Proportion of work appropriate for pharmacy technicians in anticoagulation clinics

A two-part study helped to determine how much of a pharmacists work in an anticoagulation clinic (AC) could be shifted to CPTs. A group of eight clinical pharmacists and four pharmacy technicians from VA Anticoagulation clinics used a categorization technique called the Delphi process to categorize AC tasks as either appropriate or inappropriate for a CPT.

Methods included interviewing CPTs about their current roles and duties within the AC, and asking clinical pharmacists to categorize tasks currently performed at the AC as appropriate or inappropriate for an AC to perform. The framework for a standard job description for a CPT within an anticoagulation clinic was compiled. Then, an investigator observed one pharmacist at a single AC completing all of the tasks three different times.

It was found that most of the CPTS from the AC locations investigated performed administrative duties, took phone calls regarding refilling prescriptions, and clarifying dosing. CPTS also contacted no show patients and rescheduled their appointments. Two of four CPTs at one AC clinic had roles that were extended to include the clinical, task based role of calling patients with in-range INRs, which inherently includes interviewing, documenting, and scheduling. Clinical pharmacists reported that it was appropriate for CPT’s to perform administrative tasks and even some clinical tasks. There were mixed opinions of clinical pharmacists on whether point of care finger-stick INR rests, answering questions about interactions, and renewing warfarin prescriptions were appropriate or not.

This study shows that further training CPT’s to take on some of the more clinical based work within the scope of appropriateness can alleviate some time for pharmacists. I think that in the setting of an anticoagulation clinic, more specialized technicians can really be a valuable asset.

 

Am J Health-Syst Pharm. 2016;73(5):322-327. Link to Article

Enactment of mandatory pharmacy technician certification in Kansas

This article discussed the process and accomplishment of an enactment of mandatory pharmacy technician certification in Kansas. In 2004, Kansas began the step in requiring registration of all pharmacy technicians. These technicians were required to register, however they did not require any certification. Later, on September 2012, the Kansas Board of Pharmacy created a task force to research practices of technician certification in other states and to make recommendations to the board of pharmacy on how to create mandatory technician certification. This task force then formed the steps needed to achieve the legislation to support mandatory technician certification. These recommendations were then finalized at the August 2013 Kansas Pharmacy Summit and proposed legislation was then passed during the 2014 session. This legislation outlined topics such as training requirements, age and education requirements, pharmacist to technician ratio, and more.

Pharmacists are not able to provide everything that a patient in a community setting will want. That is why having pharmacy technicians is important within the community field. As of now the state of Pennsylvania has a certification that is available for people interested in becoming a pharmacy technician, however this is not required. Along with this, there are no strict guidelines for being a pharmacy technician. These guidelines and requirements might make a positive impact on work conducted within a community setting. Having a more regular and monitored assistant position within a community pharmacy might also improve patient care and reduce the risk of mistakes.

Lucas A.. Massey L., Gill T., et al. Enactment of mandatory pharmacy technician certification in Kansas. Am J Health Syst Pharm. 2016; 73: 133-36

Novel and Expanded Role for the Pharmacy Technician

A CMS Health Care Innovations Award – funded care transitions program known as SafeMed has the goal of reducing hospital readmissions and overall healthcare cost through the optimization of drug therapy. In particular they focus on adherence to drug therapy in addition to the efficiency of the drug regimens being undertaken by patients who are taking multiple chronic conditions – much like what we would expect in a patient who is eligible for MTM services.

Hospital readmissions are common in these patients who have an abrupt transition from extensive medical oversight to being unmonitored in their homes. Here, SafeMed decided to expand the role of their pharmacy technicians having them follow up with these patients by giving the patients phone calls after they return home from their hospital stays. These technicians were put through a training program with teachings provided by a pharmacist with expertise in MTM and through their basic understanding of MTM services they were appointed to a role of identification of some drug therapy problems. The idea here is not to have a technician assume the role of a pharmacist but rather be a less expensive extra set of eyes which could help draw attention to problems that could then be more promptly resolved by the pharmacist.

More time would be needed to draw conclusions about the clinical outcomes surrounding this program. However, an increase in DTP pharmacist interventions did result from this method which intuitively should result in more effective outpatient treatment and less hospital readmissions resulting in less medical expenses, a parameter which is to be measured in follow up studying of this method. In addition, they aim to improve the education of these technicians which can provide a very useful arm for the pharmacists helping them spot the patients who could use their expertise most.

Reference

Bailey J. SafeMed: using pharmacy technicians in a novel role as community health workers to improve transitions of care.” J Am Pharm Assoc. 2016; 56(1): 73-81.

J Am Pharm Assoc. 2016; 56(1): 73-81