THERAPY DRUG PROTOCOL The Texas State Board of Medical Examiners has approved drug therapy management by a pharmacist under a written protocol of a physician. This protocol describes the drug therapy guidelines for a Doctor of Pharmacy (Pharm.D.) employed by the Department of Psychiatry at Scott and White Hospital. Under this protocol the physician can delegate to a qualified pharmacist the management of drug therapy. Management of drug therapy can include the collecting and reviewing of patient drug histories, ordering or performing routine drug therapy, related patient assessment procedures including temperature, pulse, respiration, blood pressure, height, weight, and ordering of drug therapy related laboratory tests. In addition the pharmacist, who is under the direction of a written protocol, can implement or modify drug therapy following the diagnosis and patient assessment by a qualified mental health professional as detailed in the protocol. The pharmacist can also engage in any other drug therapy related act designated by a physician. For a pharmacist covered under this protocol who is also credentialed as a Licensed Professional Counselor (LPC), drug therapy management tasks are in addition to the diagnostic and therapeutic services allowed by the LPC licensure. For the purposes of this protocol, a supervising physician is any physician who is a faculty member within the Department of Psychiatry at Scott and White Hospital as designated by the department chairman. For this current position, the principal supervising physicians are Jay Burke, M.D., Jennifer Johnson, M.D., Jane Ripperger-Suhler, M.D., and Helen Zaphiris, M.D. The supervising physicians designated in this protocol are authorized to prescribe drugs and responsible for the delegation of drug therapy management. Maria Llana, Pharm.D., LPC will be the individual pharmacist authorized to dispense drugs and to engage in drug therapy management as delegated by the above physicians. Dr. Llana will conduct follow-up assessments of patients already evaluated, will evaluate the progress of the patients symptoms, will address any issues with regard to medication such as side effects, required laboratory monitoring and required blood levels for certain medications. She will review the care of patients with the supervising physician. No less than every two weeks, the pharmacist, Dr. Llana, will meet with Drs. Johnson, Ripperger-Suhler, and Zaphiris separately to review overall drug management issues and patient care. More intensive supervision will be given for new patients and those patients who are more difficult to manage. medically The assessments and decisions made in the course of the pharmacist following drug management cases will be documented in the patients medical chart on the same day the patient was seen. If any deviations need to be made from the standard protocol listed for each medication, the supervising physician shall record the deviations made. The written protocol will be reviewed at least annually by the principal supervising physicians and the pharmacist and revised if necessary. The physician will establish and maintain a physician patient relationship with each patient provided drug therapy management by the pharmacist through supervision and documentation in the medical record. The principal supervising physicians wrote this protocol. The principal supervising physicians will oversee the periodic status report on the patient by the pharmacist and will always be available by direct telecommunication for consultation, assistance, and direction. A supervising physician will be physically present daily to provide medical care and supervision.
The pharmacist will provide the Board of Pharmacy with the medical license number and address of the principal supervising physicians, the address where the records of such drug therapy management are maintained and a statement attesting to the fact that the pharmacist has, within the last year and annually thereafter, completed at least six hours of continuing education related to drug therapy offered by a provider approved by the American Council on Pharmaceutical Education or engaged in drug ther...