288-290 Wells

Collaborative Agreements The degree of authority to write prescriptions delegated to pharmacists varies by state, depending upon the legislation governing pharmacy practice and its interpretation. Generally, however, collaborative agreements allow pharmacists to prescribe and dispense certain drug therapies directly to clients. Currently, 22 states allow pharmacists to prescribe directly or adjust medications through collaborative agreements, which have worked well for immunizations and management of drug therapy for pain relief, as well as for other therapies. The scope of collaborative agreements can be wide or relatively circumscribed. In some states, regulations limit pharmacists’ authority to a specific formulary of drugs that can be dispensed by the pharmacist directly, according to state-authorized protocols. In other states, pharmacists have the right to prescribe a wide range of medications, as long as they have developed collaborative agreements with licensed prescribers that include a specific prescribing protocol for each medication. These protocols are used as the basis for delegating prescriptive authority, and are generally submitted to and reviewed by the State Board of Pharmacy. Once an agreement for a particular therapy is established, the pharmacist can use the agreement to prescribe that therapy to any patient who has a need for it and who meets the screening criteria outlined in the protocol. Health outcomes are improved when pharmacists are actively involved in patient care, according to studies conducted within the past 30 years.1 Furthermore, a Elisa S. Wells and Jane Hutchings are senior program officers and Jennifer L. Winkler is program associate at the Program for Appropriate Technology in Health (PATH), Seattle. Jacqueline S. Gardner is associate professor, University of Washington Department of Pharmacy, Seattle. Don Downing is pharmaceutical care coordinator, Washington State Pharmacists Association, Renton, WA, and assistant professor of pharmacy, University of Washington Department of Pharmacy. Timothy S. Fuller is consultant to the Washington State Board of Pharmacy, Olympia. Rod Shafer is executive director of the Washington State Pharmacists Association. The David and Lucile Packard Foundation provided financial support for this project. Using Pharmacies in Washington State To Expand Access to Emergency Contraception