Collaborative Agreement Michigan
Posted on December 5, 2020
Pharmacists are uniquely positioned by the use of Cooperation Agreements (CPAs) to play a role in the health care system. CPAs are formal practical agreements between pharmacists and physicians that expand the clinical responsibility of pharmacists.2 Michigan law allows pharmacists to take CPAs under medical delegation, allowing Michigan pharmacists to support patient care and connect with the highest licensees.3 CPAs identify the patient population and diseases covered by the CPA. This may include individual or multiple conditions, such as hypertension, asthma, COPD, diabetes, etc., or age limitations, to name a few. Once the patient population is identified, the CPA will outline the patient care activities that pharmacists can offer under certain conditions and conditions. Practitioners can determine what interventions pharmacists are allowed to perform, including initiation, modification, discontinuation or monitoring of drug therapy. Other examples of delegated responsibilities are obtaining laboratories such as ordering A1C mirrors for a diabetic patient, adapting antihypertensive treatment when needed, making subsequent calls after discharge, administering vaccines and issuing naloxone.2 Note that Michigan does not have a status that limits CPAs between physicians and pharmacists or provides guidelines for CPAs. The restriction is based on the agreement and the level approved by the delegated physician. Because pharmacists are ideal for improving drug use, compliance and outcomes, CPAs benefit not only the patient, but also, overall, health care. CPAs illustrate the practical relationships between pharmacists and physicians and integrate pharmacists into the team-based procurement model. It allows pharmacists to check qualified patients and offer treatment based on standards established in the protocol or procedure. Exposure to chronic diseases is one of the leading causes of morbidity and mortality in the United States, but it continues to increase. Approximately 71% of total health spending in the United States is related to the care of people with more than one chronic disease. It is reported that among medicare patients who are fresh per service, those with multiple chronic diseases make up 93 percent of Total Medicare spending.1 To meet demand, improve public health and reduce costs, health care is moving toward a multidisciplinary, team-based approach.
Figure 1. Report on patient outcomes after a pharmacy procedure performed under the supervision of a CPA.