Running the provider status marathon

Will 2017 be the year? Student pharmacists are not sitting around waiting to see. Instead, we are busy crafting new policy, advocating on Capitol Hill, and proving that pharmacists’ roles will continue to expand as essential members of the health care team. By now, you have probably learned that obtaining provider status is more like a marathon than a sprint. Consider the information that lies ahead as another checkpoint along the marathon course.


Pharmacist-prescribed 
hormonal contraception


One of many ways that student pharmacists continue to pave the way for the profession is by advocating for pharmacist involvement in reproductive health services. In 2007, Sally Rafie, PharmD, BCPS, then a student pharmacist and now pharmacist specialist, assistant clinical professor, and founder of the Birth Control Pharmacist and The Pharmacists Clinic, assessed student pharmacists’ opinions on providing hormonal contraception services in their future practices. Of the 502 students surveyed, 96% reported interest in providing hormonal contraception services to both minors and adults.


Fast forward a decade, and three states—Oregon (HB 2879), California (SB 493), and most recently, Colorado (SB 16-135)—have passed legislation allowing pharmacist-prescribed hormonal contraception. Following the completion of online training administered by their respective boards of pharmacy, pharmacists in these states may provide hormonal contraceptives without first consulting a physician. 


Each state follows a similar, simple five-step process: first, the patient fills out a self-screening questionnaire regarding their medical history; second, the pharmacist reviews the answers and clarifies any uncertainties; third, the patient’s blood pressure is measured and recorded; fourth, the pharmacist ensures the patient understands how to take the prescribed contraceptive; and finally, the patient is provided information regarding the importance of preventive health screenings and other pertinent reproductive health counseling points. While barriers such as lack of private counseling areas, inadequate access to patient health information, and a need for innovative practice and payment models may contribute to the slow adoption of similar policies nationwide, it is clear that the collective voice of student pharmacists has the power to meaningfully have an impact on pharmacy practice.


The Academy takes action


As an Academy, student pharmacists voted during the APhA–ASP House of Delegates to adopt resolution 2016.4, which calls for increased access to pharmacist-prescribed medications not limited to hormonal contraception. The resolution reads as follows:


2016.4—Increasing Patient 
Access to Pharmacist-Prescribed Medications


1. APhA–ASP encourages legislative and regulatory changes that would enable pharmacists, with appropriate training and working as integral members of the health care team, to assess the patient and prescribe certain medications such as those for opioid overdose, contraception, tobacco cessation, and international travel.


2. APhA–ASP encourages the development of sustainable and financially viable compensation models for pharmacist-prescribed medications.


Make a difference


• Here is how you can get involved. 

• Be familiar with your state’s scope of practice. Can pharmacists prescribe contraception in your state? If so, what types of contraception and what does the screening process entail? What is your state’s naloxone protocol? Are pharmacists in your state allowed to prescribe tobacco cessation products or travel antibiotics? 

• Explore resources provided by the CDC, pharmacy associations, your employer, and fellow practitioners, such as www.birthcontrolpharmacist.com, to meet your state’s training requirements and better prepare yourself to provide these services in your community.
• Work with your state association to see how student pharmacists can play a role in presenting a bill similar to those passed in California, Colorado, and Oregon and/or developing associated protocols.
• Continue to advocate for provider status by writing to and/or meeting with your legislators and talking to your patients about the services pharmacists can provide.

Following the 2016 APhA–ASP House of Delegates, resolution 2016.4 was forwarded to the APhA Policy Committee for consideration in the 2017 APhA House of Delegates. This March, the APhA House of Delegates adopted a policy similar to resolution 2016.4 titled “Patient Access to Pharmacist-Prescribed Medications.” To read the full policy statement, please visit www.pharmacist.com/apha-house-delegates.