Clinical Pharmacy Technician Research Articles

Clinical Oncology Pharmacy Technician: Impact of a New Role on Pharmacy and Patient Metrics at a Large Academic Cancer Center

Clinical Oncology Pharmacy Technician: Impact of a New Role on Pharmacy and Patient Metrics at a Large Academic Cancer Center

Pharmacy‐led optimization of transitions of care in patients with heart failure

AbstractIntroductionEffective transitional care for patients with heart failure is essential to ensure optimal utilization of guideline‐directed medical therapy. Clinical pharmacists and specially trained pharmacy technicians have unique skillsets that enable them to improve care transitions.ObjectivesTo evaluate the implementation of a comprehensive pharmacy transitions of care program in an acute heart failure population.MethodsA retrospective, single center, single‐arm study evaluating pharmacy‐delivered transitions of care services (admission and discharge medication reconciliation, medication cost assessment, medication counseling, bedside delivery of discharge medications, and post‐discharge phone calls) for patients discharged from the heart failure service. The primary outcome was the completion rate of transitions of care services. Secondary outcomes included the medication intervention rate and types of interventions made, medication classes assessed for cost, discharge medication prescription captured, and 30‐day all‐cause readmissions.ResultsFive hundred and ninety‐five patients were eligible for the transitions of care program. Admission and discharge medication reconciliations were completed in 68.1% and 92.1% of patients, respectively. Medication cost assessments were completed for 39.8% of patients. Heart failure medication counseling prior to discharge was completed for 83.9% of patients. Discharge prescription capture rate was 56.5% and bedside prescription delivery was provided for 27.8% of patients. The discharge medication reconciliation intervention rate was 37.4%, with the most common intervention being dose adjustment. Post‐discharge outreach was conducted for 229 patients, with education provided for 69.4% and an intervention rate of 43.7%. The 30‐day all‐cause readmission rate was lower for patients on the heart failure service compared with the institution (10.1% vs 16.5%).ConclusionHigh rates of completion and utilization were identified after the implementation of a comprehensive pharmacy transitions of care program. Utilization of clinical pharmacists and pharmacy technicians during transitions of care improved medication access, patient education, and reduced medication‐related problems.

Impact of a pharmacy technician on an interprofessional antithrombotic stewardship program at an academic medical center.

The need for monitoring and standardization of anticoagulation management has garnered the attention of national organizations, driving the implementation of antithrombotic stewardship programs (ASPs). Established ASPs have highlighted interdisciplinary collaboration between physicians, nurses, and pharmacists and demonstrated financial benefits and positive patient care outcomes. While pharmacy technicians are key members of the pharmacy profession, they are rarely utilized to expand clinical programs. The aim of this report is to describe the impact of adding a pharmacy technician to an ASP at an academic medical center. The departments of pharmacy and quality at West Virginia University Hospitals (WVUH) developed a business plan and financially justified an ASP. The ASP was implemented in January 2022 and consisted of 2 full-time clinical pharmacist specialists, 1 full-time clinical pharmacy technician, 2 full-time clinical nurse specialists, and 1 part-time physician medical director. The clinical pharmacy technician's primary role was to review patients' sequential compression device (SCD) compliance and newly started oral anticoagulants prior to discharge. The clinical nurse specialists educated patients newly started on oral anticoagulants within 24 hours of discharge and triaged any postdischarge medication access issues. The medical director provided high-level program oversight and acted as a clinical consultant on complex patient cases. In the first 6 months after the program's implementation, the clinical pharmacy technician made 174 recommendations to the clinical pharmacist specialists regarding discharge transitions of care and assessed SCD compliance in 246 patients. Of the 246 patients assessed, 217 patients (88%) were deemed to be noncompliant. The pharmacy department at WVUH successfully justified and implemented an interprofessional ASP at an academic medical center, which is the first ASP to date to incorporate a clinical pharmacy technician.

Beyond the boundaries of ward-based services – exploring the scope of “non-traditional” clinical pharmacy practice in a tertiary referral teaching hospital

Abstract Introduction Hospital clinical pharmacy practice in the UK has developed beyond traditional boundaries of ward-based inpatient services. Royal Pharmaceutical Society Hospital Pharmacy Standards recommend pharmacy team members are integrated into multidisciplinary teams across the organisation to ensure safe and appropriate medicines use whatever the setting1. Pharmacy professionals provide pharmaceutical care and specialist services in outpatient and ambulatory settings and through participation in multidisciplinary team (MDT) meetings. Within the outpatient setting, research typically focusses on single outpatient clinics within specific disciplines, little evidence describes the overall contribution to patient care across whole pharmacy services2. Aim To describe the scope of clinical pharmacy services occurring beyond traditional ward-based services in a tertiary hospital; including quantification of outpatient clinics and MDT meetings provided by pharmacy professionals. Methods The Deputy Chief Pharmacist invited clinical Principal Pharmacists to participate in semi-structured interviews exploring the scope of “non-traditional” services across the Trust during March 2023. Non-traditional services were defined as direct clinical care outside of ward-based inpatient clinical pharmacy services. Indirect clinical care activities such as guideline writing, drug expenditure and governance activities were excluded. Inpatient board rounds/ward rounds and any service not currently provided due to vacancy were excluded. Participants were asked to quantify services provided, advise who provided the services and to describe contributions provided by the pharmacy team. The study was deemed service evaluation and ethical approval waived. Results 100% invited pharmacists participated. Pharmacists attended and contributed to over 150 MDT meetings monthly across 24 sub-specialities; 80% were for outpatients. In tertiary/quaternary services, these frequently covered patients beyond local geography. MDT meetings were typically attended by specialist, principal or consultant pharmacists. Common contributions included: provision of pro-active advice/responding to queries; medicines optimisation; monitoring; income or compliance assurance; prescribing/deprescribing. Specialist pharmacists provided 80-100 outpatient clinic sessions across 17 sub-specialities through a mix of face-to-face and virtual appointments, advanced pharmacy technicians provided on-treatment and counselling clinics. Activities included: initiation, monitoring, adjustment and cessation of medicines; patient counselling and MDT referral. Medicines prescribed were typically high cost, complex and higher risk. Pharmacists prescribed and clinically verified homecare medicines and provided ongoing annual review of outpatient medicines, including prescribing/deprescribing. Teams described medicines reconciliation and counselling in ambulatory haematology settings, off-site units and infusion suites. The team organised, optimised and provided advice and counselling for patients requiring antimicrobial therapies at home. Clinical pharmacists and pharmacy technicians provided medicines information to patients, internal and external healthcare professionals. Discussion/Conclusion This study provides evidence of the broad scope of clinical pharmacy practice beyond the boundaries of traditional ward-based services in a tertiary teaching hospital. This study was limited to a single organisation, specific clinical pharmacy activities and outcomes of these services were not fully quantified. Formal collation of clinical pharmacy activities within “non-traditional” outpatient and ambulatory settings is limited because activity data collection forms in hospital pharmacy are typically validated in traditional ward-based pharmacy services. We recommend further studies to validate activity collection tools to benchmark the activities of clinical pharmacy professionals providing services in outpatient and ambulatory settings both within and between hospital Trusts.

A scoping review of clinical pharmacist and pharmacy technician contributions to cystic fibrosis care

AbstractThe purpose of this scoping literature review was to assess available published literature/abstracts, and to examine described contributions by pharmacists and/or pharmacy technicians as part of the care of people with cystic fibrosis (pwCF). This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses Extension for Scoping Reviews (PRISMA‐ScR). Published abstracts and articles from inception through December 2022 were included if they described care of pwCF (all ages), with at least one group of participants receiving care/services from pharmacy staff, and were available in English. Data extractions were outcomes, study, and participant characteristics. From 756 abstracts and papers, 91 were included. The majority were published abstracts (n = 67), from the United States (n = 64), retrospective cohort study design (n = 47), involved pharmacist intervention (n = 75), with no comparison group (n = 48), and in an outpatient/ambulatory setting (n = 59). Most often, literature were descriptions of specific pharmacist services, evaluations of adding a pharmacist, or descriptions of overall pharmacist practice/role. Specific pharmacist services were defined as patient or caregiver education, adherence support, medication reconciliation, management of pulmonary exacerbations, and medication management (including monitoring, and telehealth). Pharmacists and pharmacy technicians have contributed to the care of pwCF in various ways; however, much of the available data are currently disseminated in the form of conference abstracts. Efforts to support author publication of data as full peer‐reviewed publications should be prioritized as this data can help support others’ efforts to develop or support similar clinical pharmacy services.

Initial observations on the impact of implementation of a seven-day clinical pharmacy service on dispensary activity and performance

Abstract Introduction The need for seven-day clinical pharmacy services is widely acknowledged, although limited, in the acute sector of the National Health Service.1,2 Timely medicine supply is integral to provision of improved clinical pharmacy services to patients across seven-days, and is essential in effective discharge planning. There is a paucity of evidence for implementation of seven-day clinical pharmacy services, including the impact of service transformation on dispensary activity and performance. This limits planning and development of seven-day pharmacy services. Aim To assess the impact of a seven-day clinical pharmacy service on dispensary activity and performance, at the main site of a tertiary-referral teaching hospital. Methods A seven-day clinical pharmacy service was implemented in October 2021. Prior to this, pharmacy services were largely dispensary-based with clinical pharmacy services for acute and neurosciences admission and limited ward-based services in other specialities. At implementation, clinical pharmacy technicians and pharmacists (n=16) provided patient-facing pharmaceutical care for 7.5-hours/day across all specialities over the weekend; this included medicines reconciliation, preparation of discharge-medication lists, independent prescribing, counselling and clinical review of prioritised patients. The weekend dispensary staffing, skill-mix and shift patterns were redesigned to facilitate staff release from the dispensary rota. Dispensing activity data were obtained from Ascribe for six months pre- and post-implementation (April 2021-March 2022). Data were categorised as inpatient/discharge and the mean number of items dispensed per month analysed using Microsoft Excel. Discharge turnaround performance was calculated as percentage of discharge prescriptions dispensed within two-hours of dispensary receipt and obtained from the Prescription Tracking System. Verbal staff feedback was sought 4-months post-implementation. The study was deemed a service evaluation by the Pharmacy Research and Audit Group and so ethical approval was not required. Results Twelve dispensing staff and one pharmacist were rostered to one of three daily 3.75-hour dispensary shift patterns. Following implementation, mean total inpatient dispensing activity increased from 12799 to 13250 items/month (3.5% increase) and mean weekend activity from 2184 to 2677 items/month (22.6% increase). Mean weekday inpatient activity was stable at 10615 to 10573 items/month. The mean discharge dispensing activity increased from 9065 to 9837 items/month (8.5% increase): mean weekday discharge from 8498 to 8622 items/month (1.5% increase); mean weekend activity from 569 to 1215 items/month (114% increase). Discharge turnaround performance remained stable with 85% discharge prescriptions dispensed within 2-hours, versus 84% pre-implementation. Weekday performance also remained stable - from 84% to 83% and the weekend performance increased from 85% to 92%. Dispensary staff fed-back that weekend shift patterns were effective, activity was manageable and shifts usually ran smoothly and finished on time. Discussion/Conclusion Introduction of a seven-day clinical pharmacy service led to an increase in weekend dispensary activity, which was not offset by decrease in weekday activity. Importantly, the dispensary performance was not negatively impacted and weekend discharge performance improved. Increases could be because of weekend medicines reconciliation, pro-active medication ordering and pharmacist-led preparation of discharge-medicine lists. Dispensary activity in Winter 2020 was atypical because of COVID-19, thus it was not feasible to compare data. Further review, including 12 months data would reduce impact of seasonal variations in NHS activity. Limitations include that patient data including length of stay and time to discharge were not within scope.

Impact of pharmacy services on time to elexacaftor-tezacaftor-ivacaftor initiation.

BACKGROUND: The approval of elexacaftor-tezacaftor-ivacaftor (ELX/TEZ/IVA) expanded highly effective cystic fibrosis transmembrane receptor modulator therapy to approximately 90% of persons aged 12 years and older with cystic fibrosis. Clinical pharmacists and pharmacy technicians played a key role in planning for ELX/TEZ/IVA initiation prior to US Food and Drug Administration approval as well as initiating therapy after approval. OBJECTIVE: To evaluate the impact of pharmacy services on time to ELX/TEZ/IVA initiation. METHODS: A retrospective chart review evaluated 146 patients aged at least 12 years with cystic fibrosis qualifying for ELX/TEZ/IVA at a single health system between October 21, 2019, and April 1, 2020. RESULTS: Patients filling ELX/TEZ/IVA at an integrated health system specialty pharmacy (HSSP) vs an outside specialty pharmacy (SP) started on therapy an average of 10.8 days sooner (10.8 days ± 14.0 vs 21.6 days ± 18.8, respectively; P = 0.006). More patients filling at an HSSP received ELX/TEZ/IVA within 14 days of the prescription being written compared with outside SPs (82.0% vs 41.4%, respectively; P = 0.001). Before ELX/TEZ/IVA initiation, patients were hospitalized for a cystic fibrosis-related complication for an average of 6.26 days (range = 0-183) compared with 1.16 days (range = 0-91) after ELX/TEZ/IVA initiation. Lastly, an estimated $134,810 was saved in hospitalization dollars in the 105 patients that were able to fill ELX/TEZ/IVA at an HSSP by initiating the drug an average of 10.8 days sooner than outside SPs. CONCLUSIONS: The results of this study demonstrate the value of an integrated HSSP model. The ability to fill specialty medications at an integrated HSSP may optimize medication access, control costs, and improve patient outcomes for patients receiving care within a health system. DISCLOSURES: Dr Loucks has accepted payment for reviewing content of Lexicomp through Wolters Kluwer Consulting and for presenting and attending the American Society of Health System Pharmacists (ASHP) Summer Meeting in June 2022. Dr Loucks is also a Workgroup Chair for the ASHP Pharmacist Section of Specialty Pharmacy Practitioners - Section Advisory Group on Outcomes and Value. Dr Simonsen was a participant in the Vertex Pharmaceuticals Advisory Board in April 2019 and accepted payment for travel and expenses. The remaining authors have no conflicts of interest or financial interests to disclose. This work is in part supported by the Statistical Expertise and Network (StatNet) Award of Cystic Fibrosis Foundation.

Developing the clinical pharmacy technician role for mental health triaging

NHS England & NHS Improvement are building on the ‘NHS long-term plan‘, focusing on the mental health provision within mental health services. Against this context, we wanted to improve the therapeutic inpatient mental health care within our service by developing a clinical pharmacy technician (CPT) able to triage the patients requiring the highest levels of clinical […]

Medicines reconciliation of biologics on a primary care clinical system

With increasing number of biologics gaining approval from the National Institute for Health and Care Excellence for a wide variety of both cancer and non-cancer clinical indications in secondary care, the need for accurate medicines reconciliation in primary care also increases. The risk of patient harm from incomplete medicines reconciliation is a consideration, particularly when patient data is transferred from a secondary care setting to a primary care setting. As part of a prescribing quality improvement project, a list of biologics prescribed by secondary care providers were reconciled on to patients' primary care clinical systems (EMIS) by clinical pharmacists and pharmacy technicians at a Clinical Commissioning Groups. Patients were identified by cross-referencing high cost drug reports with clinical diagnostic codes (a mixture of READ codes and SNOMED-CT terms) on primary care clinical systems. In total, 192 medicines were reconciled safely on the relevant patients' notes across 16 different GP practices A further 81 medicines had already been reconciled at the start of the quality improvement project. The purpose of this article is three-fold; to expand the awareness of biologics in the context of medicines optimisation in the primary care arena, to discuss medicines reconciliations of biologics in primary care, including the role(s) of pharmacy professionals, and to discuss the wider implications of prescribing biologics in the light of ethical considerations such as veganism.

Evaluation of a pharmacy technician-based medication prior authorization program

BackgroundThe roles of pharmacy technicians in clinical practice are being explored. Medication prior authorizations (PAs) from insurers can lead to delays in pharmacotherapy. ObjectiveTo assess the efficiency of our clinical pharmacy technicians in processing PAs for medications. Practice descriptionOutpatient clinics in a comprehensive health care provider group. Practice innovationPA requests are routed to technicians for initial data collection. Clinical pharmacists can review their work before submission. Evaluation methodsClinical pharmacy staff in 4 clinics recorded information about PA requests from January 21, 2020, to April 21, 2020. In 3 of the clinics, PA requests were primarily processed by clinical pharmacy technicians. In another clinic, requests were processed by a clinical pharmacist. Information collected included the date the request was received, outcomes (e.g., approval, therapy change, or nonapproval), and the date of final outcome. Descriptive statistics were prepared, including number of requests that were approved, number of business days between request and decision, and final outcome. ResultsOverall, 720 PA requests were received. Of these, 88.6% were approved with first response, and 673 (93.5%) were eventually approved. Median time to first response was 0 business days, regardless of clinic. In 75% of cases, first response was within 1 business day. PA characteristics varied across clinics; however, PA approval percentages were comparable (91.2%–94.3%). ConclusionIn an assessment of clinical pharmacy technicians’ efficiency in responding to pharmacy plan PA requests, more than 90% were approved, often within one business day. Our results must be interpreted in light of local factors and a virus pandemic during the study. However, results of requests handled by technicians were similar to results when the requests were handled by a clinical pharmacist. Clinical pharmacy technicians can be efficient and cost-effective in this role.

Forecasting (2018-2030) and the Demand of Clinical Pharmacy Technician Workforce at Over Twelve Years (2006-2017) in Saudi Arabia

International Journal of Pharmacology and Clinical Sciences,2019,8,3,186-189.DOI:10.5530/ijpcs.2019.8.31Published:September 2019Type:Research ArticleAuthors:Yousef Ahmed Alomi, Saeed Jamaan Alghamdi, and Radi Abdullah Alattyh Author(s) affiliations:Yousef Ahmed Alomi*, The Former General Manager of General Administration of Pharmaceutical Care, The Former Head, National Clinical pharmacy and pharmacy practice, The Former Head, Pharmacy R&D Administration, Ministry of Health, Riyadh, SAUDI ARABIA. Saeed Jamaan Alghamdi, General Administration of Pharmaceutical Care, Ministry of Health, Riyadh, SAUDI ARABIA. Radi Abdullah Alattyh, General Administration of Pharmaceutical Care, Ministry of Health, Riyadh, SAUDI ARABIA. Abstract:Background: The workforce of clinical pharmacy technician is one the elements of pharmacy strategic plan in Saudi Arabia. Objectives: The purpose of this study is to explore the demand clinical pharmacy technician’s workforce at Ministry of Health (MOH) hospitals and primary health care centers over the past twelve years (2006- 2017) and forecasting during the years (2018-2030) in the kingdom of Saudi Arabia. Methods: It is a retrospective analysis of twelve years (2006-2017) of MOH hospitals, Primary Health Care Center (PHCs) of the pharmacy technician’s workforce and forecasting for future years (2018-2030). All data were derived from the Ministry of Health statistical year books and any missing appropriate information about pharmacy technician’s workforce that will be estimated through allied healthcare professional’s data in each region including gender. It included all types of pharmacy technicians included in the study while excluded all pharmacists or clinical pharmacist’s workforce at MOH intuitions. All calculations were based on MOH workforce standards of hospitals or PHCs updated literatures. All calculation was done using Microsoft Excel version ten. Results: The total average of hospitals was 253.92 in the kingdom of Saudi Arabia. The total average demand of clinical pharmacy technician at MOH hospitals will be (4,579.08) over twelve years (2006-2017) with a range (2,899 to 6,619). The total average demand of clinical pharmacy technician at primary healthcare centers will be (1,303) over twelve years (2006-2017) with a range (891 to 1,623). The total average demand of clinical pharmacy technician at hospital forecasting will be (10,271.34) over thirteen years (2008-2030) with a range (8,797.44 to 11,887.11). The total average demand of clinical pharmacy technician at primary healthcare centers forecasting will be (14,270.87) over thirteen years (2018-2030) with a range (12,223.05 to 16,515.79). Conclusion: The Ministry of Health hospitals and primary care centers sectors will be with the highest demand for clinical pharmacy technician in the future. The ratio of pharmacist to clinical pharmacy technician needs to be standardized at hospitals and primary healthcare services. Further, the analysis of the clinical pharmacy technician workforce is required in the kingdom of Saudi Arabia. Keywords:Clinical Pharmacy technician, Demand, Forecasting, Ministry of Health, Saudi Arabia, WorkforcesView:PDF (168.49 KB) PDFClick here to download the PDF file. Images Forecasting (2018-2030) and the Demand of Clinical Pharmacy Technician Workforce at Over Twelve Years (2006-2017) in Saudi Arabia

Analysis of activities undertaken by ward-based clinical pharmacy technicians during patient hospital journey

IntroductionPrevious studies recognise insufficient time as an obstacle to pharmacists expanding their clinical-based activities and services. For such a reason, the role of well-trained ward-based clinical pharmacy technicians (CPTs) is...

The impact of an integrated health-system specialty pharmacy on HIV antiretroviral therapy adherence, viral suppression and CD4 count in an outpatient ID clinic

Background: Atrium Health (AH) is a Charlotte-based not for profit hospital network that currently cares for HIV-infected patients through three outpatient ID clinics. AH recognized that novel approaches to patient care which incorporate clinical pharmacists and health-system specialty pharmacy into the practice model can help improve the HIV continuum. As a result, AH created an HIV specialty pharmacy service line that embedded an HIV-trained clinical pharmacist and pharmacy technician within one of three health-system outpatient ID clinics. Aims: This study aimed to evaluate the antiretroviral medication adherence rate, viral load, and CD4 count among patients utilizing Atrium Health Specialty Pharmacy Service (AH SPS) compared to patients that opted out of the program. Methods: This was a single-center, retrospective cohort study conducted from 7 August 2017 to 30 June 2018. All patients were already on HIV therapy at either entry or declination to the AH SPS program. The intervention group was defined as HIV patient care that incorporated AH SPS into the practice model. The control group was defined as HIV patient care that did not involve our health-system specialty pharmacy. The primary endpoints were medication adherence, viral suppression, and CD4 counts. Adherence was measured using pharmacy claims data and the Medication Possession Ratio (MPR) calculation. Baseline viral load and CD4 count at the time of entry or declination to the program was recorded as well as at the end of the observation period. Comparisons between the opt-in and opt-out groups were made. Results: For those patients using AH SPS, the overall average adherence rate was 100% versus only 89% for those patients that opted out of the service (p < 0.01). Furthermore, all but 3 patients using AH SPS reached viral suppression (p = 0.03) and all but one had improved immunefunction with a CD4 count 200 or greater by the end of the observation period (p = 0.03). The change in viral suppression and CD4 count of 200 or greater was not statistically improved between baseline and follow up in those opting out of using AH SPS. Conclusions: The AH SPS utilized an innovative practice model that fully integrated a specialty pharmacy team within an outpatient ID clinic. This novel approach to patient care significantly improved adherence which in turn lead to improved viral suppression and immune markers in patients enrolled within the program compared to those opting out.

Factors of Pharmacy Practice on Pharmacy Technician Job Satisfaction in Saudi Arabia

Pharmacology, Toxicology and Biomedical Reports,2019,5,3,145-150.DOI:10.5530/PTB.2019.5.27Published:August 2019Type:Research ArticleAuthors:Yousef Ahmed Alomi, Faiz A. Bahadig Rph, Bayan Ibrahim Alghuraybi, Budoor Emad Aloumi, and Reem Saad Alsubaie Author(s) affiliations:Yousef Ahmed Alomi*, The Former General Manager of General Administration of Pharmaceutical Care, Former Head, National Clinical Pharmacy and Pharmacy Practice, Former Head, Pharmacy R&D Administration, Ministry of Health, Riyadh, SAUDI ARABIA. Faiz A. Bahadig Rph, Informatics Pharmacist, Pharmaceutical Care Department, King Abdul-Aziz Medical, City-WR-Jeddah, Ministry of National Guard, SAUDI ARABIA. Bayan Ibrahim Alghuraybi, Pharmacy Services, Prince Sultan Military Medical City, Riyadh, SAUDI ARABIA. Budoor Emad Aloumi, Pharmacist, Pharmaceutical Care Services, Ministry of National Guard – Health Affairs. KAMC - Central Region, SAUDI ARABIA. Reem Saad Alsubaie, Pharmacy Services, Prince Sultan Military Medical City, Riyadh, SAUDI ARABIA. Abstract:Purpose: To explore the Pharmacy practice factors on pharmacy technician job satisfaction in Saudi Arabia. Methods: It is a 4-months cross-section survey of the stress factors impact of pharmacy technician job satisfaction in Saudi Arabia. The study consisted of 35 questions divided into two-part demographic information and the second part consisted of three parts. Part one was about stress-related factors of pharmacy job. It included pharmacy management policies, pharmacy stress factors, pharmacy personal time, salary and benefits, pharmacy motivation factors. Part two included the questions about pharmacy services units of pharmacy job. It included pharmacy management structure, dispersing and patient education, clinical pharmacy services, pharmacy technology, pharmacy store and overall job satisfaction. Part three questions consisted of communication and relationships factors of pharmacy technician job. It included pharmacy supervisors, relationship with coworkers and pharmacist interaction with other healthcare providers, customer interaction and overall job satisfaction. The questionnaire was made as an electronic format and it analyzed through survey monkey system about part one about pharmacy services units of pharmacy technician job. Results: The total responders were 96. The gender distribution 83 (86.46%) were males and 13 (13.54%) were females. The majority of them 86 (89.58%) were in age group (20-39 years). The average pharmacy technician satisfaction score of pharmacy management structure was (3.14), clinical pharmacy technician activities was (3.16), pharmacy technician satisfaction of pharmacy informatics was (2.76), pharmacy technician satisfaction score of pharmacy store factors were (2.87) and the overall job satisfaction was (3.62). The finding showed for factor there are no significant differences between male or female and social status married or single, experiences of current position and the most of salary income for all pharmacy services elements satisfaction (p>0.5). Conclusion: The pharmacy services with an emphasis on information technology and pharmacy inventory management affected negatively to the pharmacy technician job satisfaction. All pharmacy services satisfactions should be corrected to improve the pharmacy technician in the Kingdom of Saudi Arabia. Keywords:Factors, Job, Pharmacy, Pharmacy Technicians, Practice, Satisfaction, Saudi ArabiaView:PDF (208.78 KB) PDF PDF Images Factors of Pharmacy Practice on Pharmacy Technician Job Satisfaction in Saudi Arabia

Evaluation of the potential impact of pharmacy technician performance of anticoagulation clinic tasks on operational efficiency.

Results of a study to determine the proportion of anticoagulation clinic workload that could be performed by clinical pharmacy technicians (CPTs) and the potential impact on operational efficiency of pharmacist-managed anticoagulation clinics (ACCs) are reported. In a quality improvement project involving 11 Veterans Affairs (VA) medical centers, investigators conducted a 3-day time study in pharmacist-managed ACCs followed by scoring of task appropriateness for CPTs via the RAND/UCLA appropriateness method by the VA Anticoagulation Subject Matter Expert (SME) Workgroup. The primary outcome was the percentage of tasks deemed appropriate for a CPT to perform. The Anticoagulation SME Workgroup determined that a wide variety of mainly administrative ACC tasks could be completed by a CPT. At the 11 VA ACCs, an average of 53.4% (range, 39.9-76.1%) of tasks being performed by pharmacists were deemed appropriate for CPTs. The average percentage of total clinic time associated with performing tasks appropriate for a CPT equated to an estimated 1,111 hours per year. Shifting that portion of the annual work hours to a CPT could potentially result in cost avoidance of $55,302. At the ACCs evaluated, a significant proportion of tasks (53.4% on average) may be appropriate to assign to CPTs to improve the operational efficiency of these clinics. This finding supports development of business plans for the addition of CPTs in ACCs along with elements to inform crafting of an effective template for ACC structure, including clearly defined CPT roles.

Evaluation of pharmacy-based telephone interventions on medication pick-up rates: a retrospective, quality improvement study at charity outpatient clinics.

To evaluate a live telephonic outreach intervention made by clinical pharmacists and clinical pharmacy technicians on medication pick-up rates. A retrospective, quality improvement study conducted at six outpatient charity clinics in Dallas-Fort Worth area between 1 January 2017 and 31 July 2017. A live telephonic call was made by a pharmacy team member if the patient did not pick-up at least one prescription item. Patients may receive more than one call if they did not pick-up medication(s) more than once during the study period. A live telephonic call resulted in three categories: contacted, left a voice message and unable to contact. Medication pick-up rates were obtained from a pharmacy claims database. The study population included 1726 individual patients who failed to pick-up at least one medication from Baylor Scott & White Health pharmacy. A total of 2551 live telephonic calls were made for the study population. A total of 1175 live telephonic calls (46.1%, n=2551) resulted in a patient picking up medication(s). Results from the generalized estimating equation logistic regression models showed that patients who received a voice message (OR: 1.37; 95% CI: 1.05 to 1.80; P<0.021) or was contacted (OR: 1.99; 95% CI: 1.54 to 2.60; P<0.001) were more likely to pick-up their medications as compared to the 'unable to contact' group. Telephonic interventions from the pharmacy team can serve as a successful means to increase medication pick-up rates among charity clinic patients.

Increasing access for veterans with hepatitis C by enhancing use of clinical pharmacy specialists

ObjectivesTo increase access to hepatitis C virus (HCV) care and cure by deploying clinical pharmacy specialist (CPS) providers across the largest integrated health care system in the United States. SettingNational integrated health care system. Practice descriptionIn late 2016, the Department of Veterans Affairs (VA) Pharmacy Benefits Management Clinical Pharmacy Practice Office (CPPO) partnered with the VA HIV, Hepatitis, and Related Conditions Program with the central priority of expanding veteran access to novel HCV treatments and timely cure to ultimately prevent morbidity and mortality associated with HCV disease progression. This successful collaboration resulted in clinical resource funding to bolster access to HCV treatment through the deployment of CPS providers. This enterprise-wide initiative to expand clinical pharmacy services for unmet health care needs in HCV treatment resulted in 52 VA facilities submitting full-time employment equivalent (FTEE) funding requests totaling more than $10 million dollars. Facilities may have requested funding for 1 or more FTEEs. ResultsFacilities hired 47 CPS providers and 5 clinical pharmacy technicians. CPS providers in this project recorded 24,888 patient care encounters providing care for 9593 unique patients and initiated new HCV treatment for 1191 treatment-naïve patients. For an additional 8402 patients, the CPS provided HCV care activities such as evaluation and monitoring before, during, and after treatment. CPPO estimates that the same care delivered by nonpharmacist provider specialists (e.g., specialty physicians) cost an additional $936,535, or 48% more. ConclusionThe deployment of HCV CPS resulted in a significant number of new HCV patients being screened and treated within the VA system.

Impact of an integrated clinical and specialty pharmacy service model on access to PCSK9 inhibitor therapy

Background: Despite the proven benefits of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in dramatically lowering low-density lipoprotein cholesterol (LDL-C) levels, access to these costly medications remains challenging. A recent nationwide report of over 51,000 patients prescribed a PCSK9 inhibitor found that only 47% of patients gained insurance approval, with an average time to approval of 29 days. Vanderbilt Specialty Pharmacy (VSP) developed a model to streamline insurance approval and increase patient access to evolocumab and alirocumab.Objectives: To evaluate the time to PCSK9 inhibitor approval and factors that impact time to approval in an integrated specialty pharmacy model.Methods: A single-center, retrospective cohort study of patients prescribed a PCSK9 inhibitor by a Vanderbilt University Medical Center provider between 1 September 2015 and 1 December 2016 was conducted. The primary endpoint was days to treatment approval from first provider treatment request. Secondary endpoints were patient, prescriber, and clinical factors related to treatment approval. Descriptive statistics, univariate, and multivariable Cox regression analyses were performed to evaluate the impact of specified factors on the time to treatment approval.Results: VSP gained access to PCSK9 inhibitor treatment through insurers in 264 patients during the study period. The majority were male (52%) with a mean age of 62 (SD ±11) and mean baseline LDL-C of 162mg/dL (SD ±57). The median time to medication approval was 7 days, ranging of 0–266. Mean time to medication approval was 17 days (SD ±25). On univariate analysis, older patients (≥65) were significantly more likely to achieve approval earlier compared to those <65 years (p = .031) as were patients prescribed PCSK9 therapy for atherosclerotic cardiovascular disease (ASCVD) (p < .001). The time to medication approval was longer when a prior authorization (PA) was required (HR 0.17, SD ±0.5; p < .001) or a first level appeal was required (HR 0.28, SD ±0.04; p < .001). On multivariable analysis, older age, the requirement of a PA, and the requirement of a first level appeal remained significant predictors to the time to medication approval (p < .001).Conclusions: The VSP model of an integrated clinical pharmacist and pharmacy technician expedited the time to PCSK9 inhibitor access and initiation. As expected, the need for a prior authorization or appeal increased the time to approval. However, age and diagnosis of ASCVD positively impacted time to approval.

Developing an appropriate staff mix for anticoagulation clinics: functional job analysis approach

Anticoagulation clinics (ACCs) are specialty clinics that manage patients with blood clotting problems. Since labor costs usually account for a substantial portion of a healthcare organization’s budget, optimizing the number and types of staff required was often the focus, especially for ACCs, where labor-intensive staff-patient interactions occur. A significant portion of tasks performed by clinical pharmacists might be completed by clinical pharmacist technicians, which are less-expensive resources. While nurse staffing models for a hospital inpatient unit are well established, these models are not readily applicable to staffing ACCs. Therefore, the objective of this paper is to develop a framework for determining the right staff mix of clinical pharmacists and clinical pharmacy technicians that increases the efficiency of care delivery process and improves the productivity of ACC staff. A framework is developed and applied to build a semi-automated full-time equivalent (FTE) calculator and compare various staffing scenarios using a simulation model. The FTE calculator provides the right staff mix for a given staff utilization target. Data collected from the ACCs at VA Boston Healthcare System is used to illustrate the FTE calculator and the simulation model. The result of the simulation model can be used by ACC managers to easily determine the number of FTEs of clinical pharmacists and clinical pharmacy technicians required to reach the target utilization and the corresponding staffing cost.

Pharmacists in general practice: a qualitative interview case study of stakeholders\u2019 experiences in a West London GP federation

BackgroundIncreased patient demand for healthcare services coupled with a shortage of general practitioners necessitates changes in professional roles and service delivery. In 2016, NHS England began a 3-year- pilot study of pharmacists in general practice, however, this is not an entirely new initiative. There is limited, current, evidence-based, UK research to inform the pilot so studies of pre-existing services must suffice until findings from a formal national evaluation are available.MethodsThe aim of this exploratory, descriptive interview study was to explore the experiences of stakeholders in eight general practices in the Ealing GP Federation, West London, where pharmacy services have been provided for several years. Forty-seven participants, including pharmacy team members (pre-registration and clinical pharmacists, independent prescribers and pharmacy technicians), general practitioners, patients, practice managers, practice nurses and receptionists took part in semi-structured, audio-recorded qualitative interviews which were transcribed verbatim, coded and analysed thematically to extract the issues raised by participants and the practicalities of providing pharmacy services in general practice.ResultsFindings are reported under the themes of Complementarity (incorporating roles, skills, education and workloads); Integration (incorporating relationships, trust and communication) and Practicalities (incorporating location and space, access, and costs). Participants reported the need for time to develop and understand the various roles, develop communication processes and build inter-professional trust. Once these were established, however, experiences were positive and included decreased workloads, increased patient safety, improved job satisfaction, improved patient relationships, and enhanced cost savings. Areas for improvement included patients’ awareness of services; pharmacists’ training; and regular, onsite access for practice staff to the pharmacy team.ConclusionsRecommendations are made for the development of clear role definitions, identification of training needs, dedication of time for team building, production of educational materials for practice staff members and patients, and provision of on-site, full-time pharmacy services. Future work should focus on evaluation of various models of employing pharmacy teams in general practice; integration of pharmacists and pharmacy technicians into multidisciplinary general practice teams; relationships between local community pharmacy and general practice personnel; and patients’ service and information needs. A formal national evaluation of the pilot scheme is overdue.