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Should Pharmacists Prescribe Prescription Medications?

Discussion in 'Pharmacy' started by Dr.Scorpiowoman, May 7, 2017.

  1. Dr.Scorpiowoman

    Dr.Scorpiowoman Golden Member

    May 23, 2016
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    Pharmacists serve a very important function in our healthcare system. With their guidance and expertise, they monitor and dispense millions of medications that medical providers prescribe daily. Their expertise regarding drug interactions and dosing schedules serve as a careful check and balance system to identify dangerous and potentially fatal interactions.

    Recently, a proposal was brought to the FDA to create and develop a third drug category which would allow pharmacists to dispense drugs for “nonprescription use” that previously would have required a medical provider's prescription. According to the Federal Register ( ), “some drug products that would otherwise require a prescription could be approved as nonprescription drug products with some type of pharmacist intervention as their condition of safe use.” As an example, a pharmacist could make a recommendation regarding appropriate drug therapy, based on results of testing for cholesterol or triglycerides. Other proposed potential roles include “assessing whether the consumer has any conditions or other risk factors that would indicate whether a drug should be not be used, or assisting the consumer in choosing between various drug products”.

    The rationale for this new proposal ultimately stems from the concern that many people with chronic medical conditions (asthma, migraine headaches, high blood pressure, and high cholesterol) are currently under treated- and since they walk into pharmacies asking their pharmacists for advice, why not allow the pharmacists to dispense medications to treat these prevalent conditions. As we all know, many people already place a significant level of trust in their local pharmacist, especially in instances when it may be impossible to speak to a medical provider.

    The American Academy of Family Physicians (AAFP) recently wrote a letter of opposition ( (5/2/12) to this proposal stating that this practice could both “endanger patients and harm patients' relationships with their physicians”. The AAFP felt that this was a dangerous practice by allowing pharmacists to prescribe powerful medications without any input from their physicians.

    I can certainly appreciate a pharmacist prescribing an inhaler to an asthma patient who is in acute distress in a pharmacy, or an Epipen auto injector to a person with an acute life threatening allergic reaction standing in line at a pharmacy counter. However, I agree that the practice of allowing pharmacists to routinely prescribe certain classes of drugs has the potential to create an unsafe practice in certain subgroups of patients with multiple medical problems.

    In my view, the potential for an unfavorable outcome exits in the context of the practice which has been proposed to the FDA. The proposed practice of allowing pharmacists to prescribe so called “routine medications” under this proposal, has the net effect of blurring the lines in the traditional relationship between patients, medical providers, and pharmacists. The practice of clinical medicine is still an art, and as such, requires a medical provider's judgment and expertise to determine if and when a medication is indicated.


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