Legal Aspects of Pharmacist Prescribing

Even if the plaintiff can prove all the necessary elements of negligence, legal defenses can avoid or reduce liability. Some defences may include a statute of limitations, comparative or contributory fault, informed consent or state immunity. It is important to keep in mind that there may be differences in both types of negligence defenses and insurance coverage for individuals and employers. More information about defence is described in the following sections. This document was written by Mellissa Sager, Staff Counsel, Network for Public Health Law – Eastern Region. The Health Law Network provides information and technical assistance on public health issues. The legal information and assistance contained herein does not constitute legal advice or representation. For legal advice, readers should consult a lawyer in their state. The idea of being sued for something you did while practicing is not pleasant at all. The first thing that comes to mind is how to avoid this.

This question opens the door to an area called risk management, which deals with how risk exposure can be reduced and managed. When it comes to prescribing, a robust process for effective prescribing and consistent compliance with the law is critical to minimizing risk exposure. There are certain steps a pharmacist can take to develop a risk management process, and each step is explained below.14 Figure 1 shows an example of a risk management process used when a pharmacist decides whether or not to participate in the prescribing process. By monitoring treatment, it is possible to determine whether the chosen drug treatment has been successful or whether additional measures are needed. There are two types of monitoring plans discussed in the literature. Passive monitoring involves explaining to the patient what to do if the treatment is ineffective, troublesome or has too many side effects. In this case, monitoring is carried out by the patient and the prescribing physician is only contacted if the patient has a drug treatment problem. Active surveillance means that the prescribing physician makes an appointment to determine if the treatment has been effective. In this situation, the prescribing physician should set a monitoring interval, which depends on the type of disease, the duration of treatment and the maximum amount of medication to be prescribed, before a new visit is necessary. At the beginning of treatment, the interval is usually short, but may gradually lengthen if necessary.6 If a pharmacist prescribes, a passive monitoring approach may be more desirable if over-the-counter products or perhaps even oral contraceptives are recommended.

For chronic disease treatment, active surveillance is the most acceptable approach. Certainly, it should be kept in mind that obtaining a pharmacist`s license does not mean that you are competent or practical to prescribe medication. It`s important from a social and personal point of view. Many states impose requirements on pharmacists entering into prescription agreements. This included obtaining certification in a particular area of practice, completing a residency program, specific continuing education programs, or previous experience with a collaborative arrangement prior to self-prescribing.1,16 Board certification in a specialty means that the individual has acquired additional knowledge, skills and experience in a defined area of pharmaceutical practice. Board certification is a way to show society that a person has a certain high level of expertise in addition to that of a general practitioner. Prior to entering into a practice agreement, a pharmacist may consider obtaining board accreditation to gain additional knowledge and skills. These changes are made by state laws in a variety of ways, all of which are aimed at improving access to certain medications.

Some states, such as Maryland (for hormonal birth control) and Maine (for nicotine replacement therapy) have added the ability to “prescribe” directly to the definition of pharmacy practice. Other state laws, such as California`s, have had a similar effect by using words like “establish” or “order” instead of “prescribe.” New Mexico and Colorado have taken a slightly different approach, allowing pharmacists to provide certain health services under statewide protocols developed by the Board of Pharmacy. This approach provides the board with linguistic flexibility as well as the ability to make changes, including changes to the type of medications a pharmacist can prescribe by regulation rather than by state law. Questions have also been raised about whether providing ID via social media amounts to an unauthorized practice in a state where the pharmacist is not licensed. In addition, patient-specific harmful advice may result in malpractice. Some pharmacists have placed a warning on their blog to emphasize: “Reading this blog should not be interpreted to mean that you and I have a pharmacy-patient relationship.” In addition to confidentiality and negligence issues, other liabilities for defamation, copyright infringement, discrimination or harassment may follow. In Libertelli v. Hoffman La Roche, Inc. & Medical Economics Co., the plaintiff became addicted to diazepam (Valium®) and sued the publisher of the Physician`s Desk Reference (PDR).55 The claim was based on the absence of caveats in the PDR regarding the addictive nature of the drug. The court dismissed the action against the publisher. In a long series of cases, a publisher is not responsible for matters of public interest if he does not know of his lie. Although some effort must be made to verify the results of the research, the pharmacist cannot be held responsible for knowing and verifying the content of all sources, whether printed or online.

However, it is advisable to check a second reference to verify the information. The state law giving pharmacists the ability to prescribe drugs appears to follow the same path as the vaccination legislation administered by pharmacists in the mid-1990s. In 1995, only nine states allowed vaccination of pharmacists. Today, pharmacists have the authority to administer vaccines in all 50 states, the District of Columbia and Puerto Rico. As vaccination campaigns expanded in pharmacies during the same period, the number of people vaccinated increased significantly. The anticoagulation clinical pharmacist receives a prescription for enoxaparin from a patient receiving warfarin. The patient`s current INR is 5.2. The anticoagulant pharmacist is a certified pharmacotherapy specialist (BCPS). The pharmacist delivers the enoxaparin and the patient is injured. Ms.

D is one of 2 pharmacists in an Indian Health Service (IHS) unit in Oklahoma. Familiarity with community members who recently died from a prescription drug overdose brought Ms. D. Focus more on preventing the abuse and misuse of prescription drugs. For example, he recently reviewed the pharmacy section of the Indian Health Handbook, which outlines the standards of practice and mission to “ensure effective, safe and cost-effective drug treatment.” 1 Since her license to practice pharmacy is from the State of Ohio, Ms D. also examined the section of the State Board of Pharmacy of the Ohio Administrative Code concerning the “appropriate responsibility”2 of prescribing and dispensing pharmacists to prescribe patients correctly. American Association of Pharmacists. Code of ethics for pharmacists. Adopted on 27 October 1994. Retrieved January 21, 2020.

www.pharmacist.com/code-ethics pharmacists are trained to optimize medication utilization and improve public health outcomes. When pharmacists are part of the healthcare team, they can help improve medication use and adherence, expand access to care, and reduce health care costs. Pharmacy practice is increasingly shifting from dispensing medications and patient counseling to patient-centred and team-based care in a variety of health care settings. A limited number of providers, costs of care, limited time and limited mobility reduce a person`s ability to access primary care. One of the ways states have begun to address this issue is by adjusting the scope of practice of pharmacists, giving appropriately trained pharmacists the opportunity to become providers themselves and prescribe specific medications to specific patients who otherwise would not be able to receive care. It is important for pharmacists who offer the CEW to be aware of the emerging legal issues surrounding the ACTD, such as the erosion of the intermediate doctrine taught and the transfer of responsibility to pharmaceutical manufacturers.89 In addition, the erosion of the learned intermediate rule, as Perez has shown, and the transfer of physician responsibility have profound implications for pharmacists. Increasingly, the courts have a view that pharmacists have an obligation to warn and intervene on behalf of patients. In 1991, the Mutual Pharmacists` Mutual Society did not report any claims related to the review of drug use.

In 1999, Drug Review claims accounted for 9% of all pharmacist liability claims. A 2002 study by the same company found that claims about drug reviews continued to increase linearly.90 In 2010, drug claims were the largest category of intellectual errors (as opposed to mechanical or administrative errors) at 7.9%. Requests for consultancy services account for 1.6 per cent of all claims.91 Is responsibility for FDI a rhetorical assumption or a real possibility? The responsibility of pharmacists providing the ID goes beyond that of the simple information broker, the person between the producer of the information and the user. According to studies published for IA centres, between 41% and 83% of the information requested is patient-specific or evaluative in nature.63 In addition to the responsibility for negligent collection and dissemination of information, the pharmacist`s role includes interpretation, evaluation and advice.