Magazine article Drug Topics

Disclosure of Prescription Information

Magazine article Drug Topics

Disclosure of Prescription Information

Article excerpt

An issue long troubling to pharmacists is the releasing to third parties of details of a patient's medication record or other information about his or her medication therapy and medical status. This "patient confidentiality" issue is surrounded by much uncertainty, and the little guidance available comes primarily from state statutory codes, board of pharmacy and other administrative agency regulations, and judicial decisions.

A recent decision of the U.S. District Court for the District of Colorado has brought federal law to bear upon the issue. The decision, while not involving pharmacy directly, is nevertheless important because pharmacies, repositories of information about an individual's drug therapy, are subject to requests for this information from various third parties. Also, pharmacies employ professional and nonprofessional staffs; thus, the decision applies to the relationship between a pharmacy enterprise and its employees.

The matter before the Colorado District Court involved an employer's requirement that employees disclose all Rx drugs they were taking. The specific legal issue involved whether such a requirement violated the Americans with Disabilities Act.

Under the ADA, Congress placed various restrictions on the use of medical examinations and medical inquiries in the employer-employee relationship. Since enactment of the ADA, significant attention has been paid to medical examinations and inquiries of persons applying for employment. However, far less attention has been given to medical examinations and inquiries of existing employees.

The ADA allows medical examinations and inquiries of current employees only if "job related and consistent with business necessity." According to the interpretive guidelines of the Equal Employment Opportunity Commission (EEOC), that phrase (by way of an example and not a definition) permits examinations and inquiries only:

when there is a need to determine whether an employee is still able to perform the essential functions of the job;

where the examination or inquiry is necessary to the reasonable accommodation process; or

where the examination or inquiry is pursuant to a legally mandated fitness-for-duty examination consistent with the ADA.

Drug testing for illicit drug use is not considered a medical examination or inquiry and thus is not prohibited under the ADA. Drug testing may be conducted for a variety of purposes, including enabling an employer to determine whether an employee can perform essential functions of a job without posing an undue threat to the health or safety of others. …

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