Facilitating multistate pharmacy practice: Streamlining continuing pharmacy education requirements.

A major regulatory impediment to achieving multistate pharmacist licensure is state-specific Continuing Pharmacy Education (CPE) mandates. States vary on CPE requirements in 6 key domains, presenting a potentially significant administrative burden for multistate pharmacists. In the short term, replicating the nursing compact model of CPE regulation is the most viable model for the pharmacy profession. In this model, a pharmacist would have to follow just the CPE requirements for the state where the pharmacist maintains primary residence, and maintenance of this home state license would be automatically recognized by other states in which the pharmacist practices.

Toward Multistate Pharmacy Practice: Enhancing Mobility and Portability of Pharmacist Licensure.

Pharmacists are licensed in all 50 states. As society becomes increasingly mobile and interconnected, several models of cross-state pharmacy practice have emerged, straining the current state-based system of licensure. The nursing profession has provided a model for license portability that offers 3 primary advantages over the current pharmacist licensure model while still protecting safety: (1) faster speed, (2) lower cost, and (3) reduced administrative burden. A hybrid approach for the pharmacy profession that builds off of the expedited license transfer model and adds a mutual recognition model is ideal.

The Basis for Elimination of the Jurisprudence Examination as a Condition of Pharmacist Licensure in Idaho.

Some national pharmacy associations have recently joined in advocacy for a more portable pharmacist license. One impediment to accomplishing this is the state-specific nature of the pharmacy jurisprudence examination, leading to calls for the exploration of alternatives to, or outright elimination of, such examinations. This manuscript reviews the rationale for the elimination of the pharmacy jurisprudence examination in Idaho. The Idaho Board of Pharmacy reviewed the absence of similar jurisprudence examinations in other health professions, the role schools of pharmacy and employers play in preparing pharmacists for lawful practice, and how the adoption of a "standard of care" regulatory model changed thinking about the need for a jurisprudence examination. Idaho eliminated the examination in 2018, and no evidence demonstrating a public safety impact has yet materialized, while the number of Idaho licensed pharmacists has grown at a higher rate than its border states. State boards of pharmacy are in a position to decide whether keeping the pharmacy jurisprudence examination is necessary, and this manuscript reviews key considerations for other states.

The mandatory residency dilemma: parallels to historical transitions in pharmacy education.

OBJECTIVE: To review recent literature regarding mandatory residencies in the perspective of the historical entry-level degree debate. DATA SOURCES: Articles were identified through searches of MEDLINE/PubMed, national pharmacy association Web sites, and a review of the references of related literature. STUDY SELECTION AND DATA EXTRACTION: Several studies, commentaries, and reviews are examined to discuss viewpoints from both the entry-level degree and mandatory residency debates. Similarities were observed between the 2 debates in regard to objectives and rationale for change, educational issues, pharmaceutical care issues, and economic issues. DATA SYNTHESIS: Fewer than 10 years ago, after many years of debate, colleges of pharmacy made the transition to offering the PharmD degree as the sole entry-level degree for licensure as a pharmacist. Similar debates have taken place over the past several years and continue to take place regarding the necessity for residency training. One key 2006 document by the American College of Clinical Pharmacy calls for mandatory residency training for entry into pharmacy practice by 2020. CONCLUSIONS: In parallel with the entry-level degree debate, consensus has yet to be reached among pharmacists and pharmacy organizations, but several have shown support for mandatory residency training for all pharmacists involved in direct patient care. Many questions have yet to be answered regarding the timeline, economics, and feasibility of such a mandate.

Transitioning pharmacy to "standard of care" regulation: Analyzing how pharmacy regulates relative to medicine and nursing.

BACKGROUND: The National Association of Boards of Pharmacy (NABP) recently established a task force to help states develop regulations based on "standards of care" rather than "prescriptive rule-based regulation." The NABP resolution signals a paradigm shift as the pharmacy profession has historically been governed by prescriptive rules at both the federal and state levels. OBJECTIVE: To identify opportunities to make the transition to a "standard of care" regulatory model in pharmacy law as NABP has advanced, this manuscript attempts to quantify the regulatory burden for the medical, nursing, and pharmacy professions in the state of Idaho to facilitate a comparison. METHOD: The relevant statutes and regulations were gathered, and key measures were extracted, including word count and restrictions (e.g., the use of specific terms like "shall"), the composition and age of each profession's laws, how frequently the respective laws have been amended, and how the composition has changed from 1996 to 2017. RESULTS: When compared to medicine and nursing, pharmacy laws have a larger overall word count, more restrictions, a younger overall age, and have been amended more frequently. In particular, pharmacy has 97.5% more words than nursing and 105.8% more words than medicine with respect to the regulation of professional practice standards. From 1996 to 2017 nursing and pharmacy took two diverging paths to professional practice standard regulation. Nursing decreased the net word count in this area (-3006 words; -28.7%), whereas pharmacy (5208 words; 36.6%) experienced gains. CONCLUSIONS: For pharmacy to continue to evolve, replicating the medical and nursing approach to the regulation of professional practice standards will be necessary to fully achieve patient and public health goals.