Boards Of Pharmacy Research Articles

Pharmacist-led Smoking-Cessation Services in the United States - A Multijurisdictional Legal Analysis.

A challenge presents itself when pharmacy students and pharmacists have the knowledge, skills, and abilities to provide optimal patient care, which can prevent the healthcare industry from incurring expenditures reaching billions of dollars annually from chronic and acute disease state management, yet due to the lack of statutory or regulatory authority to independently prescribe and dispense smoking cessation products they are unable to tap into this potential. Prescriptive authority of pharmacists is not a novel concept; however, State Legislatures and Boards of Pharmacy have been slow to expand upon the pharmacist's scope of practice to include this authority. As a consequence, this inaction hinders the opportunity of almost 21.5 million patients, who attempt to quit smoking annually, the ability to access a U.S. Food and Drug Administration approved, evidence-based medication-assisted or nicotine replacement therapy prescribed by a pharmacist.2 Current legislative efforts, laws, and regulations regarding a pharmacist's prescriptive authority for tobacco cessation therapy vary greatly amongst the states and do not include reference to e-cigarettes or electronic nicotine delivery systems (e.g.,e-cigs, vape pens, vapes, mods, etc.). Additionally, pharmacists are often required to practice under a statewide protocol or enter into a collaborative practice agreement ("CPA") with a designated physician, which are often complex and create significant barriers for the pharmacist to practice at the top of their license and for the benefit of the patient. This legal and regulatory study reveals the following: 1) Those States that have addressed or attempted to address the pharmacist's prescriptive authority for tobacco cessation therapy, 2) the authority to independently prescribe vs. practice under a statewide protocol, 3) the products able to be prescriber or dispensed under the pharmacist's prescriptive authority or statewide protocol, and 4) the guidelines and/or protocols referenced within their respective State laws and regulations. States and their residents would benefit greatly from amending their laws and regulations to expand upon the pharmacist's prescriptive authority, granting them the ability to help their communities by performing services they are highly trained to perform.

Pathways to pharmacist prescriptive authority: Do decentralized models for expanded prescribing work?

Scope of practice decisions, such as granting pharmacists independent prescriptive authority, are governed at the state level and are often contentious debates. Five states - Florida (FL), New Mexico (NM), Colorado (CO), Idaho (ID), and Oregon (OR) -- have created structures that can theoretically expand independent prescriptive authority through decentralized approaches rather than needing the legislature to approve each drug that pharmacists may prescribe. These approaches have the potential advantage of allowing the states to expand independent pharmacist prescriptive authority to address public health needs more quickly. Four distinct models have been identified from most to least restrictive in practice: 1) medical veto; 2) interdisciplinary committee; 3) board of pharmacy; and 4) pharmacist-determined. These models have generally focused on postdiagnostic and preventive care by pharmacists. In terms of enabling broad pharmacist prescribing, only two of these models have demonstrated success: board of pharmacy and pharmacist-determined. Pharmacy and public health stakeholders considering similar legislation in their own states should consider the success of these decentralized models prior to enacting legislation.

Guidelines for therapeutic interchange—2022

AbstractThe American College of Clinical Pharmacy (ACCP) Board of Regents charged the 2020 to 2021 Publications Committee to review and revise the 2004 ACCP guideline statement on therapeutic interchange. The committee reviewed previous guidelines and relevant published literature. After development of new guidelines, the committee and Board of Regents voted in support of the updated guideline. The ACCP reaffirms its support of therapeutic interchange. Additional recommendations for appropriate implementation and practice of therapeutic interchange are provided. Therapeutic interchange is an important tool in optimizing patient care, improving access to care, and reducing the cost of medications.

Fundamental issues and pandemic pushes pharmacists past their limits

Fundamental issues and pandemic pushes pharmacists past their limits

“The Board is Blue”: Kentucky Registers a Woman Pharmacist

“The Board is Blue”: Kentucky Registers a Woman Pharmacist Lynn E. Niedermeier (bio) On November 8, 1883, a native of Clay County, Kentucky, applied to the state’s Board of Pharmacy to be licensed as a druggist. The twenty-one-year-old exhibited a diploma from the University of Michigan’s School of Pharmacy and paid the ten-dollar fee, but the board’s Executive Committee unanimously denied the application. The individual, it held, was not a graduate in pharmacy, a rank that would ordinarily guarantee its holder registration as a lawful compounder and dispenser of prescriptions.1 The applicant sued, challenging the board’s methods of regulating pharmacy practice, and in particular its position on what constituted a qualifying pharmaceutical education. Only a decade old, the board had struggled with such questions since its creation, but its assertion of dominion over pharmacy practice was about to encounter a novel complication: the applicant whose credentials it rejected was a woman. The ensuing dispute constituted a unique chapter in the progress of pharmacy in Kentucky. It brought into focus the barriers faced by [End Page 145] women seeking to enter this newly professionalized field and dramatized a wider debate over the sources of pharmaceutical expertise. It invigorated an educational initiative sponsored by some of the state’s leading citizens and drew a response from the state’s highest court. In its aftermath, Kentucky clarified its standards for determining professional competency, but for women, no matter how well educated or resourceful, registration remained a distant goal. The applicant, Elizabeth “Bessie” Woods White, promised to be a formidable plaintiff, for she was not groomed to be a mute casualty of the law. Born on August 5, 1862, she belonged to one of eastern Kentucky’s most powerful and enterprising families. Her grandfather, Hugh Lowry White, was a judge for newly created Clay County, and her uncle, John White, was Speaker of the U.S. House of Representatives. In 1841, Bessie’s father, Daugherty White, defeated Theophilus T. Garrard, grandson of Kentucky’s second governor, for a term in the state House of Representatives. On his return to Clay County, Daugherty rejoined the business with which the Whites and Garrards had been identified since the days of Grandfather Hugh, namely the manufacture of salt from the briny spring waters along Goose Creek near Manchester. By 1860, Daugherty and a network of relatives also controlled some 20,000 acres of farmland in Clay and nearby counties, and more than one hundred enslaved persons. Bessie and her five older siblings were all born at Highland Cottage, the family home near the salt works.2 Clay County’s salt industry suffered irreversible decline during the Civil War, but the Whites remained economically and politically powerful. They also maintained their bitter and complex rivalry with the county’s other first family, the Garrards. Beginning around the [End Page 146] Click for larger view View full resolution Bessie Woods White received her pharmaceutical chemist degree from the University of Michigan’s School of Pharmacy in 1883. Image courtesy of University of Michigan Bentley Historical Library. [End Page 147] time of Daugherty’s election victory, the White-Garrard feud grew to encompass political warfare, bare-knuckled competition in the salt industry, and the taking of opposite sides in disputes, some murderous, between other families.3 Despite his tumultuous public life, Daugherty White evidenced considerable tenderness toward his daughters and showed particular concern for their education. In letters to one who was away at school, he urged her to be diligent in her studies. “I know you are as Smart as any of the Girls and all you need is health and industry to keep up with the foremos [sic] or in fact out Strip any of them.” To twelve-year-old Bessie, attending Hocker College in Lexington, he expressed his wish “to take you in my arms and cress [sic] you as I used to do,” but declared that “you must have an education and for a time Papa must forego the pleasure.”4 Only months later, however, Daugherty drowned himself. After her father’s suicide, two other family members took charge of Bessie. One was her twenty-two-year...

Editor’s Page

Editor’s Page Daniel J. Burge Historians have long been intrigued by biography. While many historians have written books analyzing wars, revolutions, and the fall of empires, others have sought to understand the past by examining how individuals altered the course of history. Classical historians such as Arrian, Suetonius, and Plutarch helped to establish biography as a reputable genre of historical inquiry and its popularity has only increased with time. In the twenty-first century, bookshelves bend under the weight of the biographies on Jefferson, Lincoln, Douglass, and the Roosevelts. However, as this issue of the Register reminds us, biographers do not have to exclusively deal with the stories of those who became president or who led armies. Oftentimes, we can learn more from the past by examining the lives of less well-known personages. Angelo I. George and Gary A. O’Dell illustrate the possibilities of biography by helping to recover the story of Stephen Bishop. In their article “Stephen Bishop: The Celebrated Guide of Mammoth Cave,” George and O’Dell explore how Bishop, an enslaved man in Kentucky, became one of the most famous Black men in antebellum America. Unlike Frederick Douglass or Henry Box Brown, who became noted leaders of the abolition movement after escaping north, Bishop garnered national exclaim by his subterranean exploits. Enslaved from birth, possibly by his biological father, Bishop was brought to Mammoth Cave after he was purchased by Franklin Gorin, an attorney from Glasgow, Kentucky. It was at Mammoth Cave that Bishop would rise to national fame, as he conducted underground tours, explored new regions, and entertained guests with his oratory and knowledge of cave lore. Yet, for all the tourists that he drew to [End Page 95] Mammoth Cave, Bishop hardly reaped financial rewards. His last enslaver, Dr. John Croghan, died in 1849, stipulating that Bishop and his family would only be freed after seven years. Bishop and his family were emancipated in 1856, but Bishop died a mere year later. Moving ahead several decades, Lynn E. Niedermeyer focuses her attention on the barriers that white women faced during the Gilded Age. In “‘The Board is Blue’: Kentucky Registers a Woman Pharmacist,” Niedermeier recounts the story of Elizabeth “Bessie” Woods White. Born into a prominent family in Clay County, Kentucky, White received a quality education and enrolled at the Michigan School of Pharmacy. Excelling at her studies, White graduated in 1883 with the degree of pharmaceutical chemist. Returning to Kentucky, White attempted to register with the state board of pharmacy but experienced a setback when the board responded that she lacked the requisite three years of professional experience. Recognizing that the board did not want to register a female applicant, White brought a legal case against them, which she won in 1884, when a judge ruled that the board had overstepped its authority. Although White decided to marry and step away from a career as a pharmacist, her actions opened the door for women in Kentucky to enter a profession that had been closed to them. Our third article pivots from an individual biography to a story about a family. In her article, “Medical Mysteries: Identifying Recipes in the Carpenter Family Papers,” KHS digital archivist Alyssa Ollier takes a fresh look at several recipes within the Carpenter family papers, which are housed at the Kentucky Historical Society. Ollier examines a recipe on curing sweeney, a disease that impacted horses. Ollier also analyzes a recipe on opodeldoc, a plant-based medicine used to treat a variety of ailments. Ollier uses these recipes to shed light on traditional southern folk medicine, as practiced by nineteenth-century Kentuckians. All three authors illustrate how the stories of individuals and families can be used to understand a specific era. Examining Stephen [End Page 96] Bishop’s story, for example, provides us with a different perspective of antebellum Kentucky than we could glean by looking at Henry Clay or Abraham Lincoln, who were Bishop’s contemporaries. In a similar manner, Bessie White reminds us of the extraordinary challenges that women faced as they attempted to enter occupations reserved for men, a viewpoint that is often missing from histories of the Gilded Age. By recovering the stories of...

Washington pharmacist Timothy Fuller dies at 75 years.

Timothy Stephen Fuller, collaborative practice trailblazer and longtime pharmacist–consultant for the Washington State Board of Pharmacy, died January 17 at his home in Sequim. He was 75 years old. Fuller was widely known for his research and advocacy on collaborative practice for pharmacists, an issue he championed during more than 2 decades of service with the pharmacy board. He was instrumental in establishing the nation’s first collaborative model for pharmacists to administer vaccines, and he helped normalize the profession’s role in providing emergency contraceptives and other drug therapies. In 1996, Fuller and editor Christopher P. Barry published the Handbook of Collaborative Drug Therapy Management. The handbook became a national blueprint for pharmacists to expand the reach and practical autonomy of the profession through collaborative practice agreements. “Throughout his career—as a pharmacy leader in hospitals and with the Washington Board of Pharmacy—Tim Fuller was committed to implementing cutting-edge solutions to optimize...

Development and implementation of the ACCP Code of Conduct

AbstractThe decision to develop and implement an organizational Code of Conduct required the collective effort and input of the American College of Clinical Pharmacy (ACCP) Board of Regents and staff. The process was systematic, deliberate, and reflective of the College's core values. Building an inclusive organization and embracing diversity require transparent communication of expected standards of conduct. A culture of belonging and equity for all members is necessary to ensure representation and opportunities for engagement throughout the organization.

USP releases new chapter <797> proposals

The United States Pharmacopeia (USP) has finally released its updated Chapter <797> revisions. These revisions were written over the past 22 months while USP considered appeals filed by stakeholders. The 2019 version is mostly intact in the revision, but there are some changes to beyond-use dates (BUD) for certain institutions. In addition, USP clarifies when to identify microorganisms found during various sampling activities. “There’s very little difference in what was in the 2019 and the 2021 proposed revision,” said Patricia Kienle, RPh, MPA, BCSCP, director of accreditation and medication safety at Cardinal Health and a member of the USP compounding expert committee. (Her comments are her opinions and not the opinions of USP.) “If people were ready for the 2019 version, they’re fine with the 2021 proposed revision. There won’t be any cataclysmic change from what they were expecting from the 2019 version.” This should be reassuring news to hospitals that have been diligently working toward compliance with the 2019 version. Compounded sterile products (CSPs) were assigned one of two categories in the 2019 version. Category 1 CSPs were defined as being prepared in an unclassified segregated compounding area. These products were assigned the shortest BUDs: 12 hours or less at room temp, or 24 hours or less refrigerated. Category 2 CSPs were defined as being prepared in a compliant compounding cleanroom suite and were allowed longer dating. The new revision defines a third category, applicable to those who want to extend BUDs beyond that allowed for Category 2. Using stability-indicating analytical methods, which are based on USP Chapter <1225>, “Validation of Compendial Procedures,” institutions can assign a BUD of up to 180 days. Additional stricter garbing and cleaning procedures are also required for Category 3 CSPs. Hospital pharmacies that perform sterile compounding will see some changes in how specific they need to be when identifying microorganisms collected during surface or air sampling. Pharmacists can view the updated revisions for all of the nitty-gritty details on sampling changes (apha.us/USPrevs). “If sites have not geared up for monthly surface sampling, it is unlikely that the certifier will be able to do this,” said Kienle. “The pharmacy needs to be prepared for doing this more often if they have not already done so. Incubator space is needed, [as well as] the right media, a microbiologist will need to be referred to if an excursion is noted.” Institutions that have been preparing for the 2019 revisions will likely need to abide by additional requirements. State boards of pharmacy often have other requirements with CSPs. Any institution considering making changes to become compliant with the updated revisions should also check with their state board of pharmacy’s requirements. With these new revisions, it is possible that state boards of pharmacy may amend their existing CSP-related requirements. Pharmacists should pay close attention to what their state board of pharmacy is doing so they are not caught off-guard when the new chapter becomes enforceable. The USP compounding expert committee is allowing comments on the new revisions to be submitted until March 17, 2022. Afterward, they will review the comments and determine if additional changes need to be made to the revisions. There is no timeline defined for how long they may consider comments. Regardless, there will be a 6-month implementation window defined by USP whenever the new revisions are officially published. Upon completion of this 6-month window, the chapter will likely become enforceable in many states. If an institution has not made changes to the CSP compounding strategy after the 2019 revisions were proposed, work will be needed to get up to speed. If the institution has adequately prepared for the 2019 revisions, these new revisions will require some review and changes, but should not be overwhelming. Pharmacists should spend time reviewing these proposed revisions (and then the final versions once they are published), identify gaps at their institution, and plan accordingly.

National pharmacy boards meeting: 2 February 2022

The Royal Pharmaceutical Society’s (RPS’s) three national pharmacy boards held their first meeting of the year virtually on 2 February 2022. Apologies were received from Kathleen Cowle of the Scottish Pharmacy Board (SPB), and Dylan Jones and Elly Thomas of the Welsh Pharmacy Board (WPB). Country-specific visions: an update Elen Jones, RPS director for Wales, […]

National pharmacy board elections 2022: closure of electoral roll and deadline for updating voting preferences

Any Member or Fellow who is resident in England, the Channel Islands or the Isle of Man at 17:00 on 4 April 2022 will be entitled to vote in the election of Members of the English Pharmacy Board. Any Member or Fellow who is resident in Scotland at 17:00 on 4 April 2022 will be […]

National pharmacy boards meeting: 28 June 2022

The Royal Pharmaceutical Society’s (RPS’s) English, Scottish and Welsh pharmacy boards held their joint summer meeting via Zoom on 28 June 2022. Claire Anderson and Paul Bennett, president and chief executive, respectively, of the RPS, welcomed board members and observers to the meeting and extended a particular welcome to new board members, following the results of […]

Tase Oputu and Lola Dabiri: ‘We are the first, but we don’t want to be the last’

Tase Oputu and Lola Dabiri are reluctant trailblazers. The only black pharmacists currently on the Royal Pharmaceutical Society (RPS) English Pharmacy Board and Scottish Pharmacy Board, respectively, Oputu and Dabiri are using their position in the profession to inspire others to think big. But they both admit that they wish they didn’t have to. “I […]

Pharmacists should be able to refer patients to NHS genomics services, says Royal Pharmaceutical Society

Pharmacists should be able to refer patients to NHS genomics services, the Royal Pharmaceutical Society (RPS) has said. In its response to an NHS England consultation on an update to the Clinical Genomics Service specification, Thorrun Govind, chair of the RPS English Pharmacy Board, said: “Pharmacy professionals should have the potential to signpost patients and […]

Highlights of 2022: a letter from the three Royal Pharmaceutical Society national pharmacy board chairs

A central focus for the Royal Pharmaceutical Society (RPS) in England in 2022 was the development of our ‘Vision for pharmacy professional practice‘, in partnership with The King’s Fund. This report, published on 14 December 2022, sets out how pharmacy teams can support better patient care and help address key challenges facing the nation’s health. […]

National pharmacy board elections 2022: information for candidates

The Royal Pharmaceutical Society (RPS) has published information for candidates who are standing for election to the national pharmacy boards in 2022. Nominations for the 2022 elections will open on 14 March 2022. The information for candidates, as well as further details of the national pharmacy board elections 2022, may be found at: https://www.rpharms.com/about-us/who-we-are/national-boards/boards-elections

National Pharmacy Board meeting: 29 September 2022

The Royal Pharmaceutical Society’s (RPS’s) three national pharmacy boards held a joint meeting of open business on 29 September 2022. This was the first joint board meeting to be held in hybrid format, with some members joining through Zoom and others present in each of the Society’s three national headquarters. Apologies were received from Iain […]

Scottish Pharmacy Board election 2022

The scheme for the 2022 election provides for three places on the Scottish Pharmacy Board for Members or Fellows who work or live wholly or mainly in Scotland. The eligibility criteria are set out below. Nominations for candidates in the Scottish Pharmacy Board election can not be made until 14 March 2022 and must be […]

Candidates for the 2022 elections to the national pharmacy boards

The following nominations have been received for the forthcoming Royal Pharmaceutical Society national pharmacy board elections. Where elections are to be held, ballot papers are due to be distributed on or around 29 April 2022, with voting closing at 17:00 on 9 May 2022. The results will be announced on or around 10 May 2022. Scottish Pharmacy […]

Welsh Pharmacy Board Election 2022

The scheme for the 2022 election provides for three places on the Welsh Pharmacy Board for Members or Fellows who work or live wholly or mainly in Wales. The three places are to be allocated as follows: (a) One place for any eligible Member whose substantive practice is in the community practice sector; (b) Two […]