In community pharmacies, situations may arise when a patient enters, hoping to have a prescription renewed by the pharmacist because they were not able to see the original prescriber for a renewal. For a pharmacist with additional prescribing authorization (APA), this is a straightforward scenario, beginning with an assessment of the patient and the appropriateness of their current therapy. For pharmacists who do not have APA, however, there are more factors to consider.
First, depending on the assessment they perform, pharmacists without APA may renew the prescription—as originally written—to allow for continuity of care. It’s important to remember that pharmacists without APA are not empowered to alter the dose of the medication when renewing a prescription. This would be considered managing ongoing therapy and can only be performed by a pharmacist with APA.
If a pharmacist without APA determines that, based on their assessment, the patient would benefit from an alternate dose of the drug, or a different course of drug therapy, they should collaborate with the original prescriber or a pharmacist with APA, who must conduct their own assessment of the patient. The pharmacist with APA must also have seen the patient in person at the time of prescribing or have a current professional relationship with the patient established over a period of time.
Of course, the best-case scenario is that more pharmacists have their APA. Pharmacists who find themselves in situations like the one described above are strongly encouraged to apply for their APA. You can find more information on the Additional prescribing authorization page on the ACP website.
