Kentucky pharmacists have new authorities to improve patient, public health

Pharmacist services are outlined in approved protocols

Patients in Kentucky who are concerned about a urinary tract infection, influenza, or strep throat will now have the ability to seek treatment and related professional services for these conditions and a host of others from a pharmacist who is acting under the direction of a prescriber.

The new authorities were part of a 2-year effort to revise Kentucky’s pharmacy practice act with new board authorized protocols. The Kentucky legislature passed legislation in 2016 and the accompanying regulation was approved in late 2017, which set the stage for Kentucky pharmacists to provide certain services that have been outlined in a specific care protocol. The regulation states that a pharmacist can initiate the dispensing of non controlled or OTC medication and related professional services.

Procedures, set by the Kentucky Board of Pharmacy, are being established for these authorized conditions:

  • Acute influenza (pursuant to recommendations by CDC)
  • Acute streptococcal pharyngitis infection
  • Acute, uncomplicated urinary tract infection
  • Acute mucocutaneous fungal infection
  • Allergic rhinitis
  • Anaphylaxis
  • HIV infection prevention through pre-exposure prophylaxis (pursuant to recommendations by CDC)
  • Nutritional supplementation with vitamins and minerals
  • Opioid use disorder (pursuant to recommendations by the American Society of Addiction Medicine)
  • Travelers’ health (pursuant to recommendations by CDC)
  • Tuberculosis prevention and control through skin testing and referral as necessary (pursuant to recommendations by CDC)
  • Self-care conditions appropriately treated with OTC medications and products
  • Tobacco use disorder

More conditions will be added as well, according to Trish Rippetoe Freeman, RPh, PhD, director of the Center for the Advancement of Pharmacy Practice at the University of Kentucky.

“Right now, we want to give pharmacists time to find prescribers to enter into the protocol agreements with and really start implementing this and then see if we need to make other changes in the regulation before we go and try to amend it,” she said.

Protocols for opioid use disorder, self-care with diabetes testing supplies, and tobacco use disorder have been approved and are currently available on the Kentucky Board of Pharmacy website. Protocol templates for acute influenza, acute streptococcal pharyngitis infection, travelers’ health, tuberculosis prevention and skin testing will be before the board for approval at a March meeting, and others are under development.

In Kentucky, pharmacists have long collaborated with prescribers to provide immunization services via protocol. More recently, they’ve been able to do it with naloxone.

In addition to the prescriber approved protocol, the new regulation says that pharmacists must document that they have received education and training in the subject matter of the protocol prior to initiation. The Kentucky Pharmacists Association (KPhA) is leading the effort to make sure pharmacists have the needed training, tools, and resources to successfully carry out these new services.

Freeman, who is also chairman of KPhA’s Board of Directors, said working collaboratively was key to establishing the new regulation. The Advancing Pharmacy Practice in Kentucky Coalition, an advocacy group that included KPhA, the Kentucky Society of Health System Pharmacists, the Kentucky Board of Pharmacy, the American Pharmacy Services Corporation, the Sullivan University College of Pharmacy and the University of Kentucky College of Pharmacy’s Center for the Advancement of Pharmacy Practice, was critical in advancing the effort.