Pharmacist Prescribing: “Test and Treat”

There is growing policy interest in pharmacist prescribing based on the results of a rapid diagnostic test.

Current Landscape:

  • Direct Prescribing Authority:
    1. Arkansas (2021): can treat, via statewide protocol, health conditions that can be screened utilizing CLIA-waived tests
    2. Colorado (2021): can prescribe drugs for conditions that have a test used to guide diagnosis or clinical decision-making and is CLIA-waived
    3. Delaware (2022): can order, test, screen, and treat, pursuant to a statewide protocol, health conditions including flu, strep, COVID, other respiratory diseases, lice, certain skin conditions, and other existing or emerging public health threats when identified and permitted.
    4. Idaho (2018): can prescribe drugs for conditions that have a test used to guide diagnosis or clinical decision-making and is CLIA-waived
    5. Iowa (2021): can prescribe, via statewide protocol, tests and treatment for flu, strep, and COVID
    6. Kansas (2022): can initiate treatment, via statewide protocol, for flu, strep, and UTI
  • Delegated Prescribing Authority/Collaborative Practice Agreements:
    1. Beyond direct statewide prescribing authority, many states have CPA authority broad enough to allow pharmacists to prescribe pursuant to a rapid diagnostic test. Based on NASPA’s research, these states include:
      • Florida*, Idaho, Illinois, Kentucky*, Michigan, Minnesota, Montana, Nebraska, New Mexico, North Dakota, South Dakota, Tennessee, Texas, Utah, Vermont, Washington, Wisconsin (17)
    2. Florida (2020) allows pharmacists test and treat for minor, nonchronic conditions (including strep and flu) under a protocol with a physician. Because the protocol requires a physician’s signature, it functions more as a CPA than a statewide protocol.
    3. Kentucky allows pharmacists to use board approved protocols to test and treat for flu, strep, UTI, and other conditions. Because all of the protocols require a physician’s signature, they function more like CPAs than statewide protocols.

NASPA Pharmacy-based Point-of-Care Test & Treat National Certificate Program

Research Articles:

Other Resources:

 

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