38-2869 Prospective drug utilization review; counseling; requirements.
38-2869. Prospectivedrug utilization review; counseling; requirements.(1)(a)Prior to the dispensing or the delivery of a drug or device pursuant to amedical order to a patient or caregiver, a pharmacist shall in all care settingsconduct a prospective drug utilization review. Such prospective drug utilizationreview shall involve monitoring the patient-specific medical history describedin subdivision (b) of this subsection and available to the pharmacist at thepractice site for:(i) Therapeutic duplication;(ii) Drug-disease contraindications;(iii) Drug-drug interactions;(iv) Incorrect drug dosage or duration of drug treatment;(v) Drug-allergy interactions; and(vi) Clinical abuse or misuse.(b) A pharmacist conducting a prospective drug utilizationreview shall ensure that a reasonable effort is made to obtain from the patient,his or her caregiver, or his or her practitioner and to record and maintainrecords of the following information to facilitate such review:(i) The name, address, telephone number, date of birth, andgender of the patient;(ii) The patient's history of significant disease, knownallergies, and drug reactions and a comprehensive list of relevant drugs anddevices used by the patient; and(iii) Any comments of the pharmacist relevant to the patient'sdrug therapy.(c) The assessment of data on drug use in any prospectivedrug utilization review shall be based on predetermined standards, approvedby the board.(2)(a) Prior to the dispensing or delivery of a drug or devicepursuant to a prescription, the pharmacist shall ensure that a verbal offerto counsel the patient or caregiver is made. The counseling of the patientor caregiver by the pharmacist shall be on elements which, in the exerciseof the pharmacist's professional judgment, the pharmacist deems significantfor the patient. Such elements may include, but need not be limited to, thefollowing:(i) The name and description of the prescribed drug or device;(ii) The route of administration, dosage form, dose, andduration of therapy;(iii) Special directions and precautions for preparation,administration, and use by the patient or caregiver;(iv) Common side effects, adverse effects or interactions,and therapeutic contraindications that may be encountered, including avoidance,and the action required if such effects, interactions, or contraindicationsoccur;(v) Techniques for self-monitoring drug therapy;(vi) Proper storage;(vii) Prescription refill information; and(viii) Action to be taken in the event of a missed dose.(b) The patient counseling provided for in this subsectionshall be provided in person whenever practical or by the utilization of telephoneservice which is available at no cost to the patient or caregiver.(c) Patient counseling shall be appropriate to the individualpatient and shall be provided to the patient or caregiver.(d) Written information may be provided to the patient orcaregiver to supplement the patient counseling provided for in this subsectionbut shall not be used as a substitute for such patient counseling.(e) This subsection shall not be construed to require a pharmacistto provide patient counseling when:(i) The patient or caregiver refuses patient counseling;(ii) The pharmacist, in his or her professional judgment,determines that patient counseling may be detrimental to the patient's careor to the relationship between the patient and his or her practitioner;(iii) The patient is a patient or resident of a health carefacility or health care service licensed under the Health Care Facility LicensureAct to whom prescription drugs or devices are administered by a licensed orcertified staff member or consultant or a certified physician's assistant;(iv) The practitioner authorized to prescribe drugs or devicesspecifies that there shall be no patient counseling unless he or she is contactedprior to such patient counseling. The prescribing practitioner shall specifysuch prohibition in an oral prescription or in writing on the face of a writtenprescription, including any prescription which is received by facsimile orelectronic transmission. The pharmacist shall note "Contact Before Counseling"on the face of the prescription if such is communicated orally by the prescribingpractitioner;(v) A medical gas or a medical gas device is administered,dispensed, or distributed by a person described in subdivision (12) of section 38-2850; or(vi) A devicedescribed in subsection (2) of section 38-2841 is sold, distributed, or deliveredby a business or person described in subdivision (13) of section 38-2850. SourceLaws 1993, LB 536, § 55; Laws 1998, LB 1073, § 63; Laws 2000, LB 819, § 92; Laws 2001, LB 398, § 45; Laws 2005, LB 382, § 8; R.S.Supp.,2006, § 71-1,147.35; Laws 2007, LB247, § 26; Laws 2007, LB463, § 965; Laws 2009, LB604, § 9; Laws 2010, LB849, § 12.Operative Date: July 15, 2010 Cross ReferencesHealth Care Facility Licensure Act, see section 71-401.