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Collaborative Pharmaceutical Task Force Deliberations (March 2019)
We're Getting Closer But No Votes Yet
by Scott A. Meyers, Executive Vice President
At the Collaborative Pharmaceutical Task Force March 12th meeting, the discussion began with a review of the grounds for discipline in the Act and Rules. There was substantial debate about the ability to enforce some of the points presented. For example, what types of advertising or soliciting that a pharmacist may be required to undertake could impact the health, safety and welfare of the patient? While requiring pharmacists to ask each patient if they have had the appropriate age-related immunizations when they pick-up prescriptions makes sound clinical sense, does the occasional announcement over the pharmacy PA system recommending customers stop by the pharmacy for their flu-shots have an impact on patient care? A concern was raised about another recommendation that requires “sufficient personnel to prevent fatigue, distraction, or other conditions that interfere with a pharmacist’s ability to practice with competency and safety” sounds reasonable except that “sufficient” is extremely subjective. The Task Force will continue to work on refining the recommendations related to Grounds for Discipline.
The Task Force discussed what tasks pharmacy technicians may carry out when the pharmacist is out of the office on a break. There was agreement that the pharmacy technicians could continue to work in the pharmacist’s absence and could deliver refilled prescriptions that the pharmacist had previously checked as long as the pharmacist felt that no additional counseling was needed. New prescriptions would not be dispensed that had not been checked by the pharmacist and there was significant disagreement related to dispensing new prescriptions that the pharmacist had checked. Counseling on all new prescriptions is required to be done by the pharmacist or pharmacy student when the pharmacist is present, however, mail-order pharmacy is only required to make a reasonable attempt to counsel the patient by telephone for new prescriptions. In addition, currently, pharmacies that deliver to the patient’s home are only required to provide counseling in a written format and a telephone number for questions for the pharmacist. These loopholes were criticized by more than one member of the Task Force. More discussion is expected on this topic.
The Task Force deliberated on the tasks a technician should or should not be allowed to undertake. Currently in the Pharmacy Practice Act and Controlled Substance Act, the following tasks may not be done by technicians:
· Patient counseling
· Drug regimen review
· Clinical conflict resolution
· Administration of immunizations
· Transfer of prescriptions
· Receiving of telephone orders for controlled
Task Force Members agreed that the first three items listed were appropriate for exclusion, however there was lengthy discussion on the last three. Most of the Task Force felt that if technicians can receive telephone orders for non-controlled substances, why shouldn’t they be able to transfer the same? Concerns for receiving controlled substance prescriptions by telephone were based on the added opportunity for diversion and the reluctance to verify with the prescriber. Administration of immunizations seemed relatively reasonable as a task technicians could be trained to undertake but concerns were aired by the Medical Society representative over the expansion of the scope of practice. The Medical Society is opposed to any expansion of other professions’ scope of practice at this time. More discussion with a revised proposal for draft changes to the Practice Act will be discussed in April. ■