Chapter 29. Drug Therapy Management

“Amendment” means a change to:

“Applicants” means physicians, pharmacists, podiatrists, or certified advanced practice nurses with prescriptive authority submitting a prescriber-pharmacist agreement and protocol to their respective Boards.

“Authorized prescriber” means a licensed physician, licensed podiatrist, or certified advanced practice nurse with prescriptive authority under Health Occupations Article, §8-508, Annotated Code of Maryland.

“Boards” means the Board of Physicians, the Board of Pharmacy, the Board of Podiatric Medical Examiners, and the Board of Nursing.

“Condition” means a disease-state or health circumstance necessitating monitoring or intervention.

“Emergency first care” means triage of emergent conditions or treatment of the condition in those cases in which a protocol specifies treatment for the emergent condition.

Be:

Contain the following:

The modification, continuation, and discontinuation of drug therapy;

The ordering of laboratory tests;

Other patient care management measures related to monitoring or improving the outcomes of drug or device therapy; and

For protocols by a licensed physician and licensed pharmacist, the initiation of drug therapy under written, disease-state specific protocols.

The names and signatures of the physicians, podiatrists, or certified advanced practice nurses with prescriptive authority and pharmacists authorized to act under a therapy management contract;

The locations where the pharmacists may provide therapy management services;

The titles of the protocols to which the prescriber-pharmacist agreement pertains;

The methods and time frames by which documentation and routine communication will occur between the physicians, podiatrists, or certified advanced practice nurses with prescriptive authority and the pharmacists, including the time frames in which the pharmacist will fully update the patient’s record in writing;

The name, address, and telephone number of the party to the prescriber-pharmacist agreement who is to receive correspondence from the Boards related to the prescriber-pharmacist agreement;

A statement that the physicians, podiatrists, or certified advanced practice nurses with prescriptive authority and pharmacists shall comply with all State and federal laws relating to patient confidentiality; and

A list of devices available to the pharmacists performing under the prescriber-pharmacist agreement, which are relevant to the disease-states or conditions to be managed.

Shall be licensed by and in good standing with the Board of Pharmacy;

Shall possess a Doctor of Pharmacy degree or equivalent training as established in §B of this regulation;

May not have:

Shall possess relevant advanced training as indicated by one of the following:

Shall have successfully completed:

Shall document training related to the disease state specified in the protocol.

Designing, implementing, monitoring, evaluating, and modifying or recommending modifications in drug therapy to insure effective, safe, and economical patient care;

Identifying, assessing, and solving medication-related problems, and providing clinical judgments as to the continuing effectiveness of individualized therapeutic plans and intended therapeutic outcomes;

Conducting appropriate physical assessments, evaluating patient problems, and ordering and monitoring medications and laboratory tests in accordance with established standards of practice;

Monitoring patients and patient populations regarding the purposes, uses, effects, and pharmacoeconomics of their medications and related therapy;

Providing emergency first care, including cardiopulmonary resuscitation;

Using clinical data to optimize therapeutic drug regimens; and

Documenting interventions and evaluating pharmaceutical care outcomes.

The prescriber-pharmacist agreement;

Subsequent amendments made to the:

Changes to participants of the:

The prescriber-pharmacist agreement;

Subsequent amendments made to the:

Changes to participants of the:

Authorized prescriber; and

Pharmacist.

Modifies the dose or agent under the therapy management contract;

Detects an abnormal result from an assessment activity; or

Initiates drug therapy under a written, disease-state specific protocol, for protocols by a licensed physician and pharmacist.

Authorized prescriber or authorized prescribers involved in the management of the patient under a prescriber-pharmacist agreement;

Pharmacist or pharmacists involved in the management of the patient under a prescriber-pharmacist agreement; and

Patient receiving care under the therapy management contract.

A list of allowable substitutions of chemically dissimilar drugs, if any;

A statement that:

Notice to the patient stating:

A procedure for periodic review by the authorized prescriber of the drugs modified under the prescriber-pharmacist agreement or changed with the consent of the authorized prescriber;

A reference to the protocol or protocols under which the pharmacist shall act; and

Exceptions or limitations to the protocol or protocols for the specific patient.