NCPA to DEA: 'Institutional facilitators' can help LTC facilities

ALEXANDRIA, Va. The National Community Pharmacists Association sent a letter to the Drug Enforcement Administration that featured a solution to provide prescription medications to patients in long-term care facilities in a timely manner, NCPA said.

NCPA stated in its letter that recent changes in interpretation and enforcement of the Controlled Substances Act have delayed access of prescription drugs to long-term care patients; many of the medications are designed to alleviate severe pain. The CSA has upended the process in which nurses relay information between the physicians and pharmacists -- when a direct physician-pharmacist communication was impractical -- to ensure the timely administration of critical medications used to treat residents’ pain. DEA’s current enforcement approach allows such “nurse as agent” exchanges in a hospital setting, but not in long-term care facilities, NCPA said.

To mitigate this, NCPA has suggested that the DEA develop a subcategory of its registrant called an “institutional facilitator,” which would allow nurses to resume communicating valid prescriptions to the pharmacist so that the appropriate medicine is administered to the patient on a timely basis.

“The current system related to the lawful and prompt dispensing of controlled substances in long-term care facilities is broken,” NCPA said. “This solution provides for the common goal of ensuring timely medication access to patients in pain while recognizing the DEA’s mission to enforce the controlled substances laws and regulations of the United States.”

Approximately 31% of all independent community pharmacies service a long-term care facility, with the majority located in areas with a population of less than 20,000, NCPA noted.