Collaborative practice agreement

According to healthcare researcher Karen E. Koch, the first coining of the term "collaborative drug therapy management" can be traced back to William A. Zellmer's 1995 publication in the American Journal of Health-System Pharmacy.

[1] Zellmer advocates use of the term "collaborative drug therapy management" instead of "prescribing," arguing that it will make legislation that expands the authority of pharmacists more palatable to lawmakers (and physician stakeholders).

Most importantly, it centers the discussion on why pharmacists are interested in expanding that authority: to improve patient care through interdisciplinary collaboration.

[2] The modern concept of collaborative practice was derived, in part, to avoid the controversial term of dependent prescribing authority.

[11][12] This would allow pharmacists to be reimbursed through Medicare Part B for providing healthcare services in federally-defined medically underserved communities.

It has been shown that pharmacists working with providers under CPAs help deliver higher quality of care in the oncology setting, including the management of antiemetic (anti-vomiting) therapy.

Notably, pharmacists do not need to participate in CPAs to provide many pharmacy practice services that are already covered by their traditional scope of practice, such as performing medication therapy management, providing disease prevention services (e.g. immunizations), engaging in public health screenings (e.g. screening patients for depressive disorders, such as major depressive disorder, via administering the PHQ-2), providing disease-state specific education (e.g. as a certified diabetes educator), and counseling patients on information regarding their medications.

[23] Alaskan CPAs allow pharmacists to "monitor drug therapy" pursuant to 12 AAC 52.995, which includes conducting a full patient history, measuring vital signs, and ordering/evaluating CPA covered laboratory tests.

[26] On October 1, 2013, CA Governor Jerry Brown signed Senate Bill 493 that elevates a pharmacist's role to healthcare provider status, granting them authority to provide hormonal contraceptives, nicotine replacement, vaccinations including travel vaccinations which do not require a diagnosis but are recommended by the CDC, medication recommendations, and to order and interpret lab tests to optimize drug therapies.

[46] Under the PPAC, certified Pharmacist Clinician is permitted to register for a personal Drug Enforcement Administration (DEA) number.

In January 2012, the American Pharmacists Association (APhA) convened a consortium composed of pharmacy, medicine, and nursing stakeholders representing 12 states to discuss the integration of CPAs into everyday clinical practice.

[18] In July 2015, the National Alliance of State Pharmacy Associations (NASPA) convened a working group composed of appointees from the CEOs of Joint Commission of Pharmacy Practitioners (JCPP) member organizations, the National Association of Chain Drug Stores, and individual states.

[54][55] In 2015, the American College of Clinical Pharmacy (ACCP) published an updated white paper on the subject of collaborative drug therapy management.

The paper describes the recent history of CPAs, the legislative progress, and discusses payment models for collaborative drug therapy management activities.

[56]In the keynote address of the 2013 APhA annual meeting, Reid Blackwelder, President of the American Academy of Family Physicians (AAFP),[57] advocated for a "collaborative view of health care.

"[58] In 2012, the AAFP produced a position paper that expressed support for CPAs,[59] but stressed the risk of fragmenting care if pharmacists were given fully autonomous prescribing privileges.

"[61] One of the reports was focused on the profession of pharmacy, which criticized the formation of CPAs as an attempt to encroach upon the physician's scope of practice by pharmacists.