Pharmacy Practice

Question 1

What are the requirements for a pharmacist to be designated as a “provider” for reimbursement purposes and what tasks are permitted under this designation?

Answer 1

To be a prescribing pharmacist and receive reimbursement, the pharmacist must register as an Oregon Medicaid provider. The pharmacist must complete the appropriate training: Successful Implementation of Patient Assessment and Proper Billing, Oregon Comprehensive Contraceptive Education, and Certification for the Prescribing Pharmacist and Naloxone: Opioid Overdose Prevention, Recognition and Reponse.

Question 2

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

Answer 2

No

Question 3

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

Answer 3

Every two years

Question 4

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

Answer 4

The actions a pharmacist may take must be defined in the Collaborative Drug Therapy Management agreement. No restrictions are addressed in the state law.

Question 5

Are there any restrictions on what diseases a pharmacist can manage under a collaborative practice agreement?

Answer 5

No

Question 6

Is every pharmacy required to have a pharmacist-in-charge?

Answer 6

Yes

Question 7

How many pharmacies can a pharmacist serve as the pharmacist-in-charge (PIC) for at one time?

Answer 7

A pharmacist may be the PIC of two pharmacies. They can receive written approval by the board to be PIC of more than two pharmacies.

Question 8

Is there a minimum number of hours the pharmacist-in-charge (PIC) must be present at the pharmacy?

Answer 8

No

Question 9

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

Answer 9

A pharmacist may permit an intern to perform the duties of a pharmacist under their direction and supervision after the intern has successfully completed his or her first academic year, and after successful completion of coursework corresponding to those activities.

An intern cannot prescribe a drug or device and cannot perform final verification. Everything else can be performed under pharmacist supervision.

Question 10

Can technicians accept new prescriptions over the phone?

Answer 10

No

Question 11

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

Answer 11

Only a hospital pharmacy may apply to participate in a Technician Checking Validation Program (TCVP). The hospital pharmacy must:

1. Develop policies and procedures for the TCVP, including a list of high-risk medications that are excluded from the TCVP.
2. Obtain approval from the appropriate committee before the TCVP is implemented
3. Have a drug distribution system that is structured to allow for one additional check of the medications by a licensed nurse or other licensed health care professional with authority to administer medications after the delivery of the checked medications.
4. Have prior written approval from the Oregon Board of Pharmacy.
5. Submit to the Board copies of written policies and procedures, training materials, quality assurance records, and evaluation forms that will be used.
6. Provide a description of how the proposed TCVP will improve patient safety by focusing on assessing the accuracy and appropriateness of the medications ordered and on educating staff and patients.

Question 12

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

Answer 12

Clerks can send and receive stock orders, perform inventory counts, remove outdated drugs from the shelves and deliver medications.

Question 13

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

Answer 13

Pharmacists cannot prescribe for self or immediate family members. Nurse Practitioners cannot self-prescribe but can prescribe to family members if there is a patient-provider relationship.

Question 14

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

Answer 14

The board does not specify if it is acceptable to fill or refill a prescription if the prescriber is known to be retired or deceased

Question 15

Can pharmacists fill prescriptions written by prescribers in other countries?

Answer 15

No

Question 16

How many years must prescription records be kept?

Answer 16

3 years

Question 17

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

Answer 17

1 year

Question 18

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

Answer 18

No

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

72 hours

Question 20

What are the additional restrictions when dispensing an emergency refill of non-controlled drugs without prescriber authorization (e.g., time period to receive a prescription, notification of the prescriber)?

Answer 20

The health care provider should be immediately notified of the emergency refill.

Question 21

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

Answer 21

1) Name, address and telephone number of the pharmacy
2) Date of fill
3) Identifying number
4) Name of patient
5) Name of drug, strength and quantity dispensed; manufacturer or distributor if a generic name is used
6) Directions for use by the patient
7) Name of practitioner
8) Required precautionary information for controlled substances
9) Cautionary information as required for patient safety
10) An expiration date after which the drug should not be used
11) Physical description, including any identification code that may appear on tablets and capsules (unless in unit dose packaging)

Question 22

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

Answer 22

No, but a prescription reader must be available for the visually impaired

Question 23

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 23

No, a profile is not required for patients who the pharmacist has good reason to believe will not return to the pharmacy.

Question 24

How long must patient profiles be kept after the last fill?

Answer 24

3 years

Question 25

What is required to be in a patient profile?

Answer 25

1) Full name, address and phone number of the patient
2) Patient’s age or date of birth
3) Patient’s 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 pharmacist’s judgment (e.g., any information peculiar to the patient or drug, patient’s weight, over-the-counter drug use)

Question 26

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

Answer 26

No

Question 27

Is the offer to counsel required for all prescriptions?

Answer 27

Yes

Question 28

Who can provide the offer to counsel (e.g., pharmacist, intern or technician)?

Answer 28

Pharmacist or pharmacy intern

Question 29

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

Answer 29

Must offer counseling in writing

Question 30

What are the requirements for providing translation services to limited-English proficient (LEP) patients?

Answer 30

Telephone or in-person interpreter

Question 31

What are the requirements for generic substitution (e.g., must notify the patient)?

Answer 31

The generic substitution cannot cost more than the original branded product

Question 32

What resource/s can be used to select a suitable substitution (e.g., Orange Book, state formulary)?

Answer 32

The Orange Book

Question 33

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

Answer 33

The purchaser can refuse generic substitution

The prescriber can indicate that there may be no substitution

The drug cannot be substituted if the generic drug is more expensive

Question 34

What documentation is required when a generic substitution occurs?

Answer 34

The pharmacist shall label the prescription container with the name of the dispensed generic drug.

Question 35

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

Answer 35

No

Question 36

Does the state have a conscience clause?

Answer 36

No

Question 37

Does the state have death with dignity laws?

Answer 37

Yes