Physician shortage across the nation and across specialties has resulted in greater responsibilities for nurses and pharmacists. In a bid to ensure patients have consistent access to treatment, a growing number of states are authorizing pharmacists to prescribe medicines. Pharmacists with qualifying criteria can have the permission to prescribe specific medications or medication categories.
Standing orders
Standing orders (image1) can delegate prescription refills (for instance), so physicians can focus on acute care and complex medical decisions. Community pharmacists are visited 12-times more frequently than primary care physicians, pointing to their vital role as clinical care providers. Pharmacists are vital to care for patients with chronic diseases or those living in economically and geographically underserved areas.
The important role of pharmacists in our healthcare system and how quickly they can shoulder the responsibility of public health management was abundantly clear during the peak of the COVID-19 pandemic. Community pharmacists played, and continue to play, a vital role in point-of-care testing and immunization for COVID-19. In so doing, they shifted some of the burden from clinics and hospitals, allowing them to maintain focus on patient treatment and care.
Guidelines and Protocols to Direct Pharmacists
This is not happening in isolation: the National Alliance of State Pharmacy Association (NASPA) and the National Association of Boards of Pharmacy (NABP) are drafting policies that include protocols allowing pharmacists to prescribe medicine. These policies can be:
- Delegated via a collaborative practice agreement (image2) between pharmacists and prescribers, the agreement can help pharmacists deliver:
- Chronic care management
- Authorize refills
- Manage formularies
- Authorized directly by the state without delegation: These are independent protocols.
- Authorized by the state, it specifies the qualifications and procedures needed for pharmacists to implement the protocols
- These protocols are usually developed to address public health problems and patient-care-needs that do not need a new diagnosis
- Statewide protocols include pharmacist prescription of:
- Hormonal contraceptives: 19 states currently allow pharmacists to prescribe contraceptives
- Tobacco cessation: 16 states have some policies in place that allow pharmacists to prescribe certain types of tobacco cessation products
- Immunizations
- Naloxone: statewide access information in community pharmacies (current as of January 2019)
- Travel medications
- TB testing
- Fluoride replacement
The NASPA website is a good resource for additional information on the movement for pharmacists to prescribe medicine.
Surabhi Dangi-Garimella, Ph.D. is a biologist with academic research experience, who brings her skills and knowledge to the health care communications world. She provides writing and strategic support to non-profit groups via her consultancy, SDG AdvoHealth, LLC.