Toward a rational approach to the issue of prescribing authority for pharmacists

The issue of expanded prescriptive authority for pharmacists has been gaining momentum for some time and has resulted in legislation in California and Washington and clarification of legislation in Oregon allowing expanded prescribing prerogatives for pharmacists. In April 1982, the American Pharmaceutical Association Policy Committee on Professional Affairs recommended that a policy statement be adopted endorsing the concept that pharmacists have the independent authority to select and dispense pharmaceutical and therapeutic alternates. The importance of the pharmacist as a health professional strategically placed and generally qualified to contribute significantly to the optimization of drug therapy outcomes cannot be denied. The advocacy of independent authority for all pharmacists to select pharmaceutical alternates, and particularly therapeutic alternates, appears to be premature, however. Orderly transition and constructive evolution of expanded prescriptive authority for pharmacists requires: (1) a comprehensive, introspective self-analysis of the current status of pharmacy practice; (2) establishment of a communication system between pharmacist and physician that will optimize drug therapy; (3) improved recognition by pharmacy of the complexity involved in drug selection and patient monitoring; and (4) development of a process for establishing credentials that would certify the competency of pharmacists to perform defined prescribing functions.