CCPP Exam Content Outline

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Certified Collaborative Practice Pharmacist (CCPP)

Official Examination Content Outline

This document provides the official content outline for the Certified Collaborative Practice Pharmacist (CCPP) examination. The exam certifies that a pharmacist possesses the advanced clinical skills and knowledge of legal, operational, and quality requirements to manage patient care and modify medication therapy under a formal Collaborative Practice Agreement (CPA) with a physician or other prescriber.

Examination Specifications

Name of Credential Certified Collaborative Practice Pharmacist (CCPP)
Certification-Issuing Body The Council on Pharmacy Standards (CPS)
Designation Awarded CCPP
Target Population Pharmacists practicing in ambulatory care, primary care, and community settings under CPAs.
Examination Length 120 multiple-choice items
Administration Time 3.0 hours

Examination Content Outline

The CCPP examination is weighted according to the six domains listed below, covering the full spectrum of collaborative practice from foundational patient assessment and regulatory knowledge to therapeutic management, quality improvement, and interprofessional collaboration.

Domain 1: Foundational Principles & Patient Assessment 25%
Domain 2: Therapeutic & Chronic Disease Management 30%
Domain 3: Collaborative Practice Operations & Workflow 20%
Domain 4: Communication & Interprofessional Collaboration 15%
Domain 5: Legal, Ethical, and Regulatory Foundations 10%
Domain 6: Practice-Based Research, Outcomes, and Quality Improvement 10%

Domain 1: Foundational Principles & Patient Assessment (25%)

Task 1: Synthesize patient data to perform a comprehensive assessment.
  • Integrate subjective and objective data from the patient interview, medical record, and physical assessment.
  • Perform a best possible medication history (BPMH) and reconcile discrepancies across all sources.
  • Identify all active medical problems and medication therapy problems.
  • Assess patient-specific factors, including health literacy, cultural beliefs, and social determinants of health (SDOH).
  • Evaluate the patient's readiness for change and level of engagement in their own care.
Task 2: Perform focused physical assessments relevant to collaborative practice.
  • Measure vital signs (e.g., blood pressure, heart rate, respiratory rate) with proper technique.
  • Conduct targeted physical assessments (e.g., diabetic foot exam, edema assessment, respiratory assessment) to monitor disease progression and drug therapy.
  • Assess a patient's technique and ability to use medical devices (e.g., inhalers, glucometers, insulin pens).
  • Identify physical signs and symptoms indicative of adverse drug reactions or therapeutic ineffectiveness.
  • Document all physical assessment findings accurately within the patient's medical record.
Task 3: Interpret laboratory and diagnostic data to guide clinical decisions.
  • Interpret common laboratory tests (e.g., A1c, lipid panel, BMP, LFTs, INR) to evaluate disease state control.
  • Evaluate therapeutic drug monitoring results to manage medications with a narrow therapeutic index.
  • Assess lab values to screen for, diagnose, and monitor adverse drug effects (e.g., renal/hepatic toxicity).
  • Differentiate between critical and non-critical lab values and formulate an appropriate response plan.
  • Recommend and order appropriate lab tests as authorized by the CPA to monitor therapy.
Task 4: Develop an evidence-based, patient-centered care plan.
  • Apply current clinical practice guidelines to formulate therapeutic recommendations.
  • Establish patient-centered goals of care using shared decision-making principles.
  • Design a medication regimen that is safe, effective, affordable, and aligned with patient preferences.
  • Develop a comprehensive monitoring plan to assess therapeutic efficacy and safety.
  • Incorporate non-pharmacologic strategies, preventive care, and necessary referrals into the care plan.
Task 5: Assess a patient's need for preventive care and wellness services.
  • Evaluate a patient's immunization status and administer or recommend appropriate vaccines.
  • Screen for gaps in evidence-based preventive care, such as cancer screenings or osteoporosis management.
  • Calculate a patient's cardiovascular risk using a validated risk calculator to guide preventive therapy.
  • Assess lifestyle factors (e.g., diet, exercise, tobacco use) and provide appropriate counseling or referrals.
  • Identify and address medication-related risks, such as fall risk in older adults.
Task 6: Screen for and address social determinants of health (SDOH).
  • Utilize validated screening tools to identify patient-specific barriers related to SDOH (e.g., food insecurity, housing instability, transportation).
  • Adapt the care plan to account for identified social and economic barriers to care.
  • Connect patients with community-based resources to address their non-medical needs.
  • Document SDOH-related factors and interventions within the patient's medical record.
  • Advocate for policies and system-level changes that promote health equity for vulnerable populations.

Domain 2: Therapeutic & Chronic Disease Management (30%)

Task 1: Manage cardiometabolic conditions (diabetes, hypertension, dyslipidemia).
  • Apply current guidelines to initiate, adjust, and discontinue therapies for diabetes, hypertension, and dyslipidemia.
  • Select therapies based on their effects on clinical outcomes, comorbid conditions, and patient-specific factors.
  • Manage complex medication regimens, including combination oral therapies and injectable agents.
  • Monitor for and manage common adverse effects and drug-drug interactions associated with cardiometabolic medications.
  • Incorporate data from remote monitoring devices (e.g., CGMs, home BP monitors) into management decisions.
Task 2: Manage anticoagulation therapy.
  • Initiate and manage warfarin therapy using evidence-based dosing protocols.
  • Manage direct oral anticoagulants (DOACs), including agent selection, dose adjustments for renal dysfunction, and monitoring.
  • Develop protocols for peri-procedural management (bridging) of anticoagulant therapy.
  • Educate patients on the signs of bleeding/thrombosis and the importance of adherence.
  • Assess and manage drug-drug and drug-food interactions that affect anticoagulant therapy.
Task 3: Manage common respiratory conditions (asthma, COPD).
  • Apply GINA and GOLD guidelines to classify disease severity and guide medication selection.
  • Initiate, adjust, and discontinue inhaled corticosteroids, bronchodilators, and other respiratory medications.
  • Develop and review action plans for the management of exacerbations.
  • Assess and correct inhaler technique to optimize medication delivery and adherence.
  • Manage comorbidities and complications associated with chronic respiratory diseases.
Task 4: Manage women’s health conditions.
  • Apply current guidelines to select and manage hormonal contraception.
  • Manage menopausal hormone therapy, including risk/benefit assessment and regimen selection.
  • Develop and monitor treatment plans for osteoporosis, including pharmacologic and non-pharmacologic strategies.
  • Screen for and manage medication use during pregnancy and lactation.
  • Assess and manage drug-induced sexual dysfunction.
Task 5: Manage pain and implement opioid stewardship strategies.
  • Apply a multimodal approach to the management of chronic non-cancer pain.
  • Develop evidence-based tapering plans for patients on long-term opioid therapy.
  • Screen for and manage risks associated with opioid use, including substance use disorder.
  • Prescribe and provide education on naloxone for opioid overdose reversal.
  • Incorporate non-pharmacologic and non-opioid therapies into pain management plans.
Task 6: Manage common behavioral health and infectious diseases.
  • Initiate, adjust, and monitor pharmacotherapy for depression and anxiety under protocol.
  • Apply principles of antimicrobial stewardship to the outpatient management of common infections.
  • Manage medications for substance use disorders (e.g., opioid use disorder) as authorized by a CPA.
  • Manage outpatient parenteral antimicrobial therapy (OPAT) under a CPA.
  • Monitor for and manage common side effects and drug interactions of psychotropic and anti-infective medications.

Domain 3: Collaborative Practice Operations & Workflow (20%)

Task 1: Design and implement a collaborative practice service.
  • Conduct a needs assessment to justify the development of a pharmacist-led service.
  • Develop a business plan that outlines the service model, resource requirements, and value proposition.
  • Design efficient workflows for patient identification, referral, scheduling, and follow-up.
  • Integrate the pharmacist’s services into the existing clinic workflow and electronic health record (EHR).
  • Market the service to collaborating providers, staff, and eligible patients.
Task 2: Develop and maintain evidence-based treatment protocols.
  • Develop disease-specific protocols that guide clinical decision-making under the CPA.
  • Base all protocols on current, evidence-based clinical practice guidelines and literature.
  • Define clear criteria for medication initiation, dose titration, monitoring, and discontinuation.
  • Establish a process for the periodic review and update of all protocols.
  • Ensure protocols are approved by the collaborating provider and relevant institutional committees.
Task 3: Manage documentation for all clinical activities.
  • Document all patient encounters in the shared EHR in a timely, accurate, and complete manner.
  • Utilize standardized note formats (e.g., SOAP, FARM) for clinical documentation.
  • Ensure documentation is clear, concise, and effectively communicates the care plan to the entire healthcare team.
  • Document all communication with patients and other providers.
  • Ensure documentation meets all legal, regulatory, and billing requirements.
Task 4: Manage billing and coding for pharmacist-provided services.
  • Apply appropriate CPT codes for pharmacist-provided services (e.g., MTM, "incident-to," annual wellness visits).
  • Ensure compliance with all requirements for billing "incident-to" a physician's service.
  • Develop systems to track and report on billing, revenue, and productivity metrics.
  • Navigate different payment models, including fee-for-service and value-based care arrangements.
  • Justify the financial sustainability and return on investment of the CPA service.
Task 5: Leverage health information technology (IT) and telehealth.
  • Utilize telehealth platforms to conduct effective and compliant virtual patient care visits.
  • Integrate data from remote patient monitoring devices into clinical decision-making.
  • Leverage EHR functionalities such as clinical decision support, order sets, and predictive analytics to optimize care.
  • Use secure messaging and patient portals to enhance communication with patients.
  • Ensure the use of all technology complies with HIPAA and other privacy regulations.
Task 6: Manage population health and close care gaps.
  • Utilize patient registries and data dashboards to identify, risk-stratify, and manage a defined panel of patients.
  • Implement systematic processes to identify and close evidence-based gaps in care (e.g., missing labs, overdue screenings).
  • Design outreach strategies for high-risk patients to improve engagement and outcomes, aligning with ACO and payer models.
  • Track population-level metrics to assess the overall health of the patient panel.
  • Collaborate with the care team to implement team-based population health initiatives.

Domain 4: Communication & Interprofessional Collaboration (15%)

Task 1: Apply patient-centered communication strategies.
  • Utilize motivational interviewing techniques to explore ambivalence and facilitate health behavior change.
  • Engage patients in a shared decision-making process to develop a care plan they are willing and able to follow.
  • Adapt communication styles and educational materials to meet diverse health literacy levels.
  • Employ active listening and empathetic responding to build rapport and trust.
  • Use the teach-back method to confirm patient understanding of key information.
Task 2: Provide comprehensive patient education and self-management training.
  • Educate patients on their medical conditions, medications, and the importance of adherence.
  • Train patients on essential self-management skills and the proper use of medical devices.
  • Develop and provide culturally competent and language-appropriate educational materials.
  • Empower patients to take an active role in managing their health and medications.
  • Assess and address barriers to medication adherence and self-management.
Task 3: Manage communication with collaborating providers and the healthcare team.
  • Provide concise, clinically relevant, and evidence-based updates and recommendations.
  • Establish clear and reliable channels for routine and urgent communication.
  • Utilize a "closed-loop" communication process to ensure recommendations are received and understood.
  • Facilitate team-based care through participation in huddles, case conferences, and team meetings.
  • Document all interprofessional communication in the shared medical record.
Task 4: Manage interprofessional conflict and differences of opinion.
  • Identify the source of a professional disagreement regarding a patient's care plan.
  • Articulate a clinical rationale clearly and respectfully, supported by evidence.
  • Utilize negotiation and conflict resolution skills to arrive at a mutually agreeable solution.
  • Focus on shared goals and the patient's best interest to resolve disagreements.
  • Escalate unresolved conflicts through appropriate channels as defined by institutional policy.
Task 5: Manage medication therapy during transitions of care.
  • Participate in managing medication therapy when patients transition between care settings (e.g., hospital to home).
  • Perform timely and accurate post-discharge medication reconciliation to resolve discrepancies.
  • Communicate effectively with inpatient and outpatient providers to ensure a safe and seamless handoff.
  • Provide enhanced education and follow-up for patients during vulnerable transition periods.
  • Implement strategies to prevent medication-related hospital readmissions.
Task 6: Adapt care plans based on cultural competence and health equity principles.
  • Assess the influence of a patient's cultural beliefs, values, and practices on their health decisions.
  • Adapt communication styles and care plans to be culturally sensitive and responsive.
  • Utilize qualified interpreters for patients with limited English proficiency.
  • Implement specific strategies to reduce health disparities within the patient population being served.
  • Create a welcoming and inclusive practice environment for all patients.
Task 7: Provide interprofessional education and mentorship.
  • Develop and deliver education on medication-related topics to medical residents, nurses, and other healthcare professionals.
  • Serve as a preceptor and role model for pharmacy students and residents in a collaborative practice setting.
  • Design and provide in-service training for clinic staff on new medications, guidelines, or clinical protocols.
  • Provide consultative advice and serve as a drug information resource for the entire care team.
  • Mentor colleagues who are new to collaborative practice or a specific disease state.

Domain 5: Legal, Ethical, and Regulatory Foundations (10%)

Task 1: Interpret state-specific laws and regulations governing CPAs.
  • Analyze the pharmacy practice act and board of pharmacy regulations in a specific state to determine the legal requirements for a CPA.
  • Differentiate between the authorities granted and restrictions placed on pharmacists under various state laws.
  • Ensure the scope of practice defined in a specific CPA is fully compliant with state law.
  • Maintain awareness of changes to laws and regulations that affect collaborative practice.
  • Distinguish between state-mandated requirements and institutional policies related to CPAs.
Task 2: Develop and maintain a legally compliant Collaborative Practice Agreement.
  • Draft a CPA document that includes all elements required by state law.
  • Clearly define the authorized functions, patient population, and specific protocols to be used.
  • Establish and document the qualifications and training of the participating pharmacist.
  • Ensure the CPA is properly signed, dated, and reviewed at the required intervals.
  • Maintain all CPA-related documentation in a manner that is accessible for audit or review.
Task 3: Apply risk management principles to collaborative practice.
  • Maintain adequate professional liability (malpractice) insurance that covers the scope of activities under the CPA.
  • Implement policies and procedures to minimize the risk of medication errors and patient harm.
  • Ensure compliance with all documentation and communication requirements outlined in the CPA.
  • Practice strictly within the defined scope of the CPA and supporting protocols.
  • Develop a plan for managing adverse patient outcomes and communicating with the collaborating provider.
Task 4: Adhere to federal regulations affecting collaborative practice.
  • Ensure compliance with HIPAA regulations for protecting patient privacy and health information.
  • Apply federal anti-kickback and physician self-referral (Stark Law) statutes to practice arrangements.
  • Comply with CLIA waiver requirements when performing point-of-care testing.
  • Adhere to all DEA regulations when managing controlled substances under a CPA.
  • Ensure billing and coding practices comply with Centers for Medicare & Medicaid Services (CMS) regulations.
Task 5: Manage patient consent and liability in a CPA model.
  • Develop and implement a process for obtaining and documenting informed consent from patients for care under a CPA.
  • Clearly explain the role of the pharmacist and the nature of the collaborative relationship to the patient.
  • Differentiate between the legal and professional responsibilities of the pharmacist and the collaborating provider.
  • Ensure that patient care decisions and their rationale are clearly documented to mitigate liability risk.
  • Maintain a clear understanding of the legal concept of vicarious liability in collaborative practice.
Task 6: Navigate ethical dilemmas in collaborative practice.
  • Apply a systematic framework to analyze and resolve ethical issues encountered in practice.
  • Manage conflicts of interest that may arise from relationships with industry or other entities.
  • Uphold the principles of patient autonomy, beneficence, non-maleficence, and justice in all clinical decisions.
  • Maintain professional boundaries in relationships with patients and colleagues.
  • Advocate for patient needs, even when they conflict with institutional or financial pressures.

Domain 6: Practice-Based Research, Outcomes, and Quality Improvement (10%)

Task 1: Collect and analyze patient care outcomes.
  • Identify appropriate clinical, humanistic, and economic outcomes to measure the impact of the CPA service.
  • Design and implement a system for systematically collecting outcomes data.
  • Analyze outcomes data to evaluate the effectiveness of the service and identify areas for improvement.
  • Compare practice-level outcomes to national benchmarks and quality measure targets.
  • Utilize data to demonstrate the value of the pharmacist's services to stakeholders.
Task 2: Participate in quality improvement (QI) projects.
  • Apply formal QI methodologies (e.g., PDSA cycles, Lean, Six Sigma) to improve care processes.
  • Lead or participate in interprofessional teams focused on improving quality and safety.
  • Utilize QI tools, such as process maps and root cause analysis, to identify system vulnerabilities.
  • Measure the impact of QI interventions on processes and outcomes.
  • Contribute to creating a culture of continuous quality improvement within the practice setting.
Task 3: Utilize data dashboards and registries for population health management.
  • Use data dashboards and patient registries to monitor population-level health outcomes (e.g., percentage of patients at A1c goal).
  • Leverage data analytics to identify high-risk patients or care gaps within a patient panel.
  • Generate reports to track progress on key quality measures (e.g., MIPS, HEDIS).
  • Translate population-level data into actionable strategies for improving care.
  • Ensure the accuracy and integrity of data entered into registries and dashboards.
Task 4: Participate in or support practice-based research.
  • Differentiate between quality improvement, practice-based research, and traditional clinical research.
  • Contribute to the design and implementation of practice-based research projects.
  • Ensure all research activities are conducted ethically and in compliance with IRB requirements.
  • Collect and manage research data with a high degree of accuracy and integrity.
  • Disseminate the results of QI and research projects through presentations or publications.
Task 5: Evaluate the impact of the service on healthcare quality measures.
  • Identify the key quality measures relevant to the patient population and practice setting (e.g., MIPS, HEDIS, UDS).
  • Design patient care services to proactively meet and exceed quality measure targets.
  • Analyze and report on the service's contribution to achieving organizational quality goals.
  • Use quality measure performance to refine care processes and patient interventions.
  • Articulate the link between the pharmacist's activities and performance on value-based care metrics.
Task 6: Maintain personal and professional development.
  • Engage in continuous professional development to maintain expertise in areas of collaborative practice.
  • Critically evaluate medical literature to incorporate new evidence into practice.
  • Participate in peer review and feedback processes to improve clinical skills.
  • Develop a personal plan for ongoing learning and skill development.
  • Contribute to the profession by precepting students or mentoring colleagues in collaborative practice.

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