Dr Tina Joseph Discusses Collaborative Practice Agreements Between Pharmacists, Physicians

Tina Joseph, PharmD, BCACP, assistant professor, college of pharmacy, Nova Southeastern University, discusses collaborative practice agreements between pharmacists and physicians, as well as the challenges with, and best practices for, successful implementation.

Transcript

What is a collaborative practice agreement, and how is it used among pharmacists?

A pharmacist collaborative practice agreement is a formal agreement between a licensed provider, who would make diagnoses and supervise patient care, and then they can refer to a pharmacist underneath the protocol, and the pharmacist would be able to change medications, stop medications, start anything that they would want to or labs within a specific scope of practice. This is a really great opportunity for pharmacists to leverage their pharmacy services and help coordinate care.

What barriers exist for successful implementation of collaborative practice agreements?

So, there’s a few barriers to implementing collaborative practice agreements. I think the biggest one is having a strong relationship with the provider you want to have a collaborative practice agreement with. The problem with that is it can take a lot of time to develop trust and make sure that the provider feels very comfortable, but it’s a very important step. Some other barriers could be that pharmacists right now don’t have provider status, so it’s very difficult for pharmacists to bill for their services under Medicare Part D.

A few other barriers could be that a lot of patients don’t fully understand the expanded scope of pharmacists, so when you’re interacting with a patient, it may be the first time they’ve interacted with a pharmacist like that. The last barrier is that there’s a lot of different state laws for collaborative practice agreements. So, depending on the state you’re interacting in, you have to really pay attention to every single law that is particular to that state.

What best practices have been identified for successfully implementing collaborative practice agreements?

There are so many best practices or implementing collaborative practice agreement. We have the Asheville Project, we have the Diabetes Ten City Challenge, and time and time again it shows that pharmacists can improve patient care, reduce costs, and help with preventive care. A few of the other studies actually do help to show that physicians are supportive of pharmacists when they have the opportunity to work with them, and I think there’s a big stigma that physicians really don’t respect pharmacists or think that they’re trained enough. But in the experience form that program and also in my own experience, once the pharmacist can get comfortable with the physician, they feel much more comfortable to work with them and sign a collaborative practice agreement.