Pharmacy Practice

Question 1

Does a collaborative practice agreement need to be submitted to the board?

Answer 1

No

Question 2

How often does a collaborative practice agreement need to be renewed?

Answer 2

CPA renewal period is not addressed in the Michigan law

Question 3

What actions are pharmacists allowed to perform under a CPA (e,g. initiate, modify, monitor medications)?

Answer 3

Initiate new therapy and modify existing therapy. There is nothing to prohibit a pharmacist from monitoring with lab tests or physical assessment

Question 4

Are there any restrictions on what diseases a pharmacist can manage under a CPA?

Answer 4

No

Question 5

Is every pharmacy required to have a PIC

Answer 5

Except for a remote pharmacy, a pharmacy shall designate a pharmacist licensed in this state as the pharmacist in charge for the pharmacy.
For a remote pharmacy, the pharmacist designated as the pharmacist in charge of the parent pharmacy shall also serve as the PIC of the remote pharmacy

Question 6

How many pharmacies can a pharmacist serve as the PIC for at one time?

Answer 6

A pharmacist may be PIC for no more than 3 pharmacies, including remote pharmacies

Question 7

What is the minimum number of hours the PIC must be present at the pharmacy?

Answer 7

A PIC must work an average of at least 8 hours per week at each pharmacy for which he or she is PIC, unless he or she is serving as the PIC of a remote pharmacy.
The PIC of a remote pharmacy is not required to be physically present at the remote pharmacy to satisfy the hours, and can satisfy the requirement through the use of a telepharmacy system

Question 8

What activities are interns permitted to perform (e,g. counseling, compounding, final verification, taking verbal prescriptions)?

Answer 8

All activities of a pharmacist as long as the intern is under the direct supervision of a pharmacist preceptor

Question 9

Can technicians accept new prescriptions over the phone?

Answer 9

Yes, technicians can accept verbal orders for prescription drugs, except orders for controlled substances

Question 10

What are the requirements for tech-check-tech (e,g. practice site type, training or certification required)?

Answer 10

The role of pharmacy technicians is broadly defined in Michigan to include “any other specifically authorized functions”
This allows for institutions to permit tech-check-tech, although there are no state regulations or limitations on practice setting or training requirements.
The pharmacist is ultimately responsible for any allowed activites

Question 11

What activities can a clerk perform (e,g. cashier functions, receive refills, put a bottle of medication on the shelf)?

Answer 11

The Michigan Board of Pharmacy does not specify what tasks a pharmacy clerk/cashier can perform

Question 12

What are the limits on prescribing controlled or non-controlled drugs to oneself or family members?

Answer 12

Requires prescribers to be in a bona fide prescriber-patient relationship prior to prescribing schedule 2-5 controlled substances.
There are no state regulations preventing prescribing of non-controlled substances for oneself or family. The AMA code of Ethics states that generally, a prescriber should not treat themselves or immediate family members unless it is an emergency. Under Michigan law, a violation of the AMA Code of Ethics could result in administrative action against the prescriber.

Question 13

Can new prescriptions or refills be filled if the prescriber is known to be deceased or retired?

Answer 13

The board does not specify if it is acceptable to fill or refill a prescription if the prescriber is known to be retired.
A prescription cannot be filled or refilled if the prescriber is knowingly deceased

Question 14

Can pharmacists fill prescriptions written by prescribers in other countries?

Answer 14

The board does not specify if it is acceptable to fill prescriptions written by prescribers of another country

Question 15

How many years must prescription records be kept?

Answer 15

5 years

Question 16

Within what time frame from the issue date are non-controlled prescriptions permitted to be refilled?

Answer 16

1 year

Question 17

Is there a maximum number of refills permitted for non controlled drugs?

Answer 17

No

Question 18

Is emergency refilling of non-controlled drugs permitted without prescriber authorization?

Answer 18

Yes

Question 19

What is the maximum days supply that can be dispensed for an emergency refill of non-controlled drugs without prescriber authorization?

Answer 19

The pharmacist may dispense and additional quantity up to the total number of dosage units authorized by the prescriber on the original prescription for the patient

Question 20

What information is required to be on a prescription container label?

Answer 20

1) Pharmacy name and address
2) Prescription number and fill date
3) Patient’s name
4) Prescribers name
5) Directions for use and quantity dispensed
6) The name of the medication and the strength, unless the prescriber indicated “do not label”
7) The name of the manufacturer or supplier of the drug if the drug has no brand name
8) The phrase “Discard this medication 1 year after the date it is dispensed” or the actual expiration date if sooner

Question 21

Is it required to provide a larger type size on the container for patients with visual impairments?

Answer 21

No

Question 22

Are patient profiles required to be kept in the pharmacy for all patients (e,g. a traveling patient on vacation getting a one-time fill)?

Answer 22

Yes

Question 23

What is required to be in a patient profile?

Answer 23

Not addressed in Michigan law, follows federal law

1) Full name, address and phone number of the patient
2) Patients age or date of birth
3) Patients gender
4) Chronic medical conditions
5) A list of all prescription drug orders with the drug name, strength, quantity and date received, prescription number and prescriber
6) Known allergies, drug reactions and drug idiosyncrasies
7) Other information deemed relevant by the pharmacists judgement (e,g. any information peculiar to the patient or drug, patients weight, over the counter drug use)

Question 24

Is patient identification required to dispense non-controlled drugs in the community pharmacy setting?

Answer 24

No

Question 25

When must the offer to counsel a patient be made?

Answer 25

New prescriptions

Question 26

Who can provide the offer to counsel?

Answer 26

Pharmacist or intern

Question 27

What are the counseling requirements for medications delivered to the patient or sent by mail?

Answer 27

If the patient or caregiver is not present at the pharmacy, printed information designed to help the patient use the medication safely and effectively must be provided

Question 28

What are the requirements for providing translation services to limited-english proficient patients?

Answer 28

To encourage intended, positive patient outcomes, pharmacists must communicate with a patient regarding safe and effective medication use at the time a new prescription is dispensed

Question 29

What are the requirements for generic substitutions?

Answer 29

1) The patient must be notified
2) The prescription label must indicate the name of the brand prescribed and the name of the generic drug dispensed
3) The substituted drug cannot cost more than the original drug

Question 30

What resouces can be used to select a suitable substitution?

Answer 30

The law does not require any specific resource must be used

Question 31

What actions can be taken by the prescriber or patient to prevent generic interchange?

Answer 31

The prescriber signifying “dispense as written” or “DAW” on the prescription

Question 32

What documentation is required when a generic substitution occurs?

Answer 32

If the drug product selection takes place, the brand name or the name of the manufacturer or supplier of the drug dispensed must be noted on the prescription

Question 33

Are there any drugs (e,g Narrow therapeutic index) that cannot be substituted?

Answer 33

No

Question 34

Does the state have a conscience clause (if so, what are the stipulations of the clause, or what drugs does it specifically apply to)?

Answer 34

No

Question 35

Does the state have death with dignity laws?

Answer 35

No