(A) Prior to dispensing any prescription, a pharmacist shall review the patient profile for the purpose of identifying:
(1) Over-utilization or under-utilization;
(2) Therapeutic duplication;
(3) Drug-disease state contraindications;
(4) Drug-drug interactions;
(5) Incorrect drug dosage;
(6) Drug-allergy interactions;
(8) Inappropriate duration of drug treatment;
(9) Food-nutritional supplements-drug interactions.
(B) Upon recognizing any of the above, a pharmacist, using professional judgment, shall take appropriate steps to avoid or resolve the potential problem. These steps may include requesting and reviewing an OARRS report or another state's report if applicable and available, and/or consulting with the prescriber and/or counseling the patient.
(C) Prospective drug utilization review shall be performed using predetermined standards consistent with, but not limited to, any of the following:
(1) Peer-reviewed medical literature (that is, scientific, medical, and pharmaceutical publications in which original manuscripts are rejected or published only after having been critically reviewed by unbiased independent experts);
(2) American hospital formulary service drug information;
(3) United States pharmacopoeia drug information;
(4) American medical association evaluations.
(D) Prior to dispensing a prescription, at a minimum, a pharmacist shall request and review an OARRS report covering at least a one year time period and/or another state's report, where applicable and available, if a pharmacist becomes aware of a person currently:
(1) Receiving reported drugs from multiple prescribers;
(2) Receiving reported drugs for more than twelve consecutive weeks;
(3) Abusing or misusing reported drugs (i.e. over-utilization, early refills, appears overly sedated or intoxicated upon presenting a prescription for a reported drug, or an unfamiliar patient requesting a reported drug by specific name, street name, color, or identifying marks);
(4) Requesting the dispensing of reported drugs from a prescription issued by a prescriber with whom the pharmacist is unfamiliar (i.e. prescriber is located out-of-state or prescriber is outside the usual pharmacy geographic prescriber care area); or.
(5) Presenting a prescription for reported drugs when the patient resides outside the usual pharmacy geographic patient population.
After obtaining an initial OARRS report on a patient, a pharmacist shall use professional judgment based on prevailing standards of practice in deciding the frequency of requesting and reviewing further OARRS reports and/or other states' reports for that patient.
In the rare event a report is not immediately available, the pharmacist shall use professional judgment in determining whether it is appropriate and in the patient's best interest to dispense the prescription prior to receiving and reviewing a report.
R.C. 119.032 review dates: 08/10/2011 and 10/01/2016
Promulgated Under: 119.03
Statutory Authority: 4729.26
Rule Amplifies: 4729.26
Prior Effective Dates: 9/10/76, 9/1/85, 3/1/93, 2/1/98, 3/1/99, 4/27/07