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The neighborhood pharmacist has played a critical role in American towns for centuries. People usually see their pharmacists more often than their family doctor. These professionals understand medications, dosages and drug interactions.
If a physician writes a patient an incorrect prescription, a pharmacist is the last line of defense to ensure that the patient stays safe. This raises the question: Why are these pharmacists not allowed to prescribe medications in certain situations?
While some states allow pharmacists to prescribe specific medications such as flu shots or contraceptives without the patient needing a script from a doctor’s office, these exceptions are not common. Restrictions to prescribing authority mean pharmacists’ knowledge and skills are left underutilized.
In 2018, Idaho became the first state to allow pharmacists to prescribe a broad range of medications, such as rescue inhalers for asthma patients or insulin pens for diabetics. In a new working paper, I discuss the effects of this important policy change in Idaho. The conclusion:
“This expansion allows pharmacists to prescribe a limited set of medications for minor or time-sensitive conditions, such as albuterol sulfate for asthma or insulin pens for patients with diabetes. Using prescriber data from Medicare Part D files, we found that approximately one additional Medicare beneficiary per pharmacist received albuterol sulfate and two received insulin pen needles annually after the expansion of prescriptive authority for pharmacists. In aggregate, this represents hundreds of patients who can access time-sensitive care from pharmacies, which are much more common in rural and underserved areas than are specialized physicians.”
Many rural and other communities don’t have a lot of healthcare options, with hospitals and specialized doctors sometimes hundreds of miles away. The federal government refers to them as Health Professional Shortage Areas, meaning there’s an inadequate number of physicians and other clinicians offering primary care services.
Yet nearly all these underserved areas have at least one pharmacy available within a 10-mile drive. If states would allow pharmacists to prescribe basic medications to help patients manage routine and minor conditions, access to care in these communities would greatly increase.
Some will argue that pharmacists are not qualified to prescribe medications. But let’s take a close look at their credentials: To become a pharmacist, a practitioner needs to secure a Doctor of Pharmacy degree. The Pharm.D. is a professional degree similar to a Doctor of Dental Surgery or Doctor of Nursing Practitioners. To earn a Pharm.D., an aspiring pharmacist must take four years of undergraduate coursework, followed by four years of graduate-level coursework in biology, chemistry and pharmacology. Licensed pharmacists also must stay up to date with the newest medications, with most states requiring they obtain a minimum of 30 hours of continuing education credits every two years.
Having increased access to necessary medications close to home is essential to keep patients on track to manage their health needs, especially for asthma, diabetes or dozens of other routine chronic conditions. It would save resources for health systems, keep more emergency room beds open and lessen the financial burden on Medicare and Medicaid.
Idaho should serve as a prime example to policymakers in other states regarding the role pharmacists can play as a more empowered part of the medical care team, and how simple changes to regulation, such as allowing practitioners to utilize the full extent of their training, can help save lives.
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