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Learn more about "Collaborative Care" by reading excerpts from the Washington State Pharmacy Association (WSPA) submitted to the Washington State Attorney General in 2018 to frame the expansion of care as efforts to address unmet patient needs.
Timeline of Events that Changed the Practice of Pharmacy
1890 – Washington Pharmacy Law - Washington became the 42nd state in November of 1889. Washington State Pharmacy Association was formed in 1890 by the then 157 drug stores in the state. By 1890 the organization was successful in helping establish a pharmacy law that required registration books kept in the pharmacy for the sale of poisons, alcohol, wines, and spiritous liquors; and also required labeling of all poisons. The law included creating a Board of Pharmacy to self-regulate the profession[1].
1906 – The Pure Food and Drug Act - Responding to outcries from Upton Sinclair’s book, The Jungle, that described the horrific unsanitary conditions in the meat-packing industry, Congress established this act, and it was the first in a series of consumer protection laws. It mandated labeling of active ingredients for drug packaging and standards for drug purity.
1919 – Prohibition - The 19th amendment outlawed alcohol nationally (1916 in Washington state), but still allowed pharmacists to sell “medicinal liquor”. Sixty-five new drugstores opened in Seattle in the first 3 months of 1916! This remedy was made illegal in 1917, but “wine tonics” containing up to 22 percent alcohol were the exception[2].
1938 - FDA – Remember Thalidomide? - The Food, Drug and Cosmetic Act of 1938 evolved from the 1906 law to oversee the safety of food, drugs, medical devices and cosmetics. More than 100 deaths from a sulfonamide medication stimulated laws to control all aspects of drug research, manufacturing and marketing. It kept Thalidomide off the American market after it caused thousands of birth defects from use in Europe.
1965 – Medicare – President Lyndon Johnson signed this bill at the Truman Library while Vice President and former licensed pharmacist, Hubert Humphry looked on. Former President Truman was the first beneficiary who first proposed a national health insurance program in 1945. Pharmacy joined the coverage in 2006 as Medicare Part D.
1970 - Child Resistant Containers - As part of the 1970 Poison Prevention Packaging Act signed by President Nixon, this mandated all kinds of safety packaging of household cleaners, solvents and other hazardous materials that were accessible to children. It also included child-resistant packaging for prescriptions and over-the-counter medications. Annual poisonings and deaths of children decreased drastically.
1971 - Drug Interactions - Drs. Phillip Hansten (WSU) and John Horn (UW) authored their first edition of Drug Interactions in 1971 and have since sold over 1 million copies worldwide. Their work evolved into the “safety net” of ALL on-line pharmacy dispensing systems to alert pharmacists of potential drug interactions during filling and dispensing a medication.
1979 – Washington State Improves their Practice Act to Expand Pharmacy Practice - Washington was the first state to pass a new Pharmacy Practice Act allowing Collaborative Drug Therapy Agreements. This allowed pharmacists to prescribe, modify or discontinue drug therapies, plus order lab tests, and give immunizations. The law also enacted mandatory Patient Profiles and eventually required pharmacists to do patient counseling.
1994 - Washington State Begins Trainings for Immunizations by Pharmacists - Washington was the first state to establish training, licensure and implementation of immunizations. Developed by the Washington State Pharmacy Association, staff and volunteers presented programs to help other states to duplicate their immunization practice. With the CDC’s (Center for Disease Control) approval, the American Pharmacist Association (engaged in training of other states) standardized training for all states.
1997 - WA State Emergency Contraception Program (Plan B) - The “morning-after” pill was approved for prescription only in 1999. In 2006 it was approved as over-the-counter sales for women 18 and older when dispensed by a pharmacist. Washington state was the first to allow this after an approved training program was completed by the individual pharmacist.
2012 - Kelley-Ross Pharmacy in Seattle Launched the First Naloxone Opioid Rescue - The first pharmacy in the United States to provide Take-Home Naloxone Kits for opioid overdose poisoning was Kelley-Ross. Since then, Kelley-Ross has distributed over 10,000 doses to individuals, first responders, police, and school districts. The intra-nasal two-dose rescue kit gives victims valuable minutes until first responders arrive after 911 is called. Our Good Samaritan Laws protect victims and helpers from minor drug possession charges so that witnesses of an OD victim will administer aid rather than flee. See kelley-rossrx.com for more information and an educational video.
2014 - Kelley-Ross Launches PrEP Pharmacy Programs - PrEP means Pre-Exposure Prophylaxis for HIV infections. One-Step PrEP® was developed for pharmacy use by Kelley-Ross Pharmacy, presented to the Center for Disease Control and now adopted by pharmacies across the country. Patients receive one in-clinic visit every 3 months with their pharmacist to establish and maintain their treatment.
2015 - WA State Health Insurance Bill Provides Coverage for Care Provided by Pharmacists - Washington state Governor Inslee signed a bill which paved the way for pharmacists to increase patient access to medical care by recognizing pharmacists as providers of services covered by medical insurance. Prior to this law, patients could get services from pharmacists, but they were not covered by their health insurance. This law allowed pharmacies to expand covered services they offer to their patients, such as Medication Therapy Management, Immunizations, TB Screenings, Diabetes Management, in-home training visits, Brown Bag medication evaluations, ETC- by patient medical insurance plans.
2016 - WSU Launches Immunization Training for Technicians - Recognizing a health care manpower need, Washington State University developed a technician training program for vaccinations. It was then co-sponsored by the American Pharmacist Association and has trained over 10,000 pharmacy technicians for vaccination certification since March 2020, just in time for the COVID-19 vaccinations.
2018 Safe Medication Return Program - In response to the need to confront the risk of accidental and unprescribed use of opioids and other medications, Washington State passed House Bill 1047 which created the Safe Medication Return Program. The provides a safe and secure method for the disposal of outdated/unused prescription medications at no cost to patients or taxpayers. This program is funded by drug manufacturers. Most pharmacies now have disposal kiosks for customers to deposit unwanted medications for their safe destruction. Proper disposal of (Dumping unused) narcotics and other medications is critical to the safety and wellbeing of our communities. Washington state was the first state to adopt this important health care initiative.
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