The third alternative strategy participants considered was allowing people sick with flu to visit a pharmacy for a face-to-face visit with a pharmacist working under a collaborative practice agreement with a physician. Such a pharmacist would be authorized to prescribe and dispense antiviral medications by following specific prescribing “guidelines” or protocols that would be developed by “flu experts” for this purpose. To introduce participants to this idea, the ARS presurvey statements prompted them to think about whether this arrangement should be “allowed” and whether they could “trust” pharmacists to fulfill this role.
During the small-group scenario discussions that followed, participants were asked to address several questions that pertain directly to the strategy of pharmacists prescribing antivirals under collaborative practice agreement:
1. What are the pros and cons of pharmacist prescribing of antiviral medications?
• What might work well, what could go wrong, what are ways to improve this strategy?
2. Would you trust a pharmacist working under a collaborative practice agreement to prescribe antivirals if you could not see your regular health care provider?
3. Would you have any concerns about going to a pharmacy to pick up antiviral drugs during an emergency?
Advantages and Disadvantages of Antiviral Prescribing by Pharmacists Under Collaborative Practice Agreements
One advantage expressed by several participants was that the public is already familiar with the concept of expanded scope of practice by pharmacists who, for instance, provide flu shots in many locations. Other themes that many participants in small groups in each location identified are
• Pharmacists are knowledgeable and have the best training of any medical professional on antivirals and other medications.
• Pharmacists are trusted medical professionals.