Note to Texas Physicians and Pharmacists: New Statute Allows Limited Delegation of Drug Therapy "Decision Making" to Pharmacists Regarding Dangerous Drugs:
Texas physicians and pharmacists should be aware of a set of new laws passed by the 81st session of the Texas Legislature which allows a doctor to delegate drug therapy decisions to pharmacists in certain limited situations. Senate Bill No. 381 adds new sections to both the Medical Practice Act and Pharmacy Act implementing this new option for physicians and pharmacists. How the Texas Medical Board and the Texas State Board of Pharmacy will regulate / police this area remains to be seen.
The key features of the new law are as follows:
- It is limited to dangerous drugs only, not scheduled medications;
- The delegating physician is required to have previously made an initial diagnosis and patient assessment and also formulated a medication plan;
- The pharmacist must practice in a hospital, hospital-based clinic, or an academic health care institution;
- The pharmacist's place of employment must have both bylaws and a medical staff policy that permits a physician to delegate to a pharmacist the management of a patient's drug therapy;
- The pharmacist must provide both the delegating physician's and the pharmacist's contact information on each prescription signed by the pharmacist; and
- The pharmacist must provide a copy of the delegation protocol to the Texas State Board of Pharmacy for their approval.
The Pharmacy Board will also maintain a publically available list of pharmacists authorized to sign a prescription drug order pursuant to the new law.
By the start of next year, the Texas State Board of Pharmacy (TSBP) is also required to adopt appropriate administrative rules establishing more definite criteria and procedures to govern when a pharmacist operating under this new law is permitted to implement or modify a drug therapy plan initiated by the delegating physician.
While this is a welcome addition to medical staff's toolkit, physicians and pharmacists should pay careful attention to ensuring their compliance with the statute and its corresponding rules or else they could face a costly and potentially damaging investigation and disciplinary action by the Texas Medical Board and the Texas State Board of Pharmacy.
