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| Helping pharmacy & health communities improve access to Emergency Contraception (EC) |
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EC PHARMACY UPDATEThe 2007 legislative session was very productive for pharmacy in New Mexico. A House Memorial, HM 11, sponsored by Representative Mimi Stewart, established the ‘Emergency Contraception Working Group’. This working group was established considering the high rate of unintended pregnancy in New Mexico, the importance of contraception, and confusion among pharmacists, patients and medical providers about the contraception pill Plan B. NM Pharmacy worked with the sponsor & will be part of the study. Also, SB 1097 sponsored by Senator Michael Sanchez was signed by the governor. SB 1097 amends definitions contained within the Insurance Code in the Health Maintenance Organization Law and the Nonprofit Health Care Plan Law. The definition of “basic health services” under the HMO law has been amended to include “services of pharmacist and pharmacist clinicians” under medically necessary services. Definitions of pharmacist and pharmacist clinicians are also added to the HMO law. The Nonprofit Health Care Plan law has been amended to provide definitions for pharmacist and pharmacist clinicians. Every year since the program’s initiation, the New Mexico Pharmacists Association hosts several EC training and Train-the-trainer programs for pharmacists from around the state. In 2006, the training program was revised to consolidate and update information; it is now a three hour program rather two hours on EC and one hour on regulatory requirements. One of the major goals is to provide training programs in rural areas. In fall 2006, the New Mexico Religious Coalition for Reproductive Choice offered a grant to fund training programs in four rural areas: Farmington, Las Cruces, Roswell (close to Ruidoso) and Taos. In December 2002, New Mexico became the fourth state, after Washington, California and Alaska, to allow pharmacists to provide EC directly to consumers. Like Washington State, New Mexico’s strategy for policy change relied heavily on physician participation, particularly from the State Health and the University of New Mexico, and from key stakeholders in the pharmacy community. However, New Mexico’s model can be viewed as a leader in deregulating access to EC and simplifying pharmacist participation. Unlike all other EC pharmacy states, including Hawaii, eligible pharmacists now have prescribing authority for EC. Under this authority, trained pharmacists may simply download the protocol (DOC-48K) from the New Mexico Pharmaceutical Association (NMPhA) and provide EC pursuant to the procedures in the protocol. New Mexico’s EC protocol was approved in May 2003. A multidisciplinary EC Work Group is currently participating in many aspects of implementation, including public awareness, recruitment and training. This group has 15-20 members, including physicians from the State Health Department, and the University of New Mexico School of Medicine, Planned Parenthood, the Director of NMPhA and representatives from community groups, school-based clinics, private practice, and other sectors. Implementation Pharmacies providing EC services in New Mexico are listed on www.EC-Help.org. Dale Tinker with the NMPhA reports that implementation has been going well according to the feedback received from pharmacists who are providing EC. In a very short start-up time more than 190 pharmacists have completed the two-part, ACPE-approved training. NMPhA certifies that trained pharmacists are eligible to prescribe EC. According to NMPhA’s records, EC trained pharmacists currently work in 36 pharmacies, representing about 14% of the market (there are approximately 250 chain and independent pharmacies in New Mexico). Pharmacy chains differ with regard to policies about EC. Wal-Mart still does not stock the dedicated EC products. In contrast, another large chain has a written policy that if a pharmacist will not fill a prescription for EC, he or she must find someone who will, in a timely way. Pharmacist Training Regulations relating to EC specify that pharmacists who provide the drug under the Board approved protocol must receive training in the EC subject area by one of four provider types: the Department of Health, Planned Parenthood, ACPE or a similar health authority or professional body approved by the Pharmacy Board. It does not specify CE or the amount of time. Regulations also require pharmacists every two years to receive two hours of live ACPE approved training on EC. The New Mexico Pharmaceutical Association (NMPhA) provides ACPE training to practicing pharmacists. Initially, Diana Koster, MD, Medical Director of Planned Parenthood, was the only EC trainer in the state. Dr. Koster attended the American Reproductive Health Profession’s train-the-trainer session and now delivers the clinical component. Part 1 of the training is two hours and covers clinical aspects. Part 2 of the training is one hour and covers legal aspects and paperwork requirements. Other professionals have attended these training sessions as well, including nurse practitioners and pharmacy technicians. The latter have a role in EC because they can fill the prescriptions and file claims and are required to respect confidentiality. By using technicians, this frees the pharmacists to offer counseling and direct patient service. The University of New Mexico College of Pharmacy has incorporated EC into its 3rd year curriculum so that graduating pharmacists will be fully trained to provide EC. Approximately 80 students have graduated with EC training. When she trains, Dr. Koster emphasizes the important role pharmacists have in helping women get on regular, on-going contraception. She sees pharmacists as having a bridging function, a first step into getting into care and encourages pharmacists to make referral to local health care providers. The pharmacist shortage in New Mexico makes it difficult for pharmacists to arrange for coverage to attend training and distance is a barrier for those in other parts of New Mexico. Don Downing, PharmD, from Washington State and Diana Koster, MD, conducted a train-the-trainer program in December 2003. The pharmacists certified in this program are leading additional training programs in 2004, in more rural and remote areas across New Mexico. These trainings were made possible through a grant from Barr Laboratories. Materials For Pharmacists The New Mexico Pharmaceutical Association has provided all of the necessary forms for pharmacists on their website at www.nm-pharmacy.com. The NMPhA has also developed a list of health care providers so pharmacists can make referrals for follow up. The list includes Planned Parenthood, State Department of Health clinics and other providers listed on the Not-2-Late website. Public Awareness Education about EC among health care providers and women will be the key to the pharmacy access initiative in New Mexico achieving its promise. In New Mexico, as in other states, the public and many health care providers are still confused about EC. The Compton Foundation has provided a grant to Planned Parenthood to help build important public awareness. An ad agency that has experience in working with Latinos, has agreed to contribute 45 hours of pro bono work to design the campaign. Planned Parenthood’s Medical Director, and Public Affairs and Community Outreach coordinator are working with the ad agency on this campaign. A mention of New Mexico and EC made the Jay Leno show with the quip that in New Mexico people could get EC from pharmacists. It’s called RU Going to the Prom! Although a few stakeholders appreciated the publicity, they felt it further perpetuated the confusion of EC with RU-486. The level of public awareness about availability of EC in pharmacies is low. A bill to fund the State Department of Health to conduct a public awareness campaign was introduced in the legislature, but did not pass in the 2003 session. The Department of Health has conducted other successful public awareness campaigns using billboards, and TV and radio spots. Proposed changes: The NM Department of Health and the NM Medical Society have formed a Clinical Prevention Initiative workgroup on Unintended Pregnancy Prevention. Plans for this workgroup, funded by the McCune Foundation, include developing materials on contraception options and distributing the materials to primary care providers throughout the state. Evaluation A survey of certified EC pharmacists in the state was conducted in July 2004 to evaluate the impact of the pharmacy access program. The survey addressed the number of prescriptions given, issues or concerns encountered, community response, privacy needs, advertising, consumer awareness, and payment for service. Click here to view complete results. Access to EC in pharmacies is a problem. Dr. Espey with the University of New Mexico described findings of a study conducted in March 2003 in which two research assistants visited each of the pharmacies in Albuquerque twice, once asking for Preven and once asking for Plan B. Only 20% of the approximately 90 pharmacies in Albuquerque carried either dedicated EC product. The primary reason was lack of demand, rather than moral objections. An updated version of this study is expected, including questions to evaluate the pharmacy access program. The study design will change somewhat so that rural and urban pharmacies will be compared with respect to availability of Plan B. New Mexico recently added two questions to their Behavioral Risk Factor Surveillance System (BRFSS), funded by the Centers for Disease Control and Prevention. These health surveys, conducted every year for every state, ask adults 18 and older questions related to behaviors that are associated with preventable chronic diseases, injuries, and infectious diseases. The questionnaire is made up of core questions and optional ones, but the state may request to add questions. New Mexico has added 1) Have you heard of EC and 2) Have you used EC? Data is expected mid to late 2005. Related EC Efforts NARAL has been a key player in New Mexico and helped introduce two bills this year – an EC in the ER (HB 119) bill that passed March 28, 2003 and a bill, HB 315, for an EC public awareness campaign that died. The New Mexico Department of Health has been working to increase awareness and access to EC. Medical students that rotate through the State Department of Health STD clinics are being trained about EC. In general, students come to the rotation aware of EC, but few have prescribed it in the past. EC, however, is routinely offered to women in the STD clinic for immediate need or advance provision. University of New Mexico medical students rotating through OB-GYN also receive training about EC through Dr. Espey who seeks to increase EC awareness at grand rounds, and in post-partum visits with patients. The EC Work Group has asked the 3 HMOs that handle Medicaid Managed Care to ensure that Plan B is on their formularies. The task force in collaboration with NARAL is looking into the possibility of obtaining a waiver of the required rebate so that EC can be paid for through Medicaid. EC Work Group members have contacted hospitals to ensure that Plan B is on hospital formularies. For more press coverage in this state, click here.
CONTACTSDale Tinker Diana Koster, MD Eve Espey, MD, MPH Bruce Trigg, MD
USEFUL LINKSNew Mexico Board of Pharmacy New Mexico Pharmaceutical Association New Mexico Legislature Planned Parenthood of New Mexico Planned Parenthood of the Rocky Mountains NARAL Pro-Choice New Mexico
PROTOCOL ENVIRONMENTOptimal 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. Pharmacist initiation of EC requires: The State Board of Pharmacy, Nursing and Medical Examiners approved a statewide EC protocol in 2003. New Mexico pharmacists have authority to prescribe EC under this protocol. Implementation requires:
PHARMACY PRACTICE ACTPharmacy 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. NEW MEXICO Recently, pharmacists were given explicit authority under the Emergency Contraception Drug Therapy regulations promulgated by the Board of Pharmacy to prescribe and administer emergency contraception pursuant to the written protocol approved by the Board, which is not patient-specific. (This prescriptive authority excludes, however, “any device [as opposed to drug] intended to prevent pregnancy after intercourse.”) Pharmacists must first complete a comprehensive, Board-approved training course. The pharmacist must generate a prescription for each drug administered, document consent, maintain such record for three years, and (upon consent) notify the patient’s primary care provider. Every two years, the pharmacist must also complete a minimum of 0.2 CEU in emergency contraception-related drug therapy. New Mexico also authorizes pharmacists to exercise arguably the broadest range of collaborative drug therapy decisions but imposes arguably the most complex set of rules to govern it. First, the pharmacists must obtain Board of Pharmacy certification as a “Pharmacist Clinician” by taking 60 hours of training in physical assessment and then either undergoing nine months of supervised clinical experience or a 150-hour, 300-patient contact preceptorship. The pharmacist must apply for recertification annually, including taking 10 hours of live CE. Board certification regulations are determined in consultation with the New Mexico Board of Medical Examiners and the New Mexico Academy of Physician Assistants. One or more certified pharmacists may then enter into a collaborative agreement with one or more practitioners who are authorized to prescribe “dangerous drugs” (defined as “drugs not safe except under a practitioner’s supervision, including controlled substances”) to “prescribe, administer or modify dangerous drug therapy.” The protocol, which must be Board approved, must identify:
The pharmacist must practice within two hours or 120 miles of the prescriber, who must meet with the pharmacist at the pharmacy at least once every two weeks (60 days if the pharmacist is based at a nursing home) and review at least 20% of the records, unless the Board approves an alternative schedule. These reviews must be documented and maintained for five years. In return, the law authorizes pharmacists to “prescribe, administer, . . . or modify dangerous drug therapy,” including controlled substances if the pharmacist obtains a DEA number and is authorized under the protocol. He or she may also collect histories, take vital signs and order lab tests. The Board reserves the right to place limits on the pharmacist’s authorized tasks. Statutory authority: Provided in section governing “Pharmacist Prescription Authority” and related definitions, N.M. Stat. Ann. §§ 61-11-2 and B Regulatory authority: Provided in Board rules governing “pharmacist clinician” and implementing the “Pharmacist Prescription Authority Act,” N.M. Reg. 16-19-4.17, governing “Vaccines,” N.M. Reg. 16-19-4, N.M. Reg. 16-19-26.8, and governing “Emergency Contraception Drug Therapy,” N.M. Reg. 16-19-26.9
NEW MEXICO STATUTE ARTICLE 11 PHARMACY 61-11-2. Definitions. 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 as a result of an order of a licensed practitioner; L. “drug regimen review” includes an evaluation of a prescription and patient record for:
P. “licensed practitioner” means a person engaged in a profession licensed by any state, territory or possession of the United States who, within the limits of his license, may lawfully prescribe, dispense or administer drugs for the treatment of a patient’s condition; V. “pharmaceutical care” means the provision of drug therapy and other patient care services related to drug therapy intended to achieve definite outcomes that improve a patient’s quality of life, including identifying potential and actual drug-related problems, resolving actual drug-related problems and preventing potential drug-related problems; BB. “practice of pharmacy” means the evaluation and implementation of a lawful order of a licensed practitioner; the dispensing of prescriptions; the participation in drug and device selection or drug administration that has been ordered by a licensed practitioner, drug regimen reviews and drug or drug-related research; the provision of patient counseling and pharmaceutical care; the responsibility for compounding and labeling of drugs and devices; the proper and safe storage of drugs and devices; and the maintenance of proper records; PHARMACIST PRESCRIPTION AUTHORITY (61-11B-1 to 61-11B-3) ARTICLE 11B 61-11B-1. Short title. This act [61-11B-1 to 61-11B-3 NMSA 1978] may be cited as the “Pharmacist Prescriptive Authority Act”. 61-11B-2. Definitions. As used in the Pharmacist Prescriptive Authority Act [61-11B-1 to 61-11B-3 NMSA 1978]:
F. “pharmacist” means a person duly licensed by the board of pharmacy to engage in the practice of pharmacy pursuant to the Pharmacy Act [61-11-1, 61-11-2, 61-11-4 to 61-11-28 NMSA 1978]; 61-11B-3. Pharmacist clinician prescriptive authority. A. A pharmacist clinician planning to exercise prescriptive authority in his practice shall have on file at his place of practice written guidelines or protocol. The guidelines or protocol shall authorize a pharmacist clinician to exercise prescriptive authority and shall be established and approved by a practitioner in accordance with regulations adopted by the board. A copy of the written guidelines or protocol shall be on file with the board. The practitioner who is a party to the guidelines or protocol shall be in active practice and the prescriptive authority that he grants to a pharmacist clinician shall be within the scope of the practitioner's current practice.
C. The written guidelines or protocol shall be reviewed and shall be revised every two years if necessary.
NEW MEXICO REGULATIONS BOARD OF PHARMACY RULES CHAPTER 19 PHARMACISTS PART 4 - PHARMACIST 16.19.4.18 PHARMACIST CLINICIAN: A. PURPOSE: The purpose of these regulations is to implement the Pharmacist Prescriptive Authority Act, Sections 61-11B-1 through 61-11B-3 NMSA 1978 by providing minimum standards, terms and conditions for the certification, practice, and supervision of pharmacist clinicians. These regulations are adopted pursuant to Section 61-11B-3 of the Pharmacist Prescriptive Authority Act. B. DEFINITIONS: (1) Board means the New Mexico Board of Pharmacy. (2) “dangerous drug” means a drug that, because of any potentiality for harmful effect or the methods of its use or the collateral measures necessary to its use, is not safe except under the supervision of a practitioner licensed by law to direct the use of such drug and the drug prior to dispensing is required by federal law and state law to bear the manufacturer's legend “Caution: Federal law prohibits dispensing without a prescription”. (3) “guidelines or protocol” means a written agreement between a pharmacist clinician or group of pharmacist clinicians and a practitioner or group of practitioners that delegates prescriptive authority. (4) “monitor dangerous drug therapy” means to review the dangerous drug therapy regimen of patients by a pharmacist clinician for the purpose of evaluating and rendering advice to the prescribing practitioner regarding adjustment of the regimen. “Monitor dangerous drug therapy” includes:
(5) “oversight committee” means a joint committee made up of four (4) members to hear issues regarding pharmacist clinicians' prescriptive authority activities and supervising practitioners' direction of these activities. (6) “pharmacist” means a person duly licensed by the Board to engage in the practice of pharmacy pursuant to the Pharmacy Act, Sections 61-11-1, 61-11-2, 61-11-4 to 61-11-28 NMSA 1978. (7) “pharmacist clinician” means a pharmacist with additional training required by regulations adopted by the Board in consultation with the New Mexico Board of Medical Examiners and the New Mexico Academy of Physician Assistants, who exercises prescriptive authority in accordance with guidelines or protocol. (8) “practitioner” means a physician duly authorized by law in New Mexico to prescribe dangerous drugs including controlled substances in Schedules II through V. (9) “prescriptive authority” means the authority to prescribe, administer, monitor or modify dangerous drug therapy. (10) “supervising practitioner” means a doctor, or group of doctors, of medicine or osteopathy approved by the respective Board to supervise a pharmacist clinician; “supervising practitioner” includes a practitioner approved by the respective Board as an alternate supervising practitioner. (11) “scope of practice” means those duties and limitations of duties placed upon a pharmacist clinician by the supervising practitioner, the Board, and applicable law, and includes the limitations implied by the specialty practiced by the supervising practitioner. C. INITIAL CERTIFICATION: (1) The Board may certify a pharmacist as a pharmacist clinician upon completion of an application for certification and satisfaction of the requirements set forth in these regulations. (2) A pharmacist who applies for certification as a pharmacist clinician shall complete application forms as required by the Board and shall pay a fee. The fee shall be set by the Board to defray the cost of processing the application, which fee is not returnable. (3) To obtain initial certification as a pharmacist clinician, an applicant must provide proof that the applicant has satisfied one of the following:
(4) The Board shall issue a document of certification to each pharmacist certified as a pharmacist clinician. A copy of the document of certification shall at all times be maintained at each place of practice of the pharmacist clinician. (5) Upon certification by the Board, the name and address of the pharmacist clinician, name of the supervising practitioner, and other pertinent information shall be enrolled by the Board on a roster of pharmacist clinicians. (6) No person shall represent that he or she is certified as a pharmacist clinician without maintaining current certification with the Board. D. ANNUAL RENEWAL OF CERTIFICATION: (1) Every pharmacist clinician certified to practice in New Mexico shall apply during the month of his or her birth each year to the Board for renewal of certification as a pharmacist clinician for the ensuing year. (2) Applications for renewal must include:
(d) other additional information as requested by the Board. E. PRESCRIPTIVE AUTHORITY, GUIDELINES OR PROTOCOL: (1) No pharmacist clinician may exercise prescriptive authority unless guidelines or protocol from the current supervising practitioner are on file with the Board. (2) A certified pharmacist clinician seeking to exercise prescriptive authority shall submit an application to the Board. The application must include the supervising practitioner's name and current medical license, guidelines or protocol and other information requested by the Board. A pharmacist may submit the application with the initial application for certification or as a separate application after becoming certified as a pharmacist clinician. (3) The guidelines or protocol will be established and approved by the supervising practitioner as set forth in these regulations and will be kept on file at each practice site of the pharmacist clinician and with the Board. (4) The guidelines or protocol must include:
(c) activities to be followed by the pharmacist clinician while exercising prescriptive authority, including documentation of feedback to the authorizing practitioner concerning specific decisions made; documentation may be made on the prescriptive record, patient profile, patient medical chart or in a separate log book; (d) description of appropriate mechanisms for reporting to the supervising practitioner; and (e) description of the scope of practice of the pharmacist clinician. F. SCOPE OF PRACTICE: (1) A pharmacist clinician shall perform only those services that are delineated in the guidelines or protocol and are within the scope of practice of the supervising practitioner. (2) A pharmacist clinician may practice in a health care institution within the policies of that institution. (3) A pharmacist clinician may prescribe controlled substances provided that the pharmacist clinician (i) has obtained a New Mexico Controlled Substances registration and a Drug Enforcement Agency registration, and (ii) prescribes controlled substances within the parameters of written guidelines or protocols established under these regulations and Section 3, A. of the Pharmacist Prescriptive Authority Act. (4) The Board may, in its discretion after investigation and evaluation, place limitations on the tasks a pharmacist clinician may perform under the authority and direction of a supervising practitioner. G. RELATIONSHIP OF PHARMACIST CLINICIANS TO DESIGNATED SUPERVISING PRACTITIONERS: (1) The direction and supervision of pharmacist clinicians may be rendered by approved supervising practitioners and not through intermediaries. (2) A pharmacist clinician must meet in person with the supervising practitioner or the supervising practitioner's Board-approved alternate at least once every two (2) weeks to discuss patient management. Supervising practitioners must provide direction to pharmacist clinicians to specify the pharmacotherapeutic services to be provided under the circumstances in each case. This may be done by written guidelines or protocol or by oral communications in person, over the phone or by other electronic means. It is the responsibility of the supervising practitioner to assure that the appropriate directions are given and understood. (3) The supervising practitioner must visit the premises of the pharmacist clinician's practice at least once every sixty (60) days in a nursing home setting and once every fourteen (14) days in the primary place of practice of the pharmacist clinician, and evaluate the quality of all pharmacotherapeutic services rendered by the pharmacist clinician by reviewing not less than twenty percent (20%) of all medical records to assure compliance with the guidelines or protocol and directions. (4) If the supervising practitioner is of the opinion that circumstances warrant exceptions to the requirements set forth in paragraphs A, B or C [1, 2 or 3] above, the supervising practitioner must specify the circumstances in writing and deliver the same to the Secretary of the State of New Mexico Board of Medical Examiners or the State of New Mexico Board of Osteopathic Medical Examiners. The respective Board will review, grant or deny requests for exceptions or waivers, in the Board's discretion. (5) Documentation of the supervising practitioner's reviews must be retained by the pharmacist clinician and be available for Board inspection for a period of not less than five (5) years from the date of review. (6) The pharmacist clinician must function in reasonable proximity to the supervising practitioner and must have prompt access to the practitioner by telephone or two-way radio or two-way television or other electronic means for advice and direction. “Reasonable proximity” means a location not more than 120 miles or two hours, whichever is greater, from the supervising practitioner. (7) If the supervising practitioner plans to be or is absent from his or her practice for any reason, the supervising practitioner cannot designate a pharmacist clinician to take over those duties or cover the practice during such absence. The supervising practitioner may designate an alternate supervising practitioner, approved by the respective Board, to cover the practice and perform the duties of supervising practitioner. The alternate supervising practitioner will then supervise the pharmacist clinician and will be responsible for the pharmacist clinician's actions or omissions in exercising prescriptive authority or other duties as a pharmacist clinician. (8) Upon any change in supervising practitioner between annual renewals of certification, a pharmacist clinician shall submit to the Board within ten (10) working days, the new supervising practitioner's name, current medical license, and guidelines or protocol. This notice requirement does not apply to an alternate supervising practitioner who is designated to cover during the absence of the supervising practitioner. (9) The Chair of the Board will appoint two (2) members of the Board, and the President of the supervising practitioner's respective Board will appoint two (2) members of the respective Board to the oversight committee. The oversight committee will make a report that may include non-binding recommendations to both the Board and respective Board regarding disciplinary action. Each Board can accept or reject the recommendations. Other History: 16 NMAC 19.4, Pharmacists - Pharmacist, filed 02-02-96; 16 NMAC 19.4, Pharmacists - Pharmacist, filed 05-02-96; 16 NMAC 19.4, Pharmacists - Pharmacist, filed 02-25-98, reformatted and renumbered to 16.19.4 NMAC, Pharmacist, effective 03-30-2002. TITLE 16 OCCUPATIONAL AND PROFESSIONAL LICENSING CHAPTER 19 PHARMACISTS PART 26 PHARMACIST PRESCRIPTIVE AUTHORITY 16.19.26.2 SCOPE: All pharmacists that intend to exercise the authority to prescribe dangerous drugs based on written protocols approved by the Board. [16.19.26.2 NMAC - N, 12-15-02] * * * 16.19.26.4 DURATION: Permanent. [16.19.26.4 NMAC - N, 12-15-02] 16.19.26.5 EFFECTIVE DATE: 12-15-02, unless a later date is cited at the end of a section. [16.19.26.5 NMAC - N, 12-15-02] 16.19.26.6 OBJECTIVE: The objective of Part 26 of Chapter 19 is to protect the health and safety of New Mexico citizens by regulating the prescriptive authority of pharmacists. [16.19.26.6 NMAC - N, 12-15-02] 16.19.26.7 DEFINITIONS: A “Antigen” means a substance recognized by the body as being foreign; it results in the production of specific antibodies directed against it. G. “Emergency Contraception Drug Therapy” means the use of a drug to prevent pregnancy after intercourse. [16.19.26.7 NMAC - N, 12-15-02] 16.19.26.9 EMERGENCY CONTRACEPTION DRUG THERAPY: A. PROTOCOL: (1) Prescriptive authority for emergency contraception drug therapy shall be exercised solely in accordance with the written protocol for emergency contraception drug therapy approved by the Board; (3) Continuing Education: Any pharmacist exercising prescriptive authority for emergency contraception drug therapy shall complete a minimum of 0.2 CEU of live ACPE approved emergency contraception drug therapy related continuing education every two years. Such continuing education shall be in addition to requirements in NMAC 16.19.4.10. D. RECORDS: Upon signed consent of the patient or guardian, the pharmacist shall notify the patient's designated physician or primary care provider of emergency contraception drug therapy prescribed and provided. History of 16.19.26 NMAC: [RESERVED]
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