Pharmacies consider expanded services
CAP Center offers aid on new law
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FARGO - The North Dakota Legislature last January expanded the services pharmacies can provide in the state. Since then, pharmacies have been looking at how they might bring those services to their communities.
Helping in that effort is North Dakota State University Center for Collaboration and Advancement in Pharmacy, a largely grant-funded entity created in 2021 to help pharmacists expand services and improve health outcomes, especially in rural communities. Its core principles are education and training; programs and implementation; consulting and support; and developing data and identifying outcomes.
Elizabeth Skoy, director of the CAP Center and professor of pharmacy practice at NDSU, said the center has been helping draft documents for policies and procedures needed to properly execute new patient care services allowed under the law. Pharmacists now can prescribe medications for issues such as motion sickness and smoking cessation. They can provide basic vitals and tests and treatments for common illnesses such as flu, COVID-19 and strep throat.
Pharmacies across North Dakota are just beginning to add the new services. Most still are looking at whether the expansion is right for them and, if so, how to go about it. The CAP Center is helping by offering assistance as needed, from peer-reviewed handouts for patients who might test positive for an illness to guidance in navigating government paperwork.
"It can be really time consuming to figure out those things," Skoy said. "We're kind of doing some of that front work for the pharmacies, so that they know there’s a trusted resource that is providing that information to them."
NDSU also is utilizing the talents of its pharmacy students to assist in preparing the patient materials and traveling to pharmacies to provide training, which enhances their own training and experience, according to the CAP Center.
Prior to January's passage of the state law, pharmacies could implement the expanded services through a collaborative practice agreement with another healthcare professional, such as a medical doctor or nurse practitioner.
"We had a couple of pharmacies that were doing this type of work with collaborative practice agreements, but now, since this legislation," Skoy said, "we've seen a lot more showing interest and starting to actually go ahead and take that step in offering these services. We already have a few pharmacies across the state that have started getting this up and running."
There has been interest in Minot and area towns, and Skoy said those communities could start to see expanded services coming soon.
So far, the CAP Center has been simply engaging with pharmacies that reach out for information. Over the next couple of months, it plans to proactively collect information from pharmacies to determine their status in terms of the new services. Interest has come not only from pharmacies in the major cities but some rural pharmacies are getting involved, Skoy said.
Some rural communities may have clinics that are only open certain days a week. Having access to urgent care through a pharmacy can be a huge resource, Skoy said. Even in larger communities, during the peak respiratory illness season, wait times at walk-in clinics can be long. Pharmacies can ease that pressure by serving some of those patients, she said.
Skoy said training students to provide these types of expanded services has been part of the pharmacy school's curriculum for about a decade. NDSU began that training with the understanding that these services were the new frontier, just as administering vaccines at pharmacies was the new frontier 20 years ago, she said. For pharmacists already in practice, the CAP Center has been filling that training need.
Independent prescribing by pharmacists has been a national trend, Skoy added. Some states have lifted nearly all restrictions on pharmacists as long as they're properly qualified and trained, she said. In Idaho, a pharmacist in a remote mountainous area became qualified to suture wounds to be able to serve patients because access to a clinic wasn't readily available.
In North Dakota, staffing limitations can be a hurdle for pharmacists looking to take on more services. Skoy said NDSU aims to help address the shortage of pharmacists, particularly in western North Dakota, through a new Doctor of Pharmacy degree program at Dickinson State University that could begin in the fall of 2027. NDSU is going through an accreditation process currently to create a satellite partnership with DSU that will be an extension of the pharmacy program at the Fargo campus.
"They'll be attending Dickinson State University, but they would also be NDSU students," Skoy said. "This is a way where we will, hopefully, be able to tap into some of those individuals that will be wonderful pharmacists, but it's just that they don't necessarily want to move to Fargo for six years."
The CAP Center also is engaged in a collaborative project with the North Dakota Department of Health and Human Services in which it provides stipends to advanced-practice pharmacy students to intern in western North Dakota or rural areas of the state. The stipend can offset the cost of housing. Additionally, the CAP Center received a Rural Health Transformation grant for use in incentivizing healthcare students to practice in rural areas.
As the CAP Center continues its efforts, its need for long-term funding is rising. In response, the center promoted its initiative Tuesday, Oct. 27, on NDSU Giving Day, to start an endowment. The center is seeking donations to build the endowment, which would provide proceeds to expose students to new communities, provide scholarships to students working on CAP Center initiatives and fuel pilot projects and other programming.