CPA legislation varies from state to state. This relates to the specific services that pharmacists are allowed to provide under a CPA, as well as the terms of the agreement (for example. B requirements for the extension of the CPA). Wisconsin Act 294, for example, has been described by the American Pharmacists Association (APhA) as granting some of the broadest powers to pharmacists in any CPA government law. [6] [20] In 2012, the AAFP prepared a position paper expressing support for CPAs,[59] but highlighted the risk of fragmentation of supply if fully autonomous prescribing privileges were granted to pharmacists. [60] CPAs also report cost savings within the health care system. Touchette and colleagues examined the economic impact of clinical pharmaceutical services and found that the benefit-to-earnings ratio ranged from 1.05:1 to 25.95:1.7. A survey conducted by Thomas and his colleagues at hospitals in Illinois, Indiana and Michigan showed that hospital administrators believe that pharmaceutical drug management contributes to the hospital`s strategic vision.8 NPO has currently integrated its two clinical pharmacists into five of its member practices. These pharmacists have current collaborative practice agreements that allow them to tailor drugs to optimize health outcomes in collaboration with practitioners. On clinic days, PCMH apothecaries have a provider plan and see patients at the clinic, call patients by phone or perform virtual telephetem meetings. The meetings focus on managing the state of the disease through medication and lifestyle interventions. Pharmacists are trained in care management and motivational interviews.

These meetings focus mainly on diabetes, hypertension and hyperlipidemia of the patient, who have all the evidence of the involvement and effectiveness of pharmacists in this role. During these meetings, the pharmacist will focus on progress in developing health goals, adapting disease-related drugs, compliance issues and gaps in care based on HEDIS quality measures. Patients are booked on the apothecary by referral from doctor/provider or identified by a registry examination. Ongoing efforts to manage the condition of the disease have been to extend the management of patients with additional pathologies beyond diabetes, high blood pressure and hyperlipidemia. The focus has been on chronic diseases, managed or influenced by medications such as asthma and COPD, heart disease and smoking cessation. The CDTM is an extension of the traditional practice of pharmacists, which helps to manage drug-related problems (PDs) led by pharmacists, with an emphasis on a collaborative and interdisciplinary approach to pharmacy practice in the health sector.