1919.1 Following review of a patient's medical record and prior to dispensing a drug or medical device, a pharmacist shall make a verbal offer to counsel, or his designee shall notify the patient or the patient's agent of the opportunity to receive an oral consultation from the pharmacist:

1. (a) Whenever a prescription drug or device has not previously been dispensed to a patient;
2. (b) Whenever a prescription drug or device has not previously been dispensed to a patient in the same dosage form, strength, or with the same written directions;
3. (c) Once yearly on maintenance medications; or
4. (d) Whenever the pharmacist deems it warranted in the exercise of his or her professional judgment.

1919.2 The pharmacy shall post a sign in a conspicuous manner informing patients of their right to receive an oral consultation from the pharmacist regarding their prescriptions.

1919.3 The consultation shall be face to face, whenever practicable, or by telephone and shall include appropriate elements of patient counseling which may include the following:

1. (a) The name and description of the drug or device;
2. (b) The dosage form, dosage, route of administration, and duration of drug therapy;
3. (c) Intended use of the drug or device and expected action;
4. (d) Special directions and precautions for preparation, administration, and use by the patient;
5. (e) Common severe side or adverse effects or interactions and therapeutic contraindications that may be encountered, including their avoidance, and the action required if they occur;
6. (f) Techniques for self-monitoring of drug therapy;
7. (g) Proper storage;
8. (h) Prescription refill information;

(i) Action to be taken in the event of a missed dose; and

(j) Pharmacist comments relevant to the individual's drug therapy, including any other information peculiar to the specific patient, drug, or device.

1919.4 The consultation shall be reinforced with the provision of written information which may include:

(a) Information leaflets:

(b) Pictogram labels; or

(c) Video programs.

1919.5 When the patient or patient's agent is not present, as in the case of prescription deliveries, the pharmacist shall ensure that the patient receives written notice:

(a) Of his or her right to request consultation; and

(b) A telephone number from which the patient may obtain oral consultation from a pharmacist who has ready access to the patient's record.

1919.6 Only a pharmacist may counsel a patient or the patient's agent and answer questions concerning prescription drugs or devices.

1919.7 A pharmacist shall assess to the best of his or her ability that the patient or agent understands the counseling information provided.

1919.8 A pharmacist shall not be required to counsel a patient or caregiver when the patient or caregiver refuses consultation. The pharmacist shall document such refusal for consultation.

1919.9 A pharmacist shall not be required to counsel an inpatient of a health care facility, where other licensed health care professionals are authorized to administer drugs, except upon request.

SOURCE: Final Rulemaking published at 38 DCR 6734, 6752 (November 8, 1991); as amended by Notice of Final Rulemaking published at 55 DCR 270 (January 11, 2008).