Are pharmacists required to perform a prospective drug review prior to each dispensing for a patient?

Yes;

Such review shall include screening for potential drug therapy problems due to therapeutic duplication, drug-disease contraindications, drug-drug interactions, including serious interactions with nonprescription or over-the-counter drugs, incorrect drug dosage or duration of drug treatment, drug-allergy interactions, and clinical abuse or misuse.

Are montly reviews of drug therapy required for patients in a long-term car facility?

Yes.

The PIC of a pharmacy serving a hosptial shall be responsible for maintaining a policy and procedure for providing reviews of drug therapy to include at a minimum any irregularities in drug therapy.

The pharmacist shall sign and date the notation of the review.

All significant irregularities shall be brought to the attention of the attending or someone able to actually correct the problem (pharmacist = useless!).

Central or remote processing of a prescription does not include the actual dispensing of a drug, but does include any of the following activities related to the dispensing process such as?

(1) receiving, interpreting, analyzing, or clarifyling prescriptions

(2) Entering prescription and patient data into a data processing system

(3) Transferring prescription information

(4) Performing a prospective drug review

(5) Obtaining refill or substitution authorizations, or otherwise communicating with the prescriber concerning a patient's prescription

(6) Interpreting clinical data for prior authorization for dispensing

(7) Performing therapeutic interventions

(8) Providing drug information or counseling concerning a patient's prescription to the patient or patient's agent

A pharmacy may outsource certain prescription processing functions to another pharmacy in VA or a registered non-resident pharmacy under the following conditions?

(1) pharmacies shall either have the same owner or have a written contract describing the scope of services to be provided and the responsibilities and accountabilities of each pharmacy in compliance with all federal and state laws and regulations to the practice of pharmacy.

(2) Any centeral or remote pharmacy shall comply with VA law and regulations with respect to requirements for supervision of pharmacy technicians and the duties which are restricted to pharmacists and pharmacy technicians. Pharmacy technicians at the remote pharmacy shall either be registered in VA or posses credentials substantially equivalent to those required for a technician registered in VA.

NOTE: Pharmacists don't have to be registered in VA

(3) A pharmacists licensed in VA, whether at the remote pharmacy or the dispensing pharmacy, shall perform a check for accuracy on all processing done by the remote processor

(4) pharmacies shall share a common electronic file of have technology which allows sufficient information necessary to process a non-dispensing function

A policy and procedure manual that relates to central or remote processing shall be maintained at each pharmacy involved in the processing of a prescription and available for inspection. The manual shall at a minimum include the following?

(1) responsibilities of each pharmacy

(2) list of the name, address, telephone numbers, and permit/registration numbers of all pharmacies invloved in central or remote processing

(3) procedures for protecting the confidentiality and integrity of patient information

(4) procedures for ensuring that pharmacists performing prospective drug reviews have access to appropriate drug information resources

(5) procedures for maintaining required recrods

(6) procedures for complying with all applicalbe laws and regulations to include counseling

(7) procedures for objectively and systematically monitoring and evaluating the quality of the program to resolve problems and improve services

(8) procedures for annualy reviewing the written policies and proceudres for needed modifications and documenting such review

Pharmacies engaged in central or remote processing shall maintain retrievalbe records which show, or each prescirption processed, each individual processing function and identity of the pharmacist or pharmacy technician who performs a processing function and the pharmacist who checked the processing function, if applicable.

Records must be maintained for two years.

Statement. Not a question.

Note that the requirements for "remote prerscription order processing for hospitals and long term care facilities" is basically the same for "Central or remote processing"

See page 53 of 18 VAC for the complete list.

Note: that pharmacist ultimately must be licensed in VA even if they are performing their remote duties outside of VA

Statement. Not a question.