米国薬剤師の薬物療法マネージング―Ｃｏｌｌａｂｏｒａｔｉｖｅ Ｄｒｕｇ Ｔｈｅｒａｐｙ Ｍａｎａｇｅｍｅｎｔ（ＣＤＴＭ）による取組み―

Abstract

Pharmacists in the United States perform a wider range of occupational functions,and have greater authority than thosein Japan.Possible reasons for this are that they provide specific evidence of clinical benefits for patients and contribute toreducing medical costs through their involvement in clinical activities.The legal basis for their wider range of functions andgreater authority is defined in Collaborative Drug Therapy Management (CDTM) in the law that authorizes pharmacists totake part in the management of drug therapy and other tasks in accordance with a prior written agreement between physiciansand them.We recently investigated laws and regulations in the states that have introduced CDTM in order to examine the legal basisdefined in it for the wide range of occupational functions of pharmacists in the US,agreements on CDTM,and qualificationsof and requirements for pharmacists who take part in CDTM.We found that although different state laws have differentprovisions,there were no substantial differences among them regarding the basic structure of CDTM.In addition,publicly-available protocols actually used in the clinical setting were obtained from 3 institutions and examinedto determine how pharmacists and physicians reached agreement on the planning and implementation of CDTM,andthe drug therapies they provided according to different protocols,and the protocols were compared.All of them had thesame basic concept of CDTM and were prepared according to the joint statement of ACP and ASTM.