Pharmacists are uniquely positioned to play a role in the healthcare system through the use of Collaborative Practice Agreements (ASAs). SPAs are formal practical agreements between pharmacists and physicians that expand the clinical responsibilities of pharmacists.2 Michigan law allows pharmacists to enter into ASPs under medical delegation, allowing Michigan pharmacists to support patient care and connect with providers at the highest level of authorization.3 ASPs identify the patient population and diseases covered by the CPA. These specifications may include one or more disease states such as high blood pressure, asthma, COPD, diabetes, etc., or age limits, to name a few. Once the patient population has been identified, the CPA will outline the patient care activities that pharmacists can offer in certain situations and conditions. Practitioners can determine which procedures pharmacists are authorized to, including initiating, modifying, stopping or following up drug treatment. Other examples of delegated responsibilities include acquiring laboratories such as ordering A1C values for a diabetic, tailoring antihypertensive therapy as needed, conducting follow-up calls after the patient`s dismissal, administering vaccines, and dispensing naloxone.2 Note that Michigan does not have a law limiting or instructing CPAs between physicians and pharmacists. The restriction is based on the agreement and extent authorized by the delegated physician. Since pharmacists are ideal for improving medication utilization, compliance, and outcomes, CSAs benefit not only the patient, but healthcare as a whole. Patients receive many of the benefits of CPA practice. Research consistently shows that patients who care for pharmacists` clinical services are more likely to achieve their health goals and receive guideline-based preventive therapies. This allows patients to lead healthier lives, which ultimately reduces hospital readmission rates and prevents problems resulting from uncontrolled chronic diseases.
These findings are particularly important for the most vulnerable patients, with an increased disease burden, who are offered pharmacist services. These services have been the most frequently studied as part of the treatment of diabetes and asthma. It is important that patients be more satisfied with their overall health care when a pharmacist is part of the clinical team.4-6 Figure 1 shows clinical outcome data after pharmacist and CPA intervention. Figure 1. Benefits reported for patient outcomes after pharmacist intervention, performed under the authority of a CPA. ASAs also show cost savings within the healthcare system. Touchette et colleagues reviewed studies on the economic impact of clinical pharmacy services and found that the benefit-cost ratio ranged from 1.05:1 to 25.95:1.7 A survey conducted by Thomas and colleagues at hospitals in Illinois, Indiana and Michigan showed that hospital administrators believe that pharmacists` medication management contributes to the hospital`s strategic vision.8 Pharmacists as well as the benefits of the health system by providing a broader effect of health services. . . .