As telemedicine becomes more commonplace, telepharmacy grows more popular as well, especially for patients in remote rural areas who lack easy access to physicians and pharmacists. When it comes to controlled substances, though, the practice of prescribing medication through telemedicine becomes tricky; should in-person office visits between patients and providers be required?
The Controlled Substances Act defines a controlled substance as a scheduled medication that requires a prescription and tighter restrictions due to its potential for abuse. Traditionally, most states have required a face-to-face relationship between the patient and provider to be established before controlled substances could be prescribed. However, as more and more states accept telemedicine consultations as validation of an established relationship, it becomes harder to monitor the prescription and dispensation of controlled substances. In response, some states have implemented safeguards such as requiring a legitimate medical reason, allowing only prescriptions that fall within the provider’s scope of practice, and forbidding prescriptions for benzodiazepines or opioids.
With the rise of telemedicine, other issues arise as well. For instance, the provider must be licensed to practice medicine within the patient’s state of residence. One possible solution, currently under debate, is to permit multistate licensure for physicians. Other potential legislation would require providers to be licensed in the jurisdiction where they practice, rather than where the patient lives. Both of these approaches have gained support for their likely consequence of allowing doctors to reach more patients in more locations without the expense of multiple licenses.
On the other hand, increased reliance on telepharmacy will lead to increased demand from patients and their families for pharmacists’ services, such as consultations and follow-up meetings to raise the likelihood of adherence. Telepharmacy offers patients a safe, comfortable, and convenient way to contact the pharmacist—someone they otherwise might not talk to.
When it comes to increasing access to healthcare in remote regions, telemedicine is making impressive strides, but without the accompanying medications, there can only be limited success. By adding telepharmacy—and thus pharmacists—to the Continuum of Care, we can create a more comprehensive healthcare delivery system that follows the patient into the home, empowers the patient, and sets him/her up for success, with or without in-office visits.
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