General Laws of Massachusetts - Chapter 94C Controlled Substances Act - Section 21A Prescriptions; prospective drug review and counseling by pharmacist

Section 21A. A pharmacist shall conduct a prospective drug review before each new prescription is dispensed or delivered to a patient or a person acting on behalf of such patient. Such review may include, but not be limited to, screening for potential drug therapy problems due to therapeutic duplication, drug disease contraindication, drug interactions, including serious interactions with nonprescription or over-the-counter drugs, incorrect drug dosage, duration of drug treatment, drug allergy interactions and clinical abuse or misuse.

A pharmacist shall offer to counsel any person who presents a new prescription for filling. Such offer shall be made either by face to face communication between the pharmacist or the pharmacist’s designee and the patient, or by telephone, except when the patient’s needs or availability require an alternative method of counseling.

If a person elects delivery of a prescription drug at a location other than a pharmacy, the requirements of this section may be satisfied by providing such person with access to a toll-free telephone service to facilitate communication between such person and the pharmacist at such pharmacy. The number of such toll-free telephone service shall be printed on a label affixed to each container of a prescription drug dispensed by a pharmacy to a patient.

For the purposes of medical assistance and other third party reimbursements or payment programs, any of the above methods, or a combination thereof, shall constitute an acceptable offer to provide counseling.

If an offer to provide counseling is accepted, the pharmacist shall counsel the person presenting the prescription to the extent the pharmacist deems appropriate. Such counseling may include, but not be limited to, the following:

(1) the name and description of the medication;

(2) the dosage form, dosage, route of administration and duration of drug therapy;

(3) special instructions and precautions for preparation, administration and use by the patient;

(4) common adverse or severe side effects or interactions and therapeutic contraindications that may be encountered, including their avoidance and the action required if they occur;

(5) techniques for self-monitoring drug therapy;

(6) proper storage;

(7) prescription refill information; and

(8) action to be taken in the event of a missed dose.

Nothing in this section shall be construed to require a pharmacist to provide counseling if the person presenting the prescription declines to accept such offer for counseling.

The pharmacist or his designee shall make reasonable efforts to obtain, record and maintain the following patient information generated at an individual pharmacy:

(1) the name, address, telephone number, date of birth or age, and gender;

(2) individual history where significant, including known allergies and drug reactions, and a comprehensive list of medications and relevant devices; and

(3) any additional comments relevant to the patient’s drug use, including any failure to accept the pharmacist’s offer to counsel.

Such information may be recorded in the patient’s manual or electronic profile or in the prescription signature log, or in any other system of records and may be considered by the pharmacist in the exercise of his professional judgement concerning both the offer to counsel and the content of counseling. The absence of any record of a failure to accept the pharmacist’s offer to counsel shall create a presumption that such counseling was provided.

The provisions of this section shall not apply to any drug dispensed to an inpatient at a hospital or nursing home, except to the extent required by regulations promulgated by the Federal Health Care Financing Administration pursuant to the provisions of 42 USC 1396r-8.

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Last modified: September 11, 2015