Abstract
Pharmacist prescriptive authority continues to increase at the state level in the United States. Recently, the Idaho Board of Pharmacy (BOP) finalized regulations that expanded autonomous prescriptive authority in its state to a range of preventative care as well as acute and chronic conditions. This manuscript reviews the key decision points made by the BOP regarding drug categories included, education requirements, protocols, access to data, and use of standards of care. Overall, Idaho’s approach closely reflects the medical model of regulation and may prove useful to other states and jurisdictions as they consider similar issues.
Highlights
Pharmacist prescriptive authority continues to increase at the state level in the United States
Most states (49) and the District of Columbia currently allow pharmacists to prescribe under a collaborative practice agreement (CPA), and an increasing body of evidence has demonstrated that patient outcomes improve when pharmacists are fully practicing to the extent of their clinical abilities [3,4,5]
If the patient does not have a primary care provider (PCP)—which studies suggest will occur in approximately 25% of the patients who seek care for minor ailments at the pharmacy—the Board of Pharmacy (BOP) encourages pharmacies to partner with the medical community and provide lists of PCPs who are enrolling new patients in the local community [36]
Summary
Pharmacist prescriptive authority continues to increase at the state level in the United States. The protocol is non-negotiable at the practice level, and the state must continuously update it if practice guidelines change In the latter model, pharmacists have true independent prescriptive authority, limited to certain classes of medications. While CPAs have formed the historical basis for advanced pharmacist roles in ambulatory care and institutional practice settings, they have been less common in community pharmacy settings [2]. This is in part due to the difficulty in finding a willing collaborator and aligning incentives among providers who may view each other as competitors for certain services [7]. Our hope is that this manuscript will prove useful for other states considering similar issues
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