Staff Report with Final Results: Texas State Board of Pharmacy Page: 13
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Sunset Advisory Commission June 2017
supervision of a licensed pharmacist. Delegate accounts allow pharmacy
technicians to access the system to pull a patient report the pharmacist
can then quickly review. Thirty-eight states currently authorize delegate
accounts. In Texas, statute already authorizes the board to create delegate
accounts, but the Department of Public Safety has not set up this feature.
Ensuring the board makes this enhancement to the new system would
help busy pharmacists use the Prescription Monitoring Program more
frequently and reduce the burden of any additional requirements to check
the database for certain high-risk prescriptions.
" Delayed reporting. Up-to-date information helps prescribers, pharmacists,
and regulatory agencies better identify potentially dangerous prescription
drug activity. The Center of Excellence recommends real-time data
entry into prescription monitoring databases, or as close to real time as
possible. Requiring pharmacies to enter data quickly improves the quality
of the information and ensures other users are able to access up-to-date
prescription information. Without viewing the most recent prescription data
for a patient, pharmacists and prescribers do not have the best information
about whether giving a controlled substance to a patient may be harmful.
About half of all state prescription monitoring programs require pharmacists
to enter dispensing information within one day, and Oklahoma requires
real time reporting within five minutes of dispensing a controlled substance.
However, Texas' timeframe is much longer, allowing a lag time of up to
one week for pharmacists to enter dispensing information. This window
can allow patients who abuse drugs to obtain additional prescription
medications without any information available to track their activity.
Requiring pharmacists to enter dispensing information within one
business day would make the already required data more useful for public
protection purposes, without creating a new or overly burdensome reporting
requirement on pharmacies.
" No proactive alerts about suspicious activity. The Center of Excellence
recommends states send automated push notifications to flag prescriptions
meeting pre-determined thresholds that could indicate questionable
prescribing or dispensing activity. Push notifications proactively engage
prescribers and pharmacists, encourage use of the system to improve care,
and help draw attention to potentially unsafe or invalid prescriptions.
Forty-four states have authority to send push notifications to end users,
typically triggered when a patient has visited a set number of prescribers
or pharmacies in a short time period to obtain controlled substances.
Users then receive an alert directing them to view the patient's profile for
further analysis. States where prescribers and pharmacists receive push
notifications have noted positive changes in prescribing and dispensing
behavior, with users more likely to discuss the report with the patient,
refer patients for substance abuse treatment, or call pharmacists who have
dispensed controlled substances to the patient.27Texas
pharmacists
can take as long
as one week to
enter dispensing
information.Texas State Board of Pharmacy Staff Report with Final Results
Issue 113
Sunset Advisory Commission
June 2017
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Ogle, Steven; Schiff, Tamara; Hartley, Cee & Teleki, Katharine. Staff Report with Final Results: Texas State Board of Pharmacy, report, June 2017; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth1033475/m1/37/: accessed July 17, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu.; crediting UNT Libraries Government Documents Department.