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EC PHARMACY UPDATE
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PROTOCOL ENVIRONMENT
Optimal Environment: No Revision to Authority Necessary
Existing statutes and regulations would accommodate pharmacists’ initiation of emergency contraception, generally under a collaborative practice agreement (protocol) with a prescriber.
Pharmacists practicing in any setting may implement a collaborative practice agreement with one or more physicians pursuant to a protocol that specifies the type of patient care functions the pharmacist is authorized to perform, and under what conditions or limitations. No outside review is required. Implementation would require development of a protocol and securing prescriber authorization.
PHARMACY PRACTICE ACT
Pharmacy Practice Act Regulatory and Statutory Authority
Note: The text presented below has been prepared by the American Pharmacists Association for the Pharmacy Access Partnership and reflects legislation or regulation promulgated as of June 15, 2003.
GUAM
Pharmacists practicing in any setting may implement a collaborative practice agreement with one or more physicians pursuant to a protocol which specifies what patient care functions the pharmacist is authorized to perform under what conditions or limitations. There is no outside review required.
The practice of pharmacy is defined as including the implementation of medical orders and drug administration (by any route), among others. Similarly, the statute broadly defines the areas where pharmacists may “provide pharmaceutical care” that includes, but is not limited to: chronic disease management, smoking cessation; maternal and child health; immunization; “family planning;” self-care consulting; drug selection under protocol; treatment of common diseases and injuries; nutrition; and general health education and promotion.
Finally, pharmacists may practice “telepharmacy” across jurisdictional lines if done pursuant to a collaborative practice agreement, and if other conditions are met.
Statutory authority: In the definitions of collaborative pharmacy practice, primary care and related terms, 12 Guam Code Ann. §§ 12604-605 and 12621.
Regulatory authority: N/A
GUAM STATUTE
GUAM PHARMACY PRACTICE ACT
Sec. 1
Article 6 of Chapter 12 of Title 10 of the Guam Code Annotated is hereby repealed and reenacted to read as follows: “Article 6. Guam Pharmacy Practice Act.”
Sec. 12604
Practice of Pharmacy
For purposes of this Article the “practice of pharmacy” means the interpretation, evaluation and implementation of medical orders; the dispensing of prescription drug orders; participation in drug and device selection, drug administration, drug regimen reviews, and drug related research; provision of patient counseling and the provision of those acts or services necessary to provide pharmaceutical care in all areas of patient care, including primary care; and the responsibility for compounding and labeling of drugs and devices, except labeling of by a manufacturer, repackager, or distributor of non-prescription drugs and commercially packaged legend drugs, proper and safe storage of drugs and devices, and maintenance of proper records for them.
Sec. 12605
Definitions
For purposes of this Article, the following words and phrases have been defined to mean:
(a) Administer means the direct application of a drug to the body of a patient or research subject by injection, inhalation, ingestion or any other means.
…
(e) Collaborative Pharmacy Practice is that practice of pharmacy whereby a pharmacist has jointly agreed, on a voluntary basis, to work in conjunction with one or more practitioner under protocol whereby the pharmacist may perform certain patient care functions authorized by the practitioner or practitioners under certain specified conditions and or limitations.
…
(w) Medical Order means a lawful order of a practitioner which may or may not include a prescription drug order.
. . .
(bb) Pharmaceutical Care is the provision of drug therapy and other patient care services intended to achieve outcomes related to the cure or prevention of a disease, elimination or reduction of a patient’s symptoms, or arresting or slowing of a disease process as defined in the rules of the Board.
. . .
(gg) Practice of Telepharmacy means the provision of pharmaceutical care through the use of telecommunications and information technologies to patients at a distance.
(hh) Practitioner means an individual currently licensed, registered, or otherwise authorized by the jurisdiction to prescribe and administer drugs in the course of professional practice in Guam.
. . .
(kk) Prescription Drug Order means a lawful order of a practitioner for a drug or device for a specific patient, including orders derived from Collaborative Pharmacy Practice, that is communicated directly to a pharmacist in a licensed pharmacy.
(ll) Primary Care is the first level of contact of individuals, the family, and the community with the health care delivery system, bringing health care as close as possible to where people live and work, and constitutes the first element of a continuing health care process. Areas of Primary Care where pharmacists provide Pharmaceutical Care include, but are not limited to, the following: Chronic disease management, smoking cessation; maternal and child health; immunization; family planning; self-care consulting; drug selection under protocol; treatment of common diseases and injuries; nutrition; and general health education and promotion.
Sec. 12621
Qualifications for Registration to Practice Telepharmacy Across Guam/State Lines.
(A) An applicant applying for registration to engage in the practice of telepharmacy across Guam/State Lines shall:
- (1) present to the Board proof of licensure in another jurisdiction and proof that such license is in good standing;
- (2) submit a written application in the form prescribed by the Board of Pharmacy;
- (3) pay the fee(s) specified by the Board of Pharmacy for issuance of the license; and
- (4) comply with all other requirements of the Board of Pharmacy.
(B) Application.
- (1) The written application required under Sec. 12617(A)(1) of this Act shall request of the applicant, at a minimum, the following information:
- (i) name, address and current pharmacist licensure information in all other jurisdictions, including jurisdiction(s) of licensure and license number(s);
- (ii) name, address, phone number, and if applicable, jurisdiction of licensure and license number of the site where the practice of telepharmacy will originate;
- (iii) a statement of the scope of patient services that will be provided;
- (iv) a description of the protocol framework by which patient care will be provides, including any collaborative practice arrangements with other health care practitioners; and
- (v) a statement attesting that the applicant will abide by the pharmacy laws and regulations of the jurisdiction in which the patient is located.
GUAM REGULATIONS
No implementing regulations had been promulgated as of June 15, 2003.
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