(DEA-DC-046)(EO-DEA154) Pharmacist Manual

Total Page:16

File Type:pdf, Size:1020Kb

(DEA-DC-046)(EO-DEA154) Pharmacist Manual Pharmacist’s Manual An Informational Outline of the Controlled Substances Act Revised 2020 Drug Enforcement Administration Pharmacist’s Manual --------------------------------------------------------------------------------------------------------------------- Timothy J. Shea Acting Administrator Drug Enforcement Administration William T. McDermott Assistant Administrator Diversion Control Division Loren T. Miller Chief, Policy Section This Pharmacist’s Manual has been prepared by the Drug Enforcement Administration, Diversion Control Division, as a guide to assist pharmacists in their understanding of the Federal Controlled Substances Act and its implementing regulations as they pertain to the pharmacy profession. The 2020 edition replaces all previous editions of the Pharmacist’s Manual issued by the Drug Enforcement Administration, both hard copy and electronic. Guidance documents, like this document, are not binding and lack the force and effect of law, unless expressly authorized by statute or expressly incorporated into a contract, grant, or cooperative agreement. Consistent with Executive Order 13891 and the Office of Management and Budget implementing memoranda, the Department will not cite, use, or rely on any guidance document that is not accessible through the Department’s guidance portal, or similar guidance portals for other Executive Branch departments and agencies, except to establish historical facts. To the extent any guidance document sets out voluntary standards (e.g., recommended practices), compliance with those standards is voluntary, and noncompliance will not result in enforcement action. Guidance documents may be rescinded or modified in the Department’s complete discretion, consistent with applicable laws. EO‐DEA154, October 8, 2020, DEA‐DC‐046 Drug Enforcement Administration Pharmacist’s Manual EO‐DEA154 --------------------------------------------------------------------------------------------------------------------- Table of Contents SECTION I – INTRODUCTION ........................................................................................ 6 Disclaimer .................................................................................................................................................. 6 Authorization for Public Dissemination ...................................................................................................... 7 Message from the Assistant Administrator ................................................................................................ 8 Preface ...................................................................................................................................................... 9 SECTION II – SCHEDULES OF CONTROLLED SUBSTANCES .................................. 11 Schedule I Controlled Substances .......................................................................................................... 11 Schedule II Controlled Substances ......................................................................................................... 11 Schedule III Controlled Substances ........................................................................................................ 12 Schedule IV Controlled Substances ........................................................................................................ 12 Schedule V Controlled Substances ......................................................................................................... 12 Scheduled Listed Chemical Products (SLCP) ......................................................................................... 13 SECTION III – REGISTRATION REQUIREMENTS ....................................................... 14 New Pharmacy Registration .................................................................................................................... 14 Renewal of Pharmacy Registration ......................................................................................................... 14 Affidavit for Renewal of Retail Chain Pharmacy Registration ................................................................. 15 Change of Business Address .................................................................................................................. 16 Termination of Registration ..................................................................................................................... 16 Transfer of Business ................................................................................................................................ 17 Denial of Registration in the Public Interest ............................................................................................ 18 Suspension or Revocation of Registration .............................................................................................. 18 Chemical Registration Requirements ...................................................................................................... 19 SECTION IV – ORDERING CONTROLLED SUBSTANCES ......................................... 20 Ordering Schedules I and II Controlled Substances ............................................................................... 20 Requesting DEA Forms 222 .................................................................................................................... 20 Completing DEA Forms 222 .................................................................................................................... 21 Power of Attorney to Sign DEA Forms 222 ............................................................................................. 23 Cancellation and Voiding DEA Forms 222 .............................................................................................. 26 Lost or Stolen DEA Forms 222 ................................................................................................................ 26 Return of Unused DEA Forms 222 .......................................................................................................... 26 Continued Use of Existing Stocks of Triplicate DEA Forms 222 ............................................................. 27 Procedure for Obtaining Triplicate DEA Forms 222 ................................................................................ 27 Completing Triplicate DEA Forms 222 .................................................................................................... 27 Unaccepted and Defective Triplicate DEA Forms 222 ............................................................................27 Cancellation and Voiding a Triplicate DEA Form 222 ............................................................................. 28 Lost or Stolen Triplicate DEA Forms 222 ................................................................................................ 28 Return of Unused Triplicate DEA Forms 222 .......................................................................................... 29 Controlled Substance Ordering System (CSOS) – Electronic Order Forms ............................................ 29 Unaccepted and Defective Electronic Orders ......................................................................................... 30 Cancellation and Voiding of Electronic Orders ........................................................................................ 30 Lost Electronic Orders ............................................................................................................................. 31 Ordering Schedules III-V Controlled Substances .................................................................................... 31 SECTION V – INVENTORY REQUIREMENTS ............................................................. 33 Initial Inventory ........................................................................................................................................ 33 Biennial Inventory .................................................................................................................................... 34 Newly Scheduled Controlled Substance Inventory ................................................................................. 34 2020 Edition Page 2 Drug Enforcement Administration Pharmacist’s Manual EO‐DEA154 --------------------------------------------------------------------------------------------------------------------- Inventory for Damaged, Defective, or Impure Substances ...................................................................... 34 SECTION VI – RECORDKEEPING REQUIREMENTS .................................................. 35 Required Records .................................................................................................................................... 35 Central Recordkeeping ............................................................................................................................ 36 Prescription Records ............................................................................................................................... 36 Electronic Prescription Records .............................................................................................................. 37 SECTION VII – VALID PRESCRIPTION REQUIREMENTS .......................................... 39 Acceptable Changes to a Prescription .................................................................................................... 39 Who May Issue .......................................................................................................................................
Recommended publications
  • Clinical Pharmacy Specialist
    SAMPLE JOB DESCRIPTION Clinical Pharmacist Specialist I. JOB SUMMARY The Clinical Pharmacist Specialists are responsible and accountable for the provision of safe, effective, and prompt medication therapy. Through various assignments within the department, they provide support of centralized and decentralized medication-use systems as well as deliver optimal medication therapy to patients with a broad range of disease states. Clinical Pharmacist Specialists proficiently provide direct patient-centered care and integrated pharmacy operational services in a decentralized practice setting with physicians, nurses, and other hospital personnel. These clinicians are aligned with target interdisciplinary programs and specialty services to deliver medication therapy management within specialty patient care services and to ensure pharmaceutical care programs are appropriately integrated throughout the institution. In these clinical roles, Clinical Pharmacist Specialists participate in all necessary aspects of the medication-use system while providing comprehensive and individualized pharmaceutical care to the patients in their assigned areas. Pharmaceutical care services include but are not limited to assessing patient needs, incorporating age and disease specific characteristics into drug therapy and patient education, adjusting care according to patient response, and providing clinical interventions to detect, mitigate, and prevent medication adverse events. Clinical Pharmacist Specialists serve as departmental resources and liaisons to other
    [Show full text]
  • Online Advertising
    Online advertising From Wikipedia, the free encyclopedia Jump to: navigation, search This article may require cleanup to meet Wikipedia's quality standards. Please improve this article if you can. (July 2007) Electronic commerce Online goods and services Streaming media Electronic books Software Retail product sales Online shopping Online used car shopping Online pharmacy Retail services Online banking Online food ordering Online flower delivery Online DVD rental Marketplace services Online trading community Online auction business model Online wallet Online advertising Price comparison service E-procurement This box: view • talk • edit Online advertising is a form of advertising that uses the Internet and World Wide Web in order to deliver marketing messages and attract customers. Examples of online advertising include contextual ads on search engine results pages, banner ads, advertising networks and e-mail marketing, including e-mail spam. A major result of online advertising is information and content that is not limited by geography or time. The emerging area of interactive advertising presents fresh challenges for advertisers who have hitherto adopted an interruptive strategy. Online video directories for brands are a good example of interactive advertising. These directories complement television advertising and allow the viewer to view the commercials of a number of brands. If the advertiser has opted for a response feature, the viewer may then choose to visit the brand’s website, or interact with the advertiser through other touch points such as email, chat or phone. Response to brand communication is instantaneous, and conversion to business is very high. This is because in contrast to conventional forms of interruptive advertising, the viewer has actually chosen to see the commercial.
    [Show full text]
  • Show Me the Money: Characterizing Spam-Advertised Revenue
    Show Me the Money: Characterizing Spam-advertised Revenue Chris Kanich∗ Nicholas Weavery Damon McCoy∗ Tristan Halvorson∗ Christian Kreibichy Kirill Levchenko∗ Vern Paxsonyz Geoffrey M. Voelker∗ Stefan Savage∗ ∗ y Department of Computer Science and Engineering International Computer Science Institute University of California, San Diego Berkeley, CA z Computer Science Division University of California, Berkeley Abstract money at all [6]. This situation has the potential to distort Modern spam is ultimately driven by product sales: policy and investment decisions that are otherwise driven goods purchased by customers online. However, while by intuition rather than evidence. this model is easy to state in the abstract, our under- In this paper we make two contributions to improving standing of the concrete business environment—how this state of affairs using measurement-based methods to many orders, of what kind, from which customers, for estimate: how much—is poor at best. This situation is unsurpris- ing since such sellers typically operate under question- • Order volume. We describe a general technique— able legal footing, with “ground truth” data rarely avail- purchase pair—for estimating the number of orders able to the public. However, absent quantifiable empiri- received (and hence revenue) via on-line store order cal data, “guesstimates” operate unchecked and can dis- numbering. We use this approach to establish rough, tort both policy making and our choice of appropri- but well-founded, monthly order volume estimates ate interventions. In this paper, we describe two infer- for many of the leading “affiliate programs” selling ence techniques for peering inside the business opera- counterfeit pharmaceuticals and software. tions of spam-advertised enterprises: purchase pair and • Purchasing behavior.
    [Show full text]
  • Pharmacist-Physician Team Approach to Medication-Therapy
    Pharmacist-Physician Team Approach to Medication-Therapy Management of Hypertension The following is a synopsis of “Primary-Care-Based, Pharmacist-Physician Collaborative Medication-Therapy Management of Hypertension: A Randomized, Pragmatic Trial,” published online in June 2014 in Clinical Therapeutics. What is already known on this topic? found that the role of the pharmacist differed within each study; whereas some pharmacists independently initiated and High blood pressure, also known as hypertension, is a changed medication therapy, others recommended changes major risk factor for cardiovascular disease, the leading to physicians. Pharmacists were already involved in care in all cause of death for U.S. adults. Helping patients achieve but one study. blood pressure control can be difficult for some primary care providers (PCPs), and this challenge may increase with After reviewing the RCTs, the authors conducted a randomized the predicted shortage of PCPs in the United States by 2015. pragmatic trial to investigate the processes and outcomes that The potential shortage presents an opportunity to expand result from integrating a pharmacist-physician team model. the capacity of primary care through pharmacist-physician Participants were randomly selected to receive PharmD-PCP collaboration for medication-therapy management (MTM). MTM or usual care from their PCPs. The authors conducted MTM performed through a collaborative practice agreement the trial within a university-based internal medicine medical allows pharmacists to initiate and change medications. group where the collaborative PharmD-PCP MTM team Researchers have found positive outcomes associated included an internal medicine physician and two clinical with having a pharmacist on the care team; however, the pharmacists, both with a Doctor of Pharmacy degree, at least evidence is limited to only a few randomized controlled 1 year of pharmacy practice residency training, and more than trials (RCTs).
    [Show full text]
  • A Bill to Repeal Criminal Drug Laws: Replacing Prohibition with Regulation Joseph L
    Hofstra Law Review Volume 18 | Issue 3 Article 10 1990 A Bill to Repeal Criminal Drug Laws: Replacing Prohibition with Regulation Joseph L. Galiber Follow this and additional works at: http://scholarlycommons.law.hofstra.edu/hlr Part of the Law Commons Recommended Citation Galiber, Joseph L. (1990) "A Bill to Repeal Criminal Drug Laws: Replacing Prohibition with Regulation," Hofstra Law Review: Vol. 18: Iss. 3, Article 10. Available at: http://scholarlycommons.law.hofstra.edu/hlr/vol18/iss3/10 This document is brought to you for free and open access by Scholarly Commons at Hofstra Law. It has been accepted for inclusion in Hofstra Law Review by an authorized administrator of Scholarly Commons at Hofstra Law. For more information, please contact [email protected]. Galiber: A Bill to Repeal Criminal Drug Laws: Replacing Prohibition with R A BILL TO REPEAL CRIMINAL DRUG LAWS: REPLACING PROHIBITION WITH REGULATION Joseph L. Galiber* Conventional wisdom obliges elected officials to beat the narcodrums loudly and incessantly, and to demand increasingly harsh criminal penalties for the sale and use of illegal drugs.' It is reasonable to wonder why I, a senator, would dare submit a bill2 to the New York State Legislature which would regulate all drugs cur- rently proscribed as illegal in precisely the same manner as alcohol.3 The short answer is that the use of the criminal law to control drug use has not, and never will, have anything more than a costly and marginal impact on drug consumption.4 Despite all the public hyperventilation, drug consumption remains a private, consensual * New York State Senator; B.A.
    [Show full text]
  • Definition of Controlled Substance Schedules
    UPDATED MARCH 2018 DEFINITION OF CONTROLLED SUBSTANCE SCHEDULES Drugs and other substances that are considered controlled substances under the Controlled Substances Act (CSA) are divided into five schedules. An updated and complete list of the schedules is published annually in Title 21 Code of Federal Regulations (C.F.R.) §§ 1308.11 through 1308.15. Substances are placed in their respective schedules based on whether they have a currently accepted medical use in treatment in the U.S., their relative abuse potential, and likelihood of causing dependence when abused. Examples of the drugs in each schedule are listed below. Schedule I Controlled Substances Substances in this schedule have no currently accepted medical use in the United States, a lack of accepted safety for use under medical supervision, and a high potential for abuse. Some examples of substances listed in Schedule I are: heroin, lysergic acid diethylamide (LSD), marijuana (cannabis), peyote, methaqualone, and 3,4- methylenedioxymethamphetamine ("Ecstasy"). Schedule II/IIN Controlled Substances (2/2N) Substances in this schedule have a high potential for abuse which may lead to severe psychological or physical dependence. Examples of Schedule II narcotics include: hydromorphone (Dilaudid®), methadone (Dolophine®), meperidine (Demerol®), oxycodone (OxyContin®, Percocet®), and fentanyl (Sublimaze®, Duragesic®). Other Schedule II narcotics include: morphine, opium, codeine, and hydrocodone. Examples of Schedule IIN stimulants include: amphetamine (Dexedrine®, Adderall®), methamphetamine (Desoxyn®), and methylphenidate (Ritalin®). Other Schedule II substances include: amobarbital, glutethimide, and pentobarbital. 1 Schedule III/IIIN Controlled Substances (3/3N) Substances in this schedule have a potential for abuse less than substances in Schedules I or II and abuse may lead to moderate or low physical dependence or high psychological dependence.
    [Show full text]
  • Synthetic Drugs: Overview and Issues for Congress
    Synthetic Drugs: Overview and Issues for Congress Lisa N. Sacco Analyst in Illicit Drugs and Crime Policy Kristin Finklea Specialist in Domestic Security May 3, 2016 Congressional Research Service 7-5700 www.crs.gov R42066 Synthetic Drugs: Overview and Issues for Congress Summary Synthetic drugs, as opposed to natural drugs, are chemically produced in a laboratory. Their chemical structure can be either identical to or different from naturally occurring drugs, and their effects are designed to mimic or even enhance those of natural drugs. When produced clandestinely, they are not typically controlled pharmaceutical substances intended for legitimate medical use. Designer drugs are a form of synthetic drugs. They contain slightly modified molecular structures of illegal or controlled substances, and they are modified in order to circumvent existing drug laws. While the issue of synthetic drugs and their abuse is not new, Congress has demonstrated a renewed concern with the issue. From 2009 to 2011, synthetic drug abuse was reported to have dramatically increased. During this time period, calls to poison control centers for incidents relating to harmful effects of synthetic cannabinoids (such as “K2” and “Spice”) and stimulants (such as “bath salts”) increased at what some considered to be an alarming rate. The number of hospital emergency department visits involving synthetic cannabinoids more than doubled from 2010 to 2011. In 2012 and 2013, however, the number of calls to poison control centers for incidents relating to harmful effects of synthetic cannabinoids and synthetic stimulants decreased. Calls regarding bath salts have declined each year since 2011, while calls regarding synthetic cannabinoids have increased since the drops in 2012 and 2013.
    [Show full text]
  • House of Representatives Staff Analysis Bill #: Hb 6095
    HOUSE OF REPRESENTATIVES STAFF ANALYSIS BILL #: HB 6095 Scheduling of Drug Products Containing Cannabidiol SPONSOR(S): Fischer TIED BILLS: IDEN./SIM. BILLS: SB 1476 REFERENCE ACTION ANALYST STAFF DIRECTOR or BUDGET/POLICY CHIEF 1) Professions & Public Health Subcommittee 17 Y, 0 N Morris McElroy 2) Criminal Justice & Public Safety Subcommittee 18 Y, 0 N Padgett Hall 3) Health & Human Services Committee 20 Y, 0 N Morris Calamas SUMMARY ANALYSIS Federal and state law both classify controlled substances into five schedules. The scheduling determination for a controlled substance is based on a substance’s potential for abuse, accepted medical use, and potential for addiction. The classifications range from a Schedule I substance, which has a high potential for abuse, with no accepted medical use, and high potential for addiction; to a Schedule V substance, which has a low potential for abuse, an accepted medical use, and a mild potential for addiction. Generally, cannabis and compounds derived from cannabis are listed in Schedule I of both federal and Florida law. Cannabis contains delta-9-tetrahydrocannabinol (THC), which is the psychoactive chemical in marijuana which produces the “high” commonly associated with marijuana use. Epidiolex is a prescription cannabidiol, a non-psychoactive compound derived from the cannabis plant which is used to treat seizures. Epidiolex does not contain THC. On June 25, 2018, the U.S. Food and Drug Administration approved Epidiolex for use by patients two years of age or older and the federal Drug Enforcement Administration (DEA) rescheduled Epidiolex in Schedule V of the federal Controlled Substances Act (CSA). In 2019, the Legislature, mirroring federal law, formally rescheduled Epidiolex as a Schedule V controlled substance.
    [Show full text]
  • Proceedings of the 67Th Annual Session of the ASHP House Of
    House of Delegates Session—2015 June 7 and 9, 2015 Denver, Colorado Proceedings of the 67th annual session of the ASHP House of Delegates, June 7 and 9, 2015 Proceedings of the 67th annual session of the ASHP House of Delegates, June 7 and 9, 2015 PAUL W. ABRAMOWITZ, SECRETARY The 67th annual session of the ASHP House of Delegates was James A. Trovato, Pharm.D., M.B.A., BCOP, FASHP, Associ- held at the Colorado Convention Center, in Denver, Colorado, ate Professor, University of Maryland School of Pharmacy, in conjunction with the 2015 Summer Meetings. Baltimore, MD First meeting Chair, House of Delegates 2015–2018 Amber J. Lucas, Pharm.D., BCPS, FASHP, Clinical Pharmacist, The first meeting was convened at 1:00 p.m. Sunday, June 7, Olathe Medical Center, Olathe, KS by Chair of the House of Delegates James A. Trovato. Chair Trovato introduced the persons seated at the head table: Gerald Natasha Nicol, Pharm.D., FASHP, Director of Global Patient E. Meyer, Immediate Past President of ASHP and Vice Chair Safety Affairs, Cardinal Health, Pawleys Island, SC of the House of Delegates; Christene M. Jolowsky, President of ASHP and Chair of the Board of Directors; Paul W. Abramowitz, Board of Directors, 2016–2019 Chief Executive Officer of ASHP and Secretary of the House of Debra L. Cowan, Pharm.D., FASHP, Director of Pharmacy, Delegates; and Susan Eads Role, Parliamentarian. Angel Medical Center, Franklin, NC Todd A. Karpinski, Pharm.D., M.S., FASHP, Chief Phar- Chair Trovato welcomed the delegates and described the macy Officer, Froedtert and the Medical College of Wisconsin, purposes and functions of the House.
    [Show full text]
  • Addresses of Record Not on Internet
    Newsletter Indexfrom July 1998 through March 2013 Abandonment of Application Files 07/2007 Addresses of Record to go Online 04/2000 Addresses of Record Will Not go Online 07/2000 Addresses of Record to go Online 10/2003 Addresses of Record Important 01/2010 Addresses of Record Important 03/2012 Ambulance Restocking 01/2001 Anabolic Steroid Control Act of 2004 09/2006 Anthrax Q & A 10/2001 APAP/NSAIDs on Container Labels 03/2012 Automated Drug Delivery Systems 01/2007 Automated Drug Dispensing Services 01/2002 Automated Systems in SNF/ICF 01/2005 Automation/Robotic Dispensing Check by RPH 01/2005 Beers Criteria for Potentially Inappropriate Med 03/2013 Use in Older Adults Black Box Warnings 01/2007 Board Enforces QAP and Urges Med Error Reporting 07/2007 Board Honors 50-Years Pharmacists (Ongoing) 10/2005 Board Inspectors/Verify ID 01/2010 Board Office Closed Two Days per Month 02/2009 Board Office Closed Three Days per Month 01/2010 Board Website Online 07/2000 Board Wins 5th National Award in Eight Years 10/2005 Board’s 110th Anniversary 04/2001 Board’s Budget Woes Curtails Services 01/2002 Board’s New Address/Phone Numbers 01/2006 Board Reappointments 03/2012 Board’s Web Site Info 10/2003 Boxed Warning Medications 01/2008 Brooks, Ryan/New Public Member 02/2009 BTC Drug Category Explored 01/2008 Canadian Drug Imports 03/2003 California Pharmacists Who Participate in Torture 02/2009 Carisoprodol Now Schedule IV 03/2012 Cash Compromise is Unprofessional Conduct 01/2002 Cathine Added to Schedule IV 02/2009 Cathinone Added to Schedule II
    [Show full text]
  • ASHP Statement on Pharmaceutical Care
    Medication Therapy and Patient Care: Organization and Delivery of Services–Statements 331 ASHP Statement on Pharmaceutical Care The purpose of this statement is to assist pharmacists in under- Care. Central to the concept of care is caring, a personal standing pharmaceutical care. Such understanding must pre- concern for the well-being of another person. Overall cede efforts to implement pharmaceutical care, which ASHP patient care consists of integrated domains of care including believes merit the highest priority in all practice settings. (among others) medical care, nursing care, and pharmaceu- Possibly the earliest published use of the term pharma- tical care. Health professionals in each of these disciplines ceutical care was by Brodie in the context of thoughts about possess unique expertise and must cooperate in the patient’s drug use control and medication-related services.1,2 It is a overall care. At times, they share in the execution of the various term that has been widely used and a concept about which types of care (including pharmaceutical care). To pharma- much has been written and discussed in the pharmacy pro- ceutical care, however, the pharmacist contributes unique fession, especially since the publication of a paper by Hepler knowledge and skills to ensure optimal outcomes from the and Strand in 1990.3–5 ASHP has formally endorsed the con- use of medications. cept.6 With varying terminology and nuances, the concept At the heart of any type of patient care, there exists a has also been acknowledged by other national pharmacy or- one-to-one relationship between a caregiver and a patient.
    [Show full text]
  • Intensive Care Units (ICU): the Clinical Pharmacist Role to Improve Clinical Outcomes and Reduce Mortality Rate- an Undeniable Function
    Open Access Journal of Clinical Intensive Care and Medicine Review Article Intensive Care Units (ICU): The clinical pharmacist role to improve clinical ISSN 2639-6653 outcomes and reduce mortality rate- An undeniable function Luisetto M1* and Ghulam Rasool Mashori2 1Applied Pharmacologist, Hospital Pharmacist Manager 29121, Italy 2Professor & Director, Peoples University of Medcial & Health Sciences for Woman, Nawabshah, Pakistan *Address for Correspondence: Luisetto M, Applied Abstract Pharmacologist, Hospital Pharmacist Manager 29121, Italy, Email: [email protected] Observing relevant biomedical literature we have see that clinical pharmacist play a crucial role in ICU Submitted: 09 October 2017 settings with reducing in mortality rate and improving some clinical outcomes. Approved: 01 November 2017 Published: 02 November 2017 Copyright: 2017 Luisetto M, et al. This is Introduction an open access article distributed under the Creative Commons Attribution License, which In ICU settings we can easily observe that the mortality rate is higher then other permits unrestricted use, distribution, and wards and for this reason a real multisiciplinatity medical team with added clinical ph. reproduction in any medium, provided the Competences can improve this situation. High intensity of cure, polipharmacy, critical original work is properly cited. patient conditions need also a pharmaceutical competencies to be added to the classic Keywords: ICU; Clinical pharmacy; Pharmaceutical decision making systems (clinical- managerial). The critically hill patients need a more care; Clinical outcomes; Mortality rate rational decision making systems to improve the clinical outcomes and in safety way. Material and Methods In this review and research paper we have searched some relevant biomedical literature in order to evaluate the real eficacy of clinical pharmacist in improving clinical outcomes and reducing mortality rate.
    [Show full text]