Magazine article Drug Topics

How to Set Up a Collaborative Practice

Magazine article Drug Topics

How to Set Up a Collaborative Practice

Article excerpt

Q How do I set up a collaborative practice protocol with aphysician?

A Modern pharmacy practice has grown professionally to unprecedented levels-from traditional dispensing functions to sophisticated clinical roles. One important area is collaborative drug therapy management (CDTM), whereby, according to the National Association of Boards of Pharmacy (NABP), a pharmacist has voluntarily agreed to work with a practitioner under a protocol within which die pharmacist may perform certain patient care functions authorized by the practitioner under specified conditions and/or limitations. A collaborative pharmacy practice agreement, signed among one or more pharmacists and one or more practitioners, provides for collaborative drug therapy management of patients. Drug therapy management implies review of a patients drug therapy regimen by a pharmacist for the purpose of evaluating and rendering advice to a practitioner regarding adjustment of the regimen, with decisions involving drug therapy management made in the best interest of the patient. Such management may include (1) implementing, modifying, and managing drug therapy according to the terms of the collaborative pharmacy practice agreement, (2) collecting and reviewing patient histories, (3) obtaining and checking vital signs, (4) ordering and evaluating the results of laboratory tests directly to drug therapy, when performed in accordance with approved protocols applicable to the practice setting, and (5) such other patient care services allowed by law.

To participate in CDTM, a pharmacist must adhere to a particular state's requirements for such practice. Although the vast majority of states have established some level of CDTM, there are many variations and important differences among the states' pharmacy practice acts. Attributes of state regulations governing CDTM include: (1) types of collaborative practice agreements, (2) levels of review of approval required, (3) medications induded, (4) practice environments, (5) educational requirements/demonstrated competencies, and (6) other aspects addressed by the state. Some states require a written protocol for each patient; others require only a general written protocol. Some states limit the type of practice agreement to an administration of injectables (medications, biologies, and vaccines) protocol, or to an emergency-contraceptive protocol only. Most states do not specify a limitation.

The required levels of review of approval also vary from the physician, to the board of pharmacy, to the board of medical examiners, the facility itself, or various combinations. …

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