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Revisiting the continuum of pharmacist prescriptive authority.

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    Pharmacists across the US possess prescribing authority, categorized as dependent or independent. Independent prescribing, particularly "standard of care" models, offers expanded authority and is evolving rapidly, impacting patient care.

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    Area of Science:

    • Pharmacy Practice
    • Health Policy
    • Clinical Pharmacy

    Background:

    • Pharmacists in all US states hold some form of prescriptive authority.
    • Pharmacist prescribing models exist on a spectrum from dependent to independent.

    Purpose of the Study:

    • To categorize and analyze the different models of pharmacist prescriptive authority.
    • To examine the evolution and implications of independent pharmacist prescribing.

    Main Methods:

    • Identification and categorization of pharmacist prescribing authority models.
    • Analysis of state-level legislative and regulatory innovations in pharmacist prescribing.

    Main Results:

    • Two primary categories of pharmacist prescribing identified: dependent and independent.
    • A continuum of prescribing authority exists, with independent prescribing showing recent innovation.
    • At least three states have adopted "standard of care" frameworks for broad pharmacist prescribing, including diagnosis-requiring conditions.

    Conclusions:

    • Different models of pharmacist prescriptive authority present distinct advantages and disadvantages for patient care.
    • The trend towards independent prescribing, especially "standard of care" models, represents a significant shift in pharmacy practice and patient access to care.