(a) For the purposes of this section:

Terms Used In Connecticut General Statutes 20-631

  • Care-giving institution: means an institution that provides medical services and is licensed, operated, certified or approved by the Commissioner of Public Health, the Commissioner of Developmental Services or the Commissioner of Mental Health and Addiction Services. See Connecticut General Statutes 20-571
  • Commission: means the Commission of Pharmacy appointed under the provisions of §. See Connecticut General Statutes 20-571
  • Commissioner: means the Commissioner of Consumer Protection. See Connecticut General Statutes 20-571
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Department: means the Department of Consumer Protection. See Connecticut General Statutes 20-571
  • Deprescribing: means the systematic process of identifying and discontinuing drugs in instances in which existing or potential harms outweigh existing or potential benefits within the context of an individual patient's care goals, current level of functioning, life expectancy, values and preferences. See Connecticut General Statutes 20-571
  • Device: means instruments, apparatuses and contrivances, including their components, parts and accessories, intended (A) for use in the diagnosis, cure, mitigation, treatment or prevention of disease in humans or other animals, or (B) to affect the structure or any function of the body of humans or other animals, but does not mean contact lenses. See Connecticut General Statutes 20-571
  • Drug: means (A) an article recognized in the official United States Pharmacopoeia, official Homeopathic Pharmacopoeia of the United States or official National Formulary, or any supplement to any of them, (B) an article intended for use in the diagnosis, cure, mitigation, treatment or prevention of disease in humans or other animals, (C) an article, other than food, intended to affect the structure or any function of the body of humans or any other animal, and (D) an article intended for use as a component of any article specified in this subdivision, but does not include a device. See Connecticut General Statutes 20-571
  • Medication reconciliation: means a process of comparing the medications a patient is taking and should be taking with newly ordered medications (A) for the purpose of addressing duplications, omissions and interactions and the need to continue current medications, and (B) by looking at information such as the medication name, dose, frequency, route of administration and purpose. See Connecticut General Statutes 20-571
  • Pharmacist: means an individual who is licensed to practice pharmacy under the provisions of §. See Connecticut General Statutes 20-571
  • Pharmacy: means a place of business where drugs and devices may be sold at retail and for which a pharmacy license has been issued to an applicant under the provisions of §. See Connecticut General Statutes 20-571
  • Polypharmacy: means the use of multiple drugs by a patient, including any medication that is inappropriate or not medically necessary, such as those not indicated, not effective or constituting a therapeutic duplication. See Connecticut General Statutes 20-571
  • Prescribing practitioner: means an individual licensed by the state of Connecticut, any other state of the United States, the District of Columbia, the Commonwealth of Puerto Rico or any territory or insular possession subject to the jurisdiction of the United States who is authorized to issue a prescription within the scope of the individual's practice. See Connecticut General Statutes 20-571

(1) “Care-giving institution” has the same meaning as provided in § 20-571;

(2) “Commissioner” means the Commissioner of Consumer Protection;

(3) “Collaborative drug therapy care plan” means a written document memorializing the outcome of the process through which one or more qualified pharmacists and one or more prescribing practitioners discuss, review and agree on an approach to achieve a patient’s desired health outcome;

(4) “Collaborative drug therapy management agreement” means an agreement between one or more qualified pharmacists and one or more prescribing practitioners to manage the drug therapy of, and devices prescribed to, individual patients, or a patient population, based on a written protocol or a collaborative drug therapy care plan;

(5) “Collaborative drug therapy management policy” means a written policy adopted by a care-giving institution under which one or more qualified pharmacists manage the drug therapy of, and devices prescribed to, individual patients, or a patient population, based on a written protocol or a collaborative drug therapy care plan;

(6) “Device” has the same meaning as provided in § 20-571;

(7) “Pharmacist” has the same meaning as provided in § 20-571;

(8) “Prescribing practitioner” has the same meaning as provided in § 20-571;

(9) “Provider-patient relationship” means a relationship between a prescribing practitioner and a patient in which (A) the patient has made a medical complaint, (B) the patient has provided such patient’s medical history, (C) the patient has received a physical examination, and (D) there exists a logical connection between such medical complaint, medical history and physical examination and any drug or device prescribed for such patient; and

(10) “Qualified pharmacist” means a pharmacist who (A) is deemed competent under regulations adopted by the commissioner pursuant to subsection (e) of this section, and (B) has reviewed the latest edition of the “Pharmacists’ Patient Care Process” published by the Joint Commission of Pharmacy Practitioners.

(b) Except as provided in § 20-631b, one or more qualified pharmacists may enter into a collaborative drug therapy management agreement or manage the drug therapy of, and devices prescribed to, individual patients, or a patient population, under a collaborative drug therapy management policy. In order to enter into a collaborative drug therapy management agreement or collaborative drug therapy care plan, or operate under a collaborative drug therapy management policy, a prescribing practitioner shall first establish a provider-patient relationship with the patient or patients who will receive collaborative drug therapy or devices. Each patient’s collaborative drug therapy or device management shall be based on a diagnosis made by such patient’s prescribing practitioner or a specific test set forth in a collaborative drug therapy management agreement or collaborative drug therapy management policy.

(c) A collaborative drug therapy management agreement or collaborative drug therapy management policy may authorize a qualified pharmacist or qualified pharmacists to initiate, modify, continue, discontinue or deprescribe a drug therapy, or initiate, continue or discontinue use of, or deprescribe, a device, that has been prescribed for a patient, order associated laboratory tests and administer drugs, all in accordance with a patient-specific or patient population-specific written protocol or collaborative drug therapy care plan, but shall not authorize a qualified pharmacist or qualified pharmacists to establish a port to administer parenteral drugs. A collaborative drug therapy management agreement or collaborative drug therapy management policy may specifically address issues that may arise during a medication reconciliation and concerns related to polypharmacy that enable an authorized qualified pharmacist or qualified pharmacists to initiate, modify, continue, discontinue or deprescribe drug therapy. In instances where drug therapy is discontinued or deprescribed, the qualified pharmacist or qualified pharmacists shall notify the prescribing practitioner of such discontinuance or deprescribing not later than twenty-four hours after such drug therapy is discontinued or deprescribed. Each written protocol or collaborative drug therapy care plan developed, pursuant to a collaborative drug therapy management agreement or collaborative drug therapy management policy, shall contain detailed direction concerning the actions that the qualified pharmacist or qualified pharmacists may perform for the patient or patient population. Such written protocol or collaborative drug therapy care plan shall include, but need not be limited to, (1) the specific drug or drugs, therapeutic class of drug or classes of drugs, or devices to be managed by the qualified pharmacist or qualified pharmacists, (2) the terms and conditions under which drug therapy may be initiated, modified, continued, discontinued or deprescribed, or use of a device may be initiated, continued or discontinued, or a device may be deprescribed, (3) the conditions and events upon which the qualified pharmacist is, or qualified pharmacists are, required to notify the prescribing practitioner, (4) the laboratory tests that may be ordered, and (5) a definition of the patient population included in such written protocol or collaborative drug therapy care plan. All activities performed by the qualified pharmacist or qualified pharmacists in conjunction with the protocol or collaborative drug therapy care plan shall be documented in the patient’s medical record in accordance with the prescribing practitioner’s policies or, in the case of a care-giving institution, all applicable care-giving institution policies. Each collaborative drug therapy management agreement, collaborative drug therapy management policy, written protocol and collaborative drug therapy care plan shall be available for inspection by the Department of Consumer Protection and the Department of Public Health. A copy of the protocol shall be filed in the patient’s medical record.

(d) A pharmacist shall be responsible for demonstrating, in accordance with regulations adopted pursuant to subsection (e) of this section, the competence necessary for the pharmacist to participate in each collaborative drug therapy management agreement, collaborative drug therapy management policy and collaborative drug therapy care plan in which such pharmacist seeks to participate by, among other things, demonstrating that such pharmacist has reviewed the latest edition of the “Pharmacists’ Patient Care Process” published by the Joint Commission of Pharmacy Practitioners.

(e) The Commissioner of Consumer Protection, in consultation with the Commissioner of Public Health, shall (1) adopt regulations, in accordance with chapter 54, concerning competency requirements for participation in a collaborative drug therapy management agreement, the minimum content of the collaborative drug therapy management agreement and such other matters said commissioners deem necessary to carry out the purpose of this section, and (2) on or after July 1, 2022, amend such regulations to include competency requirements for participation in a collaborative drug therapy management policy or collaborative drug therapy care plan and the minimum content of collaborative drug therapy management policies, collaborative drug therapy care plans and written protocols governing collaborative drug therapy and device management.