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6 Facts About Collaborative Practice Agreements

If you are someone who takes many medications or someone who has a loved one that needs help in medication management, you might have heard about the concept of CPA. 

CPA stands for collaborative practice agreements, and it is a legal document in the US that establishes the permitted and more formal relationship between clinical pharmacists and the physician. With this agreement, the pharmacists are allowed to help in the drug therapy management of patients and to expand their service provisions to patients and the entire healthcare team.

Here are some facts about CPA you should know about:

It has many names

If you think you’re not familiar with the term collaborative practice agreements (CPAs), but you’re already familiar with how it works, it’s probably because CPA is not its exclusive name. It has been called many names in different states in the US. Maybe you’ve heard of the following other terminologies that refer to the same system:

  • Physician delegation
  • Physician–pharmacist agreement
  • Collaborative pharmacy practice agreement
  • Consult agreement
  • Standing order/Standing protocol 

What it is called is not the only thing that differs each time. The term for the services under it may also vary depending on the state. They often refer to it as:

  • Collaborative drug therapy management
  • Collaborative pharmacy practice
  • Drug therapy management
  • Pharmaceutical care
  • Medication therapy services

The law varies from state to state

It’s not only the terminology that differs per state. The law is also limited based on the following:

  • The number of patients per CPA (single or multiple patients)
  • Practice settings
  • Type of parties allowed to join (physician and nurse practitioners, physicians only, all prescribers, etc.)
  • Qualifications for the pharmacist (should be registered with state boards, continuing with education, and the like)

It’s not a new concept

If you think this type of work collaboration in the health field is happening just now, that’s not true. The concept has been implemented since 1979 in Washington when the Pharmacy Practice Act was implemented. 

In March 2018, around 9,000 pharmacists were working under 34,000 functioning CPAs, according to Jeff Rochon’s report on Pharmacy Today. While in August 2018, 48 states in the US plus the District of Columbia gave consent to permit the pharmacist-prescriber collaborative practice authority, according to a report by the National Alliance of State Pharmacy Associations (NASPA).

CPA has many advantages

In CPA, both medical practitioners plus pharmacists help medical care give a more effective outcome for patients. Apart from the patient’s benefits from the collaboration, it also helps strengthen the pharmacists’ role as a medication expert to complement other healthcare workers’ skills. At the same time, they both aim to improve the efficiency of patient care. 

Here are some of the services that the pharmacy can provide under the CPA:

  • Authorization of prescription refills
  • Optimization of dose
  • Substitution of medications
  • Setting up of hypertension and anticoagulation clinics

CPA isn’t always a prerequisite for specific patient care services from the pharmacists

While it is a beautiful collaboration, some services under the CPA are already functions of the pharmacists. They don’t need the CPA to legally provide services like hypertension and cholesterol screenings, medical therapy assessments based on medicine-related problems, and so on. 

CPA still has its challenges

CPA would only work if the patient fully trusts their healthcare provider; however, trust is not something you can easily give and gain from others. Patients need to create a healthy relationship with their provider to make collaboration work entirely. It is the first step, but it is a highly important one. 


CPA may be called different names, and it might not be a required legal agreement to perform some health care professional’s function. Still, it is a useful tool to make sure that everyone contributes to serving the patients and allowing the healthcare system to show that it cares. 

If you agree with the concept of collaborative practice agreements, then the MedManage app is for you. It’s a medication log app to help manage your or your loved one’s medications. It helps monitor chronic illnesses, gives reminders, and allows you to ask questions from a pharmacist. Browse our FAQ section to learn more.  

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