Pharmacist Prescribing: The Time Has Come

Is there a place for pharmacists to assume a prescribing role?

The September 15, 2016, edition of the journal of the American Society of Health-System Pharmacists (ASHP) was devoted to the theme of pharmacist prescribing.

In one editorial, 3 ASHP staff members suggested that “pharmacists are the most qualified to be responsible and accountable for prescribing, monitoring, and modifying drug therapy, in many situations, once a diagnosis is made. Simply stated, as members of the same interprofessional team, physicians should diagnose and pharmacists should prescribe.”

They also suggested that “utilizing pharmacists as the health care team members who are responsible and accountable for prescribing medications is a critical step on our path to accomplishing…a safer and more accessible, effective, and efficient” health care system for the patients we serve. Of course, they recognized that this recommendation should be limited to appropriately trained and credentialed pharmacists.

I’ve been interested in this topic for quite some time. About 40 years ago, some colleagues and I worked out a program between UNC’s pharmacy school and Duke University’s physician assistant (PA) program to place selected student pharmacists in a joint program. With one additional year of training, graduates got both a PA degree and a BS in Pharmacy degree. Unfortunately, when they graduated, there weren’t any jobs that enabled them to incorporate both roles, so most of the graduates became either PAs or pharmacists, and we ended up discontinuing the program.

I think things would be different if such a program were reinstated today. These graduates would be able to step into chronic disease management roles with a large amount of professional autonomy. They’d still need to be part of an interdisciplinary team, but could assume a much broader role in patient care, especially in underserved areas.

With the large number of pharmacy programs on campuses that also have PA programs, such a program could be easily initiated. Rather than a joint PharmD/MBA or PharmD/JD, is it time to consider a joint PharmD/PA program? I think so.

Reference

Abramowitz PW, et al. The time has come: increased prescribing authority for pharmacists. AJHP. 2016;73(18):1386-1387.