CPJE Patient Consultation Requirements — Questions and Answers
Question 1: Under CCR 1707.2, a California pharmacist must provide oral consultation in which of the following situations?
- When a prescription drug the patient has not received before at that pharmacy is dispensed (Correct answer)
- Only when the patient asks for it
- Only for controlled substances in Schedules II–V
- Only when the prescriber writes 'consult' on the prescription
Correct answer: When a prescription drug the patient has not received before at that pharmacy is dispensed
CCR 1707.2 requires oral consultation whenever a prescription drug the patient has not previously received at that pharmacy is dispensed. It is also required when the dosage form, strength, or directions change, when the patient asks, and when the pharmacist judges it warranted. The pharmacist does not need a request or a prescriber note.
Question 2: A refill is dispensed, but the prescriber has changed the directions for use since the last fill. What is the consultation requirement?
- No consultation is needed because it is a refill
- Oral consultation is required because the directions changed (Correct answer)
- A written monograph is enough; oral consultation is optional
- Consultation is needed only if the drug is a controlled substance
Correct answer: Oral consultation is required because the directions changed
CCR 1707.2 requires consultation when a refill comes with a change in dosage form, strength, or directions for use. For that purpose the patient is treated as receiving new information.
Question 3: Which patient is generally exempt from the California oral consultation requirement?
- A patient picking up a new antibiotic at a community pharmacy
- An inpatient in a health facility whose medications are given by licensed health care staff (Correct answer)
- A patient getting a first fill of a generic drug
- A patient whose insurer has already sent drug information by mail
Correct answer: An inpatient in a health facility whose medications are given by licensed health care staff
The consultation requirement does not apply to inpatients of a licensed health facility when licensed health care professionals give them their medications. It still applies in community settings, to new generic fills, and regardless of any insurer mailings.
Question 4: When a pharmacy mails or delivers a new prescription and the patient is not present, how does it meet the consultation requirement?
- Consultation is waived for delivered prescriptions
- A pharmacy technician must call the patient within 24 hours
- The pharmacy gives written notice of the patient's right to consultation and a phone number for reaching a pharmacist (Correct answer)
- The prescriber must provide the consultation instead
Correct answer: The pharmacy gives written notice of the patient's right to consultation and a phone number for reaching a pharmacist
When the patient or their agent is not present, as with mail or delivery, the pharmacy must give written notice of the right to consultation. The notice must include a telephone number through which the patient can reach a pharmacist.
Question 5: Which element is required when a pharmacist consults on a prescription drug the patient has not received before?
- The drug's wholesale acquisition cost
- The prescriber's DEA number
- Directions for use and storage, and the importance of taking the drug as prescribed (Correct answer)
- The manufacturer's lot number
Correct answer: Directions for use and storage, and the importance of taking the drug as prescribed
CCR 1707.2 lists the required content of a consultation. It includes directions for use and storage, the importance of adherence, precautions and relevant warnings (including common severe side effects or interactions), and, for new drugs, the drug's name and description and its route, dosage form, dose, and duration.
Question 6: Where must patient consultation take place in a California pharmacy?
- Only in a separate private room with a closed door
- In an area suitable for confidential patient consultation (Correct answer)
- Anywhere in the store, since confidentiality rules apply only to written records
- Only by telephone, so a record exists
Correct answer: In an area suitable for confidential patient consultation
California requires consultation to happen in an area suitable for confidential consultation, to protect the patient's privacy. A fully enclosed room is not required, but the setting must allow a private conversation.
