The Board of Pharmacy Specialties (BPS) was organized in 1976 following the recommendations of the Task Force on Specialties in Pharmacy, a group developed three years prior by the American Pharmacists Association (APhA) in response to changing health care practices in the US. According to bpsweb.org, “The overriding concern of BPS is to ensure that the public receives the level of pharmacy services that will improve a patient’s quality of life,” and to achieve this goal, the Board has recognized specialty practice areas.
The available BPS certifications include Ambulatory Care Pharmacy, Critical Care Pharmacy, Oncology Pharmacy, Nuclear Pharmacy, Pediatric Pharmacy, Pharmacotherapy, Nutrition Support Pharmacy, and Psychiatric Pharmacy. Under “News Room” on the BPS website, fact sheets and brochures outlining each specialty can be viewed.
The first specialty, Board Certified Ambulatory Care Pharmacist (BCACP), “addresses the provision of integrated, accessible healthcare services for ambulatory patients in a wide variety of settings, including community pharmacies, clinics and physician offices,” as documented on its fact sheet. As a BCACP, focus will be on the special needs of patients with concurrent illnesses taking multiple drugs at home or with caregiver assistance. Pharmacists will strive to integrate the care of acute illness and exacerbations with chronic disease state management, engaging the patient in health promotion and wellness. By assessing for appropriate treatment, monitoring patient compliance, refilling prescriptions, and providing patient education, sustained partnerships with ambulatory patients will be made. According to the BPS website, 1,659 pharmacists hold the BCACP title as of June 2014.
Board Certified Critical Care Pharmacists work to guarantee the safe and effective use of medications in critically ill patients, as described on the specialty’s fact sheet. In addition to the patients’ primary conditions, their focus is on the specialized pharmacologic or technological interventions the critically ill may need to maintain blood pressure, respiration, nutrition, and other homeostatic functions. As a Critical Care Pharmacist, multifaceted clinical and technological data will be reviewed frequently for patients with life-threatening conditions and complex medications; this information will be used to make reasoned decisions, taking into account the differences in pharmacokinetic and pharmacodynamic parameters between critically ill and non-critically ill patients. The first examination for this specialty will be administered in the fall of 2015.
Oncology pharmacy is centered on the provision of evidence-based, patient-centered medication therapy management for cancer patients. A Board Certified Oncology Pharmacist (BCOP) has the ability to manage adverse events that are both cancer-related and drug-related as well as disease-specific clinical situations arising from the complexity of drug therapies to treat and prevent cancer. The BCOP fact sheet states pharmacists will be “specially trained to recommend, design, implement, monitor, and modify pharmacotherapeutic plans to optimize outcomes… and reduce medication errors” for their patients. The BCOP will work as a part of a multidisciplinary team in hospitals and ambulatory clinics; they will serve as a resource for community pharmacists filling prescriptions for outpatients with malignant disease. As of June 2014, the number of board certified oncology pharmacists is 1,626.
In 1978, nuclear pharmacy was the first specialty approved by BPS according to the online fact sheet. A Board Certified Nuclear Pharmacist (BCNP) has the expertise to prepare and handle highly toxic radiopharmaceuticals. Pharmacists are also involved in quality control, testing, and health and safety issues related to the products; their role allows for minimal error, drug-drug interactions, and patient exposure to radiation. As of 2014, there are 528 Board Certified Nuclear Pharmacists.
Another specialty new for fall 2015 is the BPS Pediatric Pharmacist certification. As described on the fact sheet, providing patient care to those under 18, including alternate dosage forms and specialized drug therapy monitoring, will be the focus. Pharmacists will serve as an advocate for the pediatric population, providing education and promoting health and wellness to advance knowledge and skills in pediatric pharmacy.
The largest specialty certification, with 14,282 certified pharmacists as of June 2014, is Board Certified Pharmacotherapy Specialist (BCPS). As a BCPS, pharmacists work as a part of an interprofessional team to guarantee the “safe, appropriate and economical use of medications… in a variety of settings, including hospitals and health systems,” as described by the online fact sheet. BCPS pharmacists work with physicians to design and/or modify treatment plans, serving as an objective, evidence-based source for therapeutic recommendations and information. In the outpatient setting, they again team with physicians to optimize medication therapy by tracking progress and compliance. Suggestions on diet and lifestyle changes are also made by pharmacists in order to improve health management.
As a Board Certified Nutrition Support Pharmacist (BCNSP), the care of patients receiving specialized nutrition support is addressed. Patients receiving parenteral (IV) or enteral (feeding tube) nutrition are included; pharmacists work to “promote the maintenance of and/or restore optimal nutrition status through design and modification of individualized treatment plans,” as outlined on the online fact sheet. Direct patient care, type of feeding design, dosing of specific nutrients, compatibility issues, clinical monitoring and identification of nutrient deficits, parenteral and enteral feeding formulation preparation, and maintenance of nutritional status during critical transition to outpatient care highlight the main responsibilities of a BCNSP. Only 533 pharmacists hold the BCNSP title as of June 2014.
Per the fact sheet for this specialty, a slightly higher pharmacist population, 805 as of June 2014, hold the BPS Board Certified Psychiatric Pharmacist credential (BCPP), through which care is provided to patients with psychiatric-related illnesses. Expertise is demonstrated when providing care to patients with multi-sided symptoms. Treatment assessment, cost-effective medication regimen design, appropriate dosing, and monitoring of complex medications for potential adverse reactions and interactions, adjusting medications accordingly, encompass a few of the responsibilities of a BCPP. Specialty pharmacists also fill important administrative roles in psychiatric, mental retardation, and substance abuse facilities. A BCPP is a valuable resource for healthcare teams and patients.
Specialty roles allow pharmacists to deliver more complete and complex patient care. With a board certification, BPS emphasizes pharmacists will be confident and prepared to step into evolving pharmacy positions on multidisciplinary teams. As an added bonus, in a competitive employment market, a certification will put the holder one step ahead of contenders. Holding a specialty certification promotes lifelong learning and provides recognition for pharmacists’ expertise by other healthcare professionals, employers, patients and insurers.
Melissa Luechtefeld, Doctor of Pharmacy Candidate Class of 2015
University of Missouri-Kansas City School of Pharmacy at MU
Board of Pharmacy Specialties. https://www.bpsweb.org/index.cfm. 2014. Accessed October 17, 2014.