“Partners in Crime”: Pharmacists and Pharmacy Technicians

Abstract

1The model indicated that implementing a core set of 5 clinical pharmacy services that have been associated with improvements in patients’ outcomes (i.e., providing drug information, managing adverse drug reactions, attending rounds, managing drug protocols, and obtaining medication histories) for 100% of inpatients by the year 2020 would require 14 508 additional full-time equivalent pharmacist positions! Although similar modelling has not been reported from Canada, the recent federally funded report Moving Forward: Pharmacy Human Resources for the Future seems to echo the US shortage. 2 In the face of such workforce shortages, and given the continually expanding roles of pharmacists as providers of patient care, the use of pharmacy technicians to support pharmacists by performing selected clinical duties has been advocated as a potential, if only partial, solution. In this issue of the Journal, Johnston and others 3 report a randomized controlled trial comparing best possible medication histories obtained in the emergency department by pharmacists and by pharmacy technicians. 3 In their study, Johnston and coauthors found that trained pharmacy techni cians were just as effective as pharmacists in obtaining medication histories in the emergency department of a community hospital and that the numbers of discrepancies identified during the subsequent medication reconciliation process for randomly selected patients were similar. Further more, these discrepancies were similar in severity, as adjudicated by a third-party reviewer. The study was underpowered, with only 59 patients, and for the majority of patients, there were no unintentional medication discrepan cies (47 patients as determined by pharmacists, 50 patients as determined by technicians). Nonetheless, this study adds to a growing body of literature supporting the role of pharmacy technicians in this aspect of the medication reconciliation process. 4,5 To push the prover bial envelope even further, the “Point Counterpoint” column in this issue of the Journal presents a debate on the further extension of the clinical role of pharmacy techni cians in areas where there are no pharmacists at all. 6,7