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Pathways to pharmacist prescriptive authority: Do decentralized models for expanded prescribing work?
Alex J Adams1, Timothy P Frost2
1Idaho Division of Financial Management, 4537 N Molly Way, Meridian, ID, 83646, USA.
Research in Social & Administrative Pharmacy : RSAP
|July 29, 2021
Summary
Decentralized state-level approaches can expand pharmacist prescribing authority. The board of pharmacy and pharmacist-determined models show success in enabling broader pharmacist prescriptive authority.
Area of Science:
- Health Policy
- Pharmacy Practice
- Public Health
Background:
- State-level scope of practice decisions, particularly regarding pharmacist independent prescriptive authority, are frequently debated.
- Five states (Florida, New Mexico, Colorado, Idaho, Oregon) have implemented decentralized structures to potentially expand pharmacist prescribing authority.
- These decentralized approaches aim to expedite the expansion of pharmacist prescribing to meet public health needs.
Purpose of the Study:
- To analyze decentralized models for expanding pharmacist independent prescriptive authority.
- To identify which of these models have been most effective in practice.
- To inform stakeholders considering similar legislation.
Main Methods:
- Identification and categorization of four distinct decentralized models for pharmacist prescribing.
- Evaluation of the restrictiveness and practical application of each model.
- Assessment of the success of these models in enabling broad pharmacist prescribing.
Main Results:
- Four models were identified: medical veto, interdisciplinary committee, board of pharmacy, and pharmacist-determined, ordered from most to least restrictive.
- These models primarily focus on postdiagnostic and preventive care.
- Only the board of pharmacy and pharmacist-determined models have proven successful in enabling broad pharmacist prescribing.
Conclusions:
- Decentralized models offer a pathway to expand pharmacist prescriptive authority more rapidly than legislative action.
- The board of pharmacy and pharmacist-determined models are most effective for broad expansion of pharmacist prescribing.
- Stakeholders should consider the success of these decentralized models when developing new legislation.
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