The collaborative drug therapy management (CDTM), also known as coordinated management of drug therapy, involves the development of a collaborative practice agreement (CPA) between one or more health care providers and pharmacists. On October 1, 2013, Jerry Brown, Governor of the Board, signed Senate Bill 493 that removes the role of a pharmacist to become a physician and gives them the power to provide hormonal contraceptives, nicotine substitutes, vaccines, including travel vaccinations, which do not require diagnosis, but are recommended by the CDC to order and interpret drug recommendations and laboratory tests to optimize drug therapy.  The bill also included the classification “Advanced Practice Pharmacist” (APh), defined by the California State Council of Pharmacy as a licensed pharmacist, which must meet two of the following criteria: To manage CPAs, pharmacists must be able to assess the health status of their patients, implement a pharmaceutical care plan , communicate with stakeholders and monitor patient progress. This also involves determining when it should intervene in a patient`s drug therapy.  Pharmacists may receive registration information from organizations approved by the Pharmacy Council.  CDTM, made possible by CPAs between pharmacists and other health care providers, has been shown to be effective in improving clinical and behavioural health indicators, including blood pressure reduction, HbA1c, and LDL cholesterol levels; Improve the quality of treatment by complying with clinical guidelines by pharmacists; and improving patient knowledge and adherence to drug regimens.2 CPAs are a priority for professional pharmacies. In January 2012, the American Pharmacists Association (APhA) brought together a consortium of pharmacy, medical and care professionals from 12 countries to discuss the integration of CPAs into daily clinical practice.  The consortium published a white paper entitled “Consortium Recommendations for Advancing Pharmacists” Patients Care Services and Collaborative Practice Agreements and summarized their recommendations.  Once authorized by the Board of Pharmacy, APh can conduct patient assessments, refer patients to providers, and work with other health care providers to manage patients` disease status by optimizing drug treatments. These include initiation, adaptation and discontinuation of drugs by protocol established by the organization on which they work.  APh certification is good for 2 years as long as the pharmacist`s licence is active and the pharmacist must complete at least 10 additional hours of training every 2 years.  In 2010, the American Medical Association (AMA) published a series of reports entitled “AMA Scope of Practice Data Series.”  One report focused on the pharmacy profession, which criticized the formation of CPAs as an attempt by pharmacists to intervene with the physician.
In response to the report, a collaboration of seven national pharmacists` associations prepared a response to the WADA Pharmacists Report.  The response called on WADA to correct its report and publish the revised report with Errata.  In 2011, WADA`s Chamber of Deputies adopted a more flexible tone of the APhA in response to contributions from aPhA and other pharmacy professional associations and finally adopted the following resolution, which paid attention to the refusal of independent conduct agreements (rather than collaborative or dependent agreements): the term “cooperation agreement” was also referred to as a consultation agreement , agreeing to the practice of collaborative pharmacy. , doctor-pharmacist agreement, permanent contract or permanent protocol and medical delegation.  A Collaborative Practice Agreement is a legal document in the United States that establishes a formal relationship between pharmacists (often clinical pharmacy specialists) and cooperating physicians, in order to create a legal and ethical basis for pharmacists involved in collaborative therapy management.   CDTM is an extension of the traditional practice of pharmacists, which is to manage