws. These further expand a pharmacist's telescopic of practice; however, they are more restrictive and specific to but those pharmacists who seek the required CPAs or certifications.

The most-common statewide protocols are for immunizations, naloxone, hormonal contraception, and smoking cessation. A few states have started to introduce additional pharmacist protocols for travel medications, fluoride, HIV pre- and postal service-exposure, and self-limiting medical conditions with low treatment risks.

Electric current states with statewide protocols for pharmacists

• Hormonal contraceptives — Pharmacists tin can prescribe hormonal contraceptives in Arizona, Arkansas, California, Colorado, District of Columbia, Hawaii, Idaho, Maryland, Minnesota, Nevada, New Hampshire, New United mexican states, Oregon, Utah, Vermont, Virginia and West Virginia.
• Tobacco-cessation aids — Pharmacists can prescribe tobacco-cessation therapy in Arizona, Arkansas, California, Colorado, Indiana, Iowa, Oregon, Maine, Minnesota, Missouri, New Mexico, Vermont, West Virginia and Wyoming.
• Naloxone — Pharmacists have statewide prescriptive authorisation in 18 states, and 12 states have standing orders. All 50 states have some form of access to naloxone via chemist prescriptive authorization or non-prescription availability.
• Immunizations— Pharmacists are permitted to administer immunizations in all fifty states nether statewide protocol, standing orders, or pursuant to a prescription with some limitations to vaccine type or patient age.
• Other statewide protocol categories include:
  • Colorado, Oregon — HIV Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP). Other states accept standing orders or laws allowing conditional pharmacist prescriptive authority for PrEP and PEP, such every bit California and New Bailiwick of jersey.
  • California, New Mexico, Idaho   — Travel medications.
  • Virginia and Idaho — Small, cocky-limiting medical conditions; epinephrine machine injectors; and fluoride supplements. Idaho allows pharmacists to follow current clinical guidelines for specified conditions in lieu of statewide protocol creation.

Contents of statewide protocols

The NASPA and NABP Statewide Protocol Workgroup recommend that statewide pharmacist protocols include:

• The medications or categories of medications.
• Required chemist training or qualifications.
• Procedures regarding:
  • Patient inclusion criteria.
  • Documentation and tape maintenance requirements.
  • Communication requirements.

Evolving from medication distribution to pharmacotherapy

The practice of pharmacy has been evolving over recent decades from medication distribution to patient-centered pharmacotherapy.  This has occurred as the pharmaceutical care curriculum became the standard expectation in pharmacy teaching, more educational institutions transitioned to the more advanced PharmD degrees, and the increased pharmacist entry into postgraduate residency grooming and fellowship programs. Statewide protocols, continuing orders, collaborative practice agreements, and advanced certifications expand the chemist'due south scope of practice.

The prescriptive authority granted to pharmacists via such protocols addresses public health concerns by increasing patient access to healthcare services and certain medications.  It too increases the likelihood of patients obtaining appropriate and necessary medical care through chemist referral to a dr..

Resources

Pharmacist Statewide Protocols: Key Elements for Legislative and Regulatory Authority , NASPA/NABP

Chemist's-Based Travel Health Services: State Approaches to Prescriptive Authorization , Periodical of Pharmacy Technology

The Continuum of Pharmacist Prescriptive Authority , Annals of Pharmacotherapy

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Source: https://rxlive.com/mapping-u-s-statewide-protocols-for-pharmacist-prescriptive-authority/