Lec 3. Advanced Pharmacist Practice in NM

Question 1

Pharmacist Prescriptive Authority

Answer 1

Question 2

Pharmacist Prescriptive Authority
-Protocol

Answer 2

• Rx authority has to be in accordance with the written protocol approved by the BOP
• Any RPh exercising prescriptive authority must maintain a current copy of the protocol for prescriptive authority approved by the BOP

Question 3

Pharmacist Prescriptive Authority
-Education and Training

Answer 3

-RPhs must successfully complete a course of training approved by the BOP.
—- Typically, training approved by the Accreditation Council for Pharmacy Education (ACPE)
- RPhs exercising Rx authority need to complete 2 hours of ACPE‐approved drug therapy related CPE every 2 years.
—— This is in addition to the requirements for licensure as a RPh
——- Exception is Tb‐testing which is as specified by the CDC.

Question 4

Pharmacist Prescriptive Authority
Authorized Drugs and records

Answer 4

Question 5

Pharmacist Prescriptive Authority
Notification

Answer 5

• The RPh shall notify the patient’s designated
  physician or primary care provider of the dangerous drug therapy prescribed
• Vaccines: must also notify the NM DOH immunization program; or can update the DOH immunization program’s electronic database (NMSIIS)
• TB testing: must also notify the DOH of any positive TB test.

Question 6

Pharmacist Clinician Certification (general)

Answer 6

• Authorized through the Pharmacist Prescriptive Authority Act (Statute 61‐11B‐1 through 61‐11B‐3.
• BOP Rules: Title 16, chapter 19, part 4, section 17 (16.19.4.17)
  .
  Pharmacist Clinician (PhC): Pharmacist with additional training required by regulations adopted by the Board in consultation with
  the New Mexico Board of Medical Examiners

Question 7

Pharmacist Clinician Certification: Requirements

Answer 7

1. Actively licensed as NM RPh
2. Proof of completion of Board‐approved, 60‐
   hour, physical assessment course
3. Proof of completion of a 150‐hour, 300‐patient contact preceptorship supervised by a MD or other practitioner with prescriptive authority, with hours counted only during direct patient interactions.

Question 8

Pharmacist Clinician Certification:
Physical assessment course completion

Answer 8

• Requires a passing score on a standardized examination
• Examination typically offered twice a year
  —— Fall (October/November) and Spring/Summer (May/June)
  ——- Examination is a series of OSCEs
  ——-Passing score is > 80%

Question 9

Pharmacist Clinician PhC Certification:
Direct Patient Contact Preceptorship

Answer 9

Question 10

PhC Patient Encounter Log

Answer 10

Question 11

PhC: Application

Answer 11

• All materials need to be submitted to the Board of Pharmacy at least 45 days prior to the next scheduled Board meeting
• If submitting a prescriptive authority protocol, once approved by the Board of Pharmacy must register with Medical Board
• Documentation of registration will be required for PhC renewal

Question 12

PhC: Continuing Education Requirements

Answer 12

• PhCʼs are required to maintain an additional 20 hours of CE per renewal period
• The CE must be “live”
• Can be CME or ACPE

Question 13

Pharmacist Clinician:
Scope of Practice

Answer 13

• A PhC shall perform only those services that are delineated in the guidelines of protocol and are within the scope of practice of the
  supervising practitioner.
• A copy of the protocol is required by the BOP to be kept on file at each practice site of the pharmacist clinician and with the BOP.

Question 14

Pharmacist Clinician:
Physician Supervision

Answer 14

• The direction and clinical supervision of PhCs may only be provided by approved supervising MD/DO and/or designated alternate supervising MD(s)/DO(s).
  -This direction may be done by written guidelines or by oral communications in person, over the phone or by other
  electronic means.
• Supervising MDs/DOs must establish a quality assurance (QA) program for review of medical services provided by the PhC
• The PhC must have prompt access to the MD/DO by telephone or other electronic means for advice and direction.

Question 15

PhC: Protocol
- Cover letter from Supervising MD/DO stating that in their opinion the PhC is competent to provide the services outlined in the protocol.
Protocol Components:

Answer 15

• Name of PhC and practice location(s) and Primary Supervising MD/DO and all alternate supervisors and their practice locations
• Purpose or Scope of Practice
• Policies (should include instances requiring immediate physician notification)
• Procedures (should outline conditions to be treated, medication classes to be prescribed, methods of documentation, and emergency/urgent contact)
• Quality assurance (QA) Program
• Signature page (PhC, Supervising physician, Alternate supervising physicians)

Question 16

PhC: Current status

Answer 16

• PhC – There are currently ~ 200 PhCʼs in New
  Mexico (About 80 – 90 with active protocols)
• PhC collaborative prescriptive authority should not be confused with RPh independent
  prescriptive authority

Question 17

Advanced Pharmacy Practice Summary

Answer 17