米国のCDTMにおける訴訟リスク

― ナースプラクティショナーの事例を踏まえて ―

抄録

The role of pharmacists in the US that have advanced functions compared to the traditional pharmacists is based on the collaborative drug therapy management (CDTM). Recently in Japan, the importance of enhancing the team approach whose concept is to make the best use of the each health providers' expertise has been discussed in the health care society. As regards pharmacists, pharmacists' pivotal role in medication therapy management is in great demand in the discussion. On the other hand, pharmacists are more exposed to a litigation risk as pharmacists sometimes are sued for their medical negligence these days.
In this manuscript, we conducted a literature and case review for pharmacist responsibility conducting the CDTM in the US. However, we could not find reports and cases, though a litigation risk for pharmacists has been enhanced with the pharmacist role expanding in the CDTM. Furthermore, we conducted a literature and case review for nurse practitioner (NP) as well. As a result, in some cases, NP's negligence was judged independently by the action of NP was whether appropriate or not with no consideration for physician's supervise, and the supervising or collaborating physician's negligence was judged according to the physician's action in the consultation is appropriate or not. As the number of litigation for NP increased, nurse societies raised so many opinions on how to judge appropriately such as which the standard of care (SOC) for physicians or for NPs was applicable and as whether a physician might have an expert witness qualification.