Pharmacists’ duty to warn in the age of social media

What constitutes a bonafide pharmacist–patient relationship? In the past, such a relationship required a series of face-to-face meetings between a patient and a pharmacist. The first change to this paradigm occurred with the development and acceptance of and eventual reimbursement for telepharmacy services. Telepharmacy is the provision of all aspects of traditional pharmaceutical care via communication technology to address distances separating participants.1,2 Since its inception, telepharmacy has been implemented in community pharmacies,1,3,4 clinics,5–8 hospitals,9–11 and health maintenance organizations.12 More recently, the viability of the pharmacist–patient relationship has been tested through a traditional community practice model housed on the Internet. While online pharmacies have existed for some time, they have been primarily used in a dispensing capacity. The acceptance of online pharmacies has been marred by rogue pharmacies, whose actions have resulted in legal consequences such as the Ryan Haight Online Pharmacy Consumer Protection Act of 2008.13 The profession has made various efforts to address the unlawful and unethical actions of such rogue pharmacies, including the National Association of Boards of Pharmacy’s Verified Internet Pharmacy Practice Sites program.14 The newest frontier for exploring the pharmacist–patient relationship is social media, also referred to as Web 2.0.