Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 15 - TEXAS STATE BOARD OF PHARMACY › Chapter 295 - PHARMACISTS › Section 295.13 - Drug Therapy Management by a Pharmacist under Written Protocol of a Physician

Current through Reg. 49, No. 28; July 12, 2024
(a) Purpose. The
				purpose of this section is to provide standards for the maintenance of records
				of a pharmacist engaged in the provision of drug therapy management as
				authorized in Chapter 157 of the Medical Practice Act and §554.005 of the
				Act.
(b) Definitions. The following
				words and terms, when used in this section, shall have the following meanings,
				unless the context clearly indicates otherwise.
(1) Act--The Texas Pharmacy Act, Chapter 551
				- 566 and 568 - 569, Occupations Code, as amended.
(2) Board--The Texas State Board of
				Pharmacy.
(3) Confidential
				record--Any health-related record maintained by a pharmacy or pharmacist, such
				as a patient medication record, prescription drug order, or medication
				order.
(4) Drug therapy
				management--The performance of specific acts by pharmacists as authorized by a
				physician through written protocol. Drug therapy management does not include
				the selection of drug products not prescribed by the physician, unless the drug
				product is named in the physician initiated protocol or the physician initiated
				record of deviation from a standing protocol. Drug therapy management may
				include the following:
(A) collecting and
				reviewing patient drug use histories;
(B) ordering or performing routine drug
				therapy related patient assessment procedures including temperature, pulse, and
				respiration;
(C) ordering drug
				therapy related laboratory tests;
(D) implementing or modifying drug therapy
				following diagnosis, initial patient assessment, and ordering of drug therapy
				by a physician as detailed in the protocol; or
(E) any other drug therapy related act
				delegated by a physician.
(5) Medical Practice Act--The Texas Medical
				Practice Act, Subtitle B, Occupations Code, as amended.
(6) Written protocol--A physician's order,
				standing medical order, standing delegation order, or other order or protocol
				as defined by rule of the Texas Medical Board under the Medical Practice Act.
(A) A written protocol must contain at a
				minimum the following:
(i) a statement
				identifying the individual physician authorized to prescribe drugs and
				responsible for the delegation of drug therapy management;
(ii) a statement identifying the individual
				pharmacist authorized to dispense drugs and to engage in drug therapy
				management as delegated by the physician;
(iii) a statement identifying the types of
				drug therapy management decisions that the pharmacist is authorized to make
				which shall include:
(I) a statement of the
				ailments or diseases involved, drugs, and types of drug therapy management
				authorized; and
(II) a specific
				statement of the procedures, decision criteria, or plan the pharmacist shall
				follow when exercising drug therapy management authority;
(iv) a statement of the activities the
				pharmacist shall follow in the course of exercising drug therapy management
				authority, including the method for documenting decisions made and a plan for
				communication or feedback to the authorizing physician concerning specific
				decisions made. Documentation shall be recorded within a reasonable time of
				each intervention and may be performed on the patient medication record,
				patient medical chart, or in a separate log book; and
(v) a statement that describes appropriate
				mechanisms and time schedule for the pharmacist to report to the physician
				monitoring the pharmacist's exercise of delegated drug therapy management and
				the results of the drug therapy management.
(B) A standard protocol may be used or the
				attending physician may develop a drug therapy management protocol for the
				individual patient. If a standard protocol is used, the physician shall record
				what deviations, if any, from the standard protocol are ordered for that
				patient.