COVER STORY

LET'S COLLABORATE

Here's how to get more R.Ph.s to use their prescriptive authority, allowed in most states but lagging in practice

Magaly Rodriguez de Bittner, Pharm.D., CDE, has to know geography as well as pharmacy. As the coordinator for Giant Brands' diabetes education program, she works at grocery store pharmacies in Delaware, Maryland, New Jersey, and Virginia. Giant offers the same pharmacy-based diabetes education program in 160 stores, but the pharmacist's role is different in each state.

"Virginia lets pharmacists manage drug therapy by protocol with physicians," Rodriguez de Bittner explained. "I can perform clean waste tests, such as finger sticks, in the store. A mile away in Maryland, I cannot do testing at the store, but the patient can. The patient has to stick his or her own finger in front of me. The different practice acts make it difficult to institute collaborative drug therapy management chainwide. It is very confusing."

The American Pharmacists Association is just as confused. APhA counts 45 states that allow some sort of collaborative drug therapy management (CDTM). ASHP counts 39 and four pending (see table). Either way, each state has its own version of collaborative practice and collaborative practice protocols (CPPs).

List of states by statutory and regulatory authority