How Do Pharmacist Prescribing Regulations Differ In Each State?
Pharmacists have been given the authority to prescribe certain categories of medications to increase the accessibility of healthcare. Under pharmacist prescribing regulations, they are required to meet predetermined conditions and criteria to obtain prescriptive authority.
It was in 1993 that pharmacists were allowed to prescribe in New Mexico when the state passed legislation to widen the state’s primary care response. Today, all 50 states have authorized pharmacists to prescribe, following the pharmacist prescribing regulations.
This article teaches the different pharmacist prescribing regulations, such as statewide protocol, category-specific prescribing, and statewide standing orders. You’ll also learn what a protocol standing order is.
What’s In The Article?
What Is A Protocol?
What Is A Standing Order?
What Is Autonomous Prescribing?
Statewide Protocol
Unrestricted (Category‐Specific)
Statewide Standing Orders
Statewide Protocols Vs. Statewide Standing Orders: What’s the difference?
Final Thoughts
What Is A Protocol?
Protocols are a set of criteria or procedures that pharmacists should carry out when providing prescriptions to patients. These standards help them take appropriate action and respond in a given situation to manage patients effectively. Protocols also determine the required training and education for pharmacists to be eligible for prescriptive authority.
What Is A Standing Order?
Standing orders are procedures ordered by a physician or medical director that specify criteria that healthcare workers must carry out when providing medical care and other clinical tasks.
What Is Autonomous Prescribing?
Autonomous or independent prescribing is the authority given to pharmacists that allows them to solely prescribe for any medical condition wherein permission from other healthcare providers, such as physicians, is not required.
Pharmacists can inform or consult other practitioners, but the decision of what to prescribe depends on the pharmacists. Autonomous prescribing is also less restrictive than collaborative prescribing.
Autonomous prescribing comes in three prescriptive authorities - statewide protocol, unrestricted (category-specific) prescribing, and statewide standing orders.
Statewide Protocol
A statewide protocol is one of the pharmacist prescribing regulations that allows all licensed pharmacists who meet the eligibility requirements to prescribe certain medications under a protocol released by an authorized organization in the state.
This protocol differs from each state and indicates the conditions and criteria pharmacists are allowed to prescribe, such as their education and training requirements, the specified medication they can prescribe, and the procedures they must follow.
While protocols differ from the state, the National Alliance of State Pharmacy Associations (NASPA) and the National Association of Boards of Pharmacists (NABP) established the Statewide Protocol Workgroup that released the
This workgroup has recommended that the statewide protocols should include the following core components:
The authorized medications that pharmacists can prescribe
Patient inclusion criteria
Training or
required for pharmacists
Communication requirements
Documentation and records that should be maintained
Here are some medications that pharmacists can prescribe under the statewide protocols:
Unrestricted (Category‐Specific)
Unrestricted or category-specific prescribing is the least restrictive among the pharmacist prescribing regulations. It has allowed pharmacists to prescribe certain medications without restrictions from an authorized body in the state. Under this regulation, pharmacists can prescribe freely based on clinical guidelines.
Statewide Standing Orders
Several states in the US have allowed pharmacists to prescribe certain medications like Naloxone, tobacco cessation products, and hormonal contraceptives through a statewide standing order.
Statewide standing orders are predetermined conditions with the state’s public health official’s approval that pharmacists should follow when prescribing. This is one of the pharmacist prescribing regulations in the US that allows pharmacists who meet the conditions to prescribe medications under the guidelines specified for all patient needs.
Statewide Protocols Vs. Statewide Standing Orders: What’s the difference?
The difference between these pharmacist prescribing regulations is that standing orders require re-implementation if the public health official leaves the position and a new officer is assigned.
Statewide protocols are issued by an authorized organization in the state, such as the board of pharmacy, while the state’s public health officer signs statewide standing orders.
Final Thoughts
The different pharmacist prescribing regulations have widened the authority of eligible pharmacists, expanded their healthcare knowledge, and provided easier access to the community. It helps prevent harmful effects and serious cases of many public health problems.