Pharmacist Prescribed Contraception Flashcards
Meaning of Behind the Counter
Over-the-counter with nonclinical restrictions: age, quantity, location of sale, or documentation (nicotine replacement, pseudoephedrine: SUDAFED)
-need interaction with the pharmacist
Pharmacist Prescribing
Pharmacist has the authority to prescribe
referred to a single drug, drug class, or specific disease state
-commonly through a collaborative practice agreement, statewide protocol, standing order
Prescriptive Authority
-Broad
-The state gives full autonomy to pharmacists to
prescribe medications
-based on clinical guidelines and professional judgment
-no protocol or agreement is needed
Statewide Protocol
-issued by a state board or agency
-authorizes pharmacists who meet the
requirements to autonomously prescribe certain
medications
-within the law and regulations
Example of Statewide Protocol
Virginia
-PPC: Pharmacist Prescribe Contraception
-Naloxone, and others
Term Definition Collaborative Practice Agreement
(CPA)
-a voluntary agreement between a pharmacist and a prescriber
-the pharmacist can initiate, adjust, discontinue medications, and order laboratory tests
-Tennessee
Standing Order
-often signed by a physician (high-ranked) within
the state agency or department of health
- authorize a pharmacist to provide care to patients when conditions in the standing order are met
-1 high-ranked MD signs for pharmacists in the whole state
-TN with Naloxone (when it was prescription only)
Statewide Protocol and Standing Order
-are similar
-for the Statewide Protocol the government signs for the pharmacists
-for the Standing Order it is a high-ranked physician that signs for the pharmacists
Issues with insurance
with Collaborative Practice Agreement (CPA) and Standing Order, often times the pharmacy will put the collaborative physician on the file even though the pharmacist was prescribing -> to get the prescription through the insurance
-f.e. Vaccines in Collaborative Practice Agreement
Why is it important that the Collaborative Practice Agreement (CPA) for Contraceptives contains a nonpatient-specific prescriptive order?
-Example: CPA with Dr. Smith -> the pharmacist is allowed to prescribe for all patients eligible, not just Dr. Smith’s
-otherwise, the pharmacist would have to have a CPA with all the different doctors of the patients
Which drugs are considered Hormonal Contraceptives and eligible to be prescribed by a pharmacist?
-Self-administered drugs
-Transdermal patch applied to the skin
What are the Contraceptives that require a doctor’s intervention?
-Permanent (Vasoctemy, hysterectomy, tubal ligation)
-Copper IUD
-Hormonal IUD
-Implant (placed under the arm)
Which Contraceptive formulations are eligible for Pharmacist Prescription?
-Shot
-Intravaginal Ring
-Transdermal Patch
-Oral Contraceptive Pill
Which Contraceptive formulations are sold OTC without a prescription?
-External Male Condom
-Internal Female Condom
-Withdrawal - Plan B
Requirements for patients to receive a prescription from a pharmacist
-Age of 18y
-Under 18y with proof that the individual is an emancipated minor as defined in § 39-11-106 (free from the control of their parents)
-does NOT affect the regular prescription filling from traditional prescriber
In Tennessee
The pharmacist is allowed to require a patient to schedule an appointment for provision or dispensing of hormonal contraceptives - T or F
False
In Tennessee
A pharmacist may charge an annual administrative fee for services provided pursuant to this section in addition to any costs associated with the dispensing of the drug and paid by the pharmacy benefit
T or F
True
Only for non-insured patients !!
right now there is not a reliable way to bill insured patients - due to reimbursement issues
How is the liability protection issued for pharmacists and prescribers in the law?
-immune from disciplinary or adverse administrative actions, when acting in good faith and with reasonable care
Board Rules for Pharmacies prescribing
-Cont’d Training:
Curriculum (Pharmacy school) + responsible for staying up to date; complement training if you change state
Board Rules for CPA
-The pharmacy must submit the CPA to the Board within 30 days
-Save the records of patients who have received prescriptions from the pharmacists for 10 years
Board Rules - Procedural Mandates
-requires a self-assessment tool (self-assessment form with Y/N questions to see if the patient is eligible for the vaccine or treatment (contraceptive))
-responsible for assessing the self-assessment, dispensing, counseling, and providing the FDA product information
-advise the patient to still see their primary care doctor; if they don’t have a doctor -> MUST provide a list of contact information of primary care provider within 72 hours
Self-Screening Form for EXAM
-Breast cancer may be related to hormone exposure -> possible exclusion of a patient when breast cancer in the family hsitory
