Herrier R N, Boyce R W, Apgar D A
US Public Health Service, Phoenix, AZ.
Hosp Formul. 1990 Jan;25(1):67-8, 76-8, 80.
The Indian Health Service (IHS), an agency of the US Public Health Service, instituted a broad range of clinical pharmacy services for ambulatory patients in the 1960s and early 1970s. One outgrowth of these services was that pharmacists were authorized to provide certain prescription legend drugs directly to patients without physician preauthorization. Also, pharmacists monitored patients' progress and were authorized to make therapeutic substitutions of drugs. Pharmacist prescribing privileges in these programs were defined by P & T Committee-approved protocols. Success with these programs led to expanding the pharmacist's role to include physical assessment and differential diagnosis of patients with specific diseases and to manage their care when that care consisted primarily of medications. The development and implementation of these programs and the results of a study of pharmacist prescribing within the IHS are described in this article, as is the IHS clinical pharmacy training program.
美国公共卫生服务机构下属的印第安卫生服务局（IHS）在20世纪60年代和70年代初为门诊患者设立了广泛的临床药学服务。这些服务的一个成果是，药剂师被授权在没有医生预先授权的情况下直接向患者提供某些有处方标识的药物。此外，药剂师监测患者的病情进展，并被授权进行药物的治疗性替换。这些项目中药剂师的处方特权由药品与治疗学委员会（P & T Committee）批准的方案界定。这些项目的成功促使药剂师的角色得到扩展，包括对特定疾病患者进行身体评估和鉴别诊断，并在主要由药物组成的护理过程中对其护理进行管理。本文描述了这些项目的开发与实施以及印第安卫生服务局内药剂师处方的一项研究结果，还介绍了印第安卫生服务局的临床药学培训项目。
