MTM Collaborative Practice Agreements 2 — Questions and Answers
Question 1: Under a CPA, which pharmacist activity is most commonly delegated by a physician?
- Diagnosing new conditions
- Adjusting medication doses within defined parameters (Correct answer)
- Ordering surgical procedures
- Issuing specialist referrals independently
Correct answer: Adjusting medication doses within defined parameters
Dose adjustment within physician-defined parameters is the most commonly delegated task in CPAs.
Question 2: Which federal law most directly enabled pharmacists to enter into collaborative practice agreements with physicians?
- HIPAA
- The Omnibus Budget Reconciliation Act of 1990 (OBRA-90)
- The Patient Protection and Affordable Care Act
- There is no single federal law; CPAs are governed by state law (Correct answer)
Correct answer: There is no single federal law; CPAs are governed by state law
CPA authority is derived from individual state pharmacy practice acts, not a single federal statute.
Question 3: A CPA between a pharmacist and a cardiologist most likely authorizes the pharmacist to:
- Perform echocardiograms
- Initiate and titrate anticoagulation therapy per protocol (Correct answer)
- Implant cardiac devices
- Diagnose atrial fibrillation
Correct answer: Initiate and titrate anticoagulation therapy per protocol
Anticoagulation management, including initiating and titrating therapy, is a common pharmacist role under cardiology CPAs.
Question 4: Which element is essential to include in the CPA document to define the pharmacist's scope of practice?
- Pharmacist's home address
- Patient inclusion and exclusion criteria (Correct answer)
- Physician's malpractice insurance number
- Pharmacy's annual revenue
Correct answer: Patient inclusion and exclusion criteria
Patient inclusion and exclusion criteria define which patients fall within the pharmacist's authority under the CPA.
Question 5: A pharmacist initiates a new medication for a patient under a CPA. Who bears primary prescriptive responsibility?
- The pharmacist alone
- The collaborating physician, as they delegate authority (Correct answer)
- The pharmacy board
- Both share equal legal liability by default in all states
Correct answer: The collaborating physician, as they delegate authority
The collaborating physician retains primary prescriptive authority as the delegating party, though the pharmacist also assumes responsibility for their actions.
Question 6: Which of the following best describes a 'protocol' within a CPA?
- A legal contract between the pharmacy and the state board
- A set of evidence-based guidelines specifying the conditions under which a pharmacist may act (Correct answer)
- A billing agreement between the pharmacist and insurance company
- A patient consent form
Correct answer: A set of evidence-based guidelines specifying the conditions under which a pharmacist may act
A protocol within a CPA defines the clinical conditions, decision rules, and parameters within which the pharmacist is authorized to manage therapy.
Question 7: How frequently should a CPA typically be reviewed and renewed according to best practice?
- Every 5 years
- Only when the pharmacist changes employers
- At least annually (Correct answer)
- Every 10 years per federal mandate
Correct answer: At least annually
Best practice and many state regulations require CPAs to be reviewed and renewed at least annually to reflect current guidelines and patient needs.
MTM Collaborative Practice Agreements 2
Under a CPA, which pharmacist activity is most commonly delegated by a physician?