Nebraska Statutes 38-2869. Prospective drug utilization review; counseling; requirements
(1)(a) Prior to the dispensing or the delivery of a drug or device pursuant to a medical order to a patient or caregiver, a pharmacist shall in all care settings conduct a prospective drug utilization review. Such prospective drug utilization review shall involve monitoring the patient-specific medical history described in subdivision (b) of this subsection and available to the pharmacist at the practice site for:
Terms Used In Nebraska Statutes 38-2869
- Action: shall include any proceeding in any court of this state. See Nebraska Statutes 49-801
- Administration: means the act of (1) administering, (2) keeping a record of such activity, and (3) observing, monitoring, reporting, and otherwise taking appropriate action regarding desired effect, side effect, interaction, and contraindication associated with administering the drug or device. See Nebraska Statutes 38-2807
- Board: means the Board of Pharmacy. See Nebraska Statutes 38-2808
- Caregiver: means any person acting as an agent on behalf of a patient or any person aiding and assisting a patient. See Nebraska Statutes 38-2809
- Device: means an instrument, apparatus, implement, machine, contrivance, implant, in vitro reagent, or other similar or related article, including any component, part, or accessory, which is prescribed by a practitioner and dispensed by a pharmacist or other person authorized by law to do so. See Nebraska Statutes 38-2814
- Dispensing: includes (a) dispensing incident to practice, (b) dispensing pursuant to a delegated dispensing permit, (c) dispensing pursuant to a medical order, and (d) any transfer of a prescription drug or device to a patient or caregiver other than by administering. See Nebraska Statutes 38-2817
- Facility: means a health care facility as defined in section Nebraska Statutes 38-2822
- Medical gas: means oxygen in liquid or gaseous form intended for human consumption. See Nebraska Statutes 38-2826.02
- Medical gas device: means a medical device associated with the administration of medical gas. See Nebraska Statutes 38-2826.03
- Medical order: means a prescription, a chart order, or an order for pharmaceutical care issued by a practitioner. See Nebraska Statutes 38-2828
- Patient counseling: means the verbal communication by a pharmacist, pharmacist intern, or practitioner, in a manner reflecting dignity and the right of the patient to a reasonable degree of privacy, of information to the patient or caregiver in order to improve therapeutic outcomes by maximizing proper use of prescription drugs and devices and also includes the duties set out in section Nebraska Statutes 38-2830
- Person: shall include bodies politic and corporate, societies, communities, the public generally, individuals, partnerships, limited liability companies, joint-stock companies, and associations. See Nebraska Statutes 49-801
- Pharmacist: means any person who is licensed by the State of Nebraska to practice pharmacy. See Nebraska Statutes 38-2832
- Practitioner: means a certified registered nurse anesthetist, a certified nurse midwife, a dentist, an optometrist, a nurse practitioner, a physician assistant, a physician, a podiatrist, or a veterinarian. See Nebraska Statutes 38-2838
- Prescription: means an order for a drug or device issued by a practitioner for a specific patient, for emergency use, or for use in immunizations. See Nebraska Statutes 38-2840
- Telepharmacy: means the provision of pharmacist care, by a pharmacist located within the United States, using telecommunications, remote order entry, or other automations and technologies to deliver care to patients or their agents who are located at sites other than where the pharmacist is located. See Nebraska Statutes 38-2845.01
(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 utilization review 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 maintain records of the following information to facilitate such review:
(i) The name, address, telephone number, date of birth, and gender of the patient;
(ii) The patient’s history of significant disease, known allergies, and drug reactions and a comprehensive list of relevant drugs and devices used by the patient; and
(iii) Any comments of the pharmacist relevant to the patient’s drug therapy.
(c) The assessment of data on drug use in any prospective drug utilization review shall be based on predetermined standards which are approved by the board.
(2)(a) Prior to the dispensing or delivery of a drug or device pursuant to a prescription, the pharmacist shall ensure that a verbal offer to counsel the patient or caregiver is made. The refusal of the verbal offer to counsel must be documented. The counseling of the patient or caregiver by the pharmacist shall be on elements which, in the exercise of the pharmacist’s professional judgment, the pharmacist deems significant for the patient. Such elements may include, but need not be limited to, the following:
(i) The name and description of the prescribed drug or device;
(ii) The route of administration, dosage form, dose, and duration 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 contraindications occur;
(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 subsection shall be provided in person whenever practical or by the utilization of telepharmacy which is available at no cost to the patient or caregiver.
(c) Patient counseling shall be appropriate to the individual patient and shall be provided to the patient or caregiver.
(d) Written information may be provided to the patient or caregiver to supplement the patient counseling provided for in this subsection but shall not be used as a substitute for such patient counseling.
(e) A verbal offer to counsel is not required when:
(i) The pharmacist, in his or her professional judgment, determines that patient counseling may be detrimental to the patient’s care or to the relationship between the patient and his or her practitioner;
(ii) The patient is a patient or resident of a health care facility or health care service licensed under the Health Care Facility Licensure Act to whom prescription drugs or devices are administered;
(iii) A medical gas or a medical gas device is administered, dispensed, or distributed by a person described in subdivision (10) of section 38-2850 ; or
(iv) A device described in subsection (2) of section 38-2841 is sold, distributed, or delivered by a person described in subdivision (11) of section 38-2850.