Rhode Island: Pharmacists address social issues
Rhode Island is rather restrictive regarding pharmacists’ scope of practice. Nevertheless, pharmacists are doing everything they can to address issues like unwanted pregnancy, opioid-use disorder, chronic disease management and health care for underserved populations.
A decade ago, Rhode Island passed the first “statewide collaborative practice agreement,” allowing pharmacists to accept prescribing authority delegated to them by physicians. Under a federal grant, this is allowing University of Rhode Island College of Pharmacy researchers to study pharmacists’ collaborative role in managing patients for opioid use disorder at six pharmacies.
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Nineteen specially trained pharmacists interview patients, take medical histories, make opioid withdrawal assessments, test for the presence of various drugs and dispense buprenorphine, said Jeffrey Bratberg, clinical professor at the University of Rhode Island College of Pharmacy and who works closely with the Rhode Island Department of Health. “We do everything a physician would do so people receive care.”
In June, the first federally funded pilot COVID-19 test-to-treat center was launched at Clinica Esperanza in Providence. It serves uninsured people, including undocumented immigrants. “It’s a hugely underserved community,” said Chris Federico, president of the Warwick-based Rhode Island Pharmacists Association, or RIPA. “Many patients would otherwise burden the system.” Federico said he hopes to use the treatment model to address other conditions.
Rhode Island has an unplanned pregnancy rate of 20%, Bratberg said. For several years, pharmacists and RIPA have supported a bill that would let them prescribe, dispense and receive service reimbursement for FDA-approved hormonal contraceptives. The bill passed the House in March. But when the Senate convened on June 23, it was not considered for a vote — ironically, this was the day before the U.S. Supreme Court voted to overturn Roe v. Wade.
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Bratberg and Federico are not entirely sure why the bill failed and whether the Roe v. Wade decision was influential. Rhode Island has long supported reproductive freedom and is one of 14 states (plus Washington, D.C.) with laws protecting abortion rights. The contraceptive bill was strongly supported by the American College of Obstetrics & Gynecology and the Rhode Island Medical Society.
“We were optimistic,” Federico said. “Now we’ll work on collaborating with bill sponsors for next year.”
Scope of practice
- In 2007, Rhode Island pharmacists gained authority to administer vaccinations. Pharmacy students also can provide them after one year of education, as can pharmacy technicians; and
- In 2021, Senate Bill 0879A authorized pharmacists’ administration of adult immunizations and medications approved by the Department of Health in consultation with the board of pharmacy pursuant to a valid prescription or physician-approved protocol. Medications have not yet been specified.