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Collaborative Practice Agreements

and Pharmacists Patient Care Services

Collaborative practice agreements (CPAs) are used to create formal relationships between pharmacists and physicians or other providers that allow for expanded services the pharmacist can provide to patients and the healthcare team. CPAs define certain patient care functions that a pharmacist can autonomously provide under specified situations and conditions. Of important note, CPAs are not required for pharmacists to perform many patient care services (e.g., medication reviews, patient education and counseling, disease screening, referral).

Consortium Meeting

In January 2012, the APhA Foundation convened a roundtable consortium in Washington, D.C., for the purposes of stimulating increased integration of collaborative practice agreements (CPAs) and pharmacists’ patient care services into practice. The healthcare environment in the United States is undergoing unprecedented change, with myriad healthcare reform initiatives, mounting evidence for the positive contributions of pharmacists, and federal government interest in pharmacist-provided services from the Centers for Medicare & Medicaid Services, Centers for Disease Control and Prevention, and Surgeon General. Many individuals and groups have asserted that pharmacists are a dramatically underused resource that could help improve outcomes within our healthcare delivery system, if properly engaged as essential members of the healthcare team.

Goal

To develop consensus recommendations that provide principles and strategies for effectively implementing healthcare system changes, including an optimized role for pharmacists to engage in team-based, patient-centered care.

The Participants

An interdisciplinary group of stakeholders representing 12 states and 10 pharmacy practice settings.

Case Studies

As the APhA Foundation was bringing together the consortium and synthesizing ideas into a white paper and translational tools, ICF Macro was studying the implementation of CPAs in three pharmacies. ICF developed in-depth case studies to report their findings and provide interested parties with an understanding of the various ways to effectively implement collaborative relationships. The case studies and a summary report will be available in 2014.

Consortium Participants

John Beckner, Martin's Pharmacy/Giant Foods, LLC, Virginia Marialice Bennett, The Ohio State University, Ohio MarcieBough, American Pharmacists Association, National ErnestBoyd, Ohio Pharmacists Association, Ohio Laura Cole, St. Vincent's Health System, Alabama Christopher DuPaul, CVS Caremark, National Scott Giberson, Public Health Service, National Anita Glicken, University of Colorado School of Medicine, Colorado Doug Hillblom, OptumRx, California Michael Hogue, Samford University McWhorter School of Pharmacy, Alabama JeffreyKelman, Center for Medicare and Medicaid Services, National Sandra Leal, El Rio Health Center, Arizona Daniel Luce, Walgreens, National J. PaulMartin, Crescent Health Solutions, North Carolina John O'Brien, CMS Innovation Center, National George Oestreich, G.L.O. and Associates, Missouri N. LeeRucker, AARP, National StevenSimenson, Goodrich Pharmacy, Minnesota Rebecca Snead, National Alliance of State Pharmacy Associations, National MargieSnyder, Purdue University College of Pharmacy, Indiana E. KimSwiger, Mirixa, Georgia Troy Trygstad, Community Care of North Carolina, North Carolina

Attendees

KristenBetts, Division for Heart Disease and Stroke Prevention, CDC Benjamin Bluml, American Pharmacists Association Foundation Anne Burns, American Pharmacists Association Siobhan Gilchrist, Columbus Technologies and Services, Inc. DyannMatson Koffman, Division for Heart Disease and Stroke Prevention, CDC LynetteSappe-Watkins, American Pharmacists Association Foundation Caroline Shedlock, American Pharmacists Association Foundation Mindy Smith, American Pharmacists Association Foundation Jim Owen, American Pharmacists Association Farah Towfic, American Pharmacists Association Foundation Lindsay Watson, American Pharmacists Association Foundation

Publication

The discussion at the consortium meeting revealed seven key themes for successfully implementing and creating infrastructure for empowering collaborative, interdisciplinary care:

  1. Use consistent terminology and language that is readily understandable by all potential audiences.

  2. Allow health care providers who enter into the CPA to define the details of each agreement.

  3. Create and expand an infrastructure that embeds pharmacists’ patient care services and CPAs into care, while creating ease of access for patients.

  4. Incentivize and facilitate the adoption of electronic health records and the use of technology in pharmacists’ patient care services.

  5. Encourage pharmacists to maintain strong, trusting, and mutually beneficial relationships with patients, physicians, other providers; encourage those individuals to promote pharmacists’ patient care services.

  6. Properly align incentives based on meaningful process and outcome measures for patients, payers, providers, and the health care system.

  7. Examine and redesign health professionals’ practice acts, education curriculums, and operational policies to create synergy, promote collaboration and optimize support staff

 

These recommendations and the supporting evidence for broad use of CPAs are encapsulated in a white paper titled, Consortium Recommendations for Advancing Pharmacists’ Patient Care Services and Collaborative Practice Agreements. This white paper was published in the Journal of the American Pharmacists Association in March of 2013.

Read the full white paper here.​

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