Pharmacist Authority to Prescribe Pursuant to Section 338.665

PURPOSE: This rule establishes requirements for pharmacists prescribing as authorized by section 338.665, RSMo. (1) Definitions. (A) A nicotine replacement therapy product; as defined by section 338.665, RSMo. (2) Training. Pharmacists prescribing must be competent to perform the services provided and shall maintain ongoing/ continued competency. (3) Pharmacist prescribing and patient care activities must be safely and properly performed. (A) Pharmacists shall collect patient or medical history to allow the pharmacist to properly assess the patient and safely provide patient care. Prior to prescribing, the pharmacist shall use a screening procedure based on generally accepted clinical guidelines to identify appropriate patients for treatment. The pharmacist shall refer high-risk patients or patients with a contraindication to the patient’s primary care provider or an appropriate healthcare provider, as deemed necessary or appropriate. (B) In addition to this rule, pharmacists shall comply with all applicable provisions of Chapter 338, RSMo, and the rules of the Board of Pharmacy governing prescribing and record-keeping, including, but not limited to, 20 CSR 2220-2.018. Pharmacists may provide a prescription to the patient or transmit a prescription for that patient to a pharmacy for dispensing. (4) Patient medical records. Prescribing pharmacists shall maintain an adequate and complete patient medical record for each patient that documents the care provided. Patient medical records must be individually retrievable. (A) At a minimum, the required patient medical record must include: 1. The patient’s name, birthdate, address and telephone number; 2. The date(s) the patient was seen; 3. The patient’s primary care provider, if provided; 4. Documentation of the patient screening as required by section (3) of this rule; 5. Any pertinent medical or medication information/ history; 6. The name and dosage of any medication prescribed; 7. Any recommended medication treatment plan(s) or follow-up consultation(s); and 8. Any healthcare provider referrals. (B) Patient medical records must be securely and confidentially maintained in compliance with applicable state and federal law. At a minimum, patient medical records must be maintained for five (5) years from the date created. Records maintained at a pharmacy must be produced immediately or within two (2) hours of a request from the Board of Pharmacy or an authorized designee of the Board of Pharmacy. Records not maintained at a pharmacy must be produced within three (3) business days of a request from the Board of Pharmacy. AUTHORITY: section 334.125, RSMo 2016, and sections 338.010 and 338.665, RSMo Supp. 2019.* Original rule filed March 9, 2020, effective Oct. 30, 2020. *Original authority: 334.125, RSMo 1959, amended 1993, 1995, 2014; 338.010, RSMo 1939, amended 1951, 1989, 1990, 2007, 2009, 2011, 2014, 2017, 2018, 2019; and 338.665, RSMo 2019.