Pharmacy Technicians Research Articles

Dispensing practices of amoxicillin suspension by community pharmacists

Abstract Background: Amoxicillin suspension is frequently prescribed to children; we hypothesized that prescribing convention system constraints lead to unusual dosing regimens and unnecessary waste of the drug. Objective: Identify antibiotic dispensing practices by community pharmacists and/or technicians to understand opportunities to decrease wasted amoxicillin liquid and optimize prescribing convention of liquid amoxicillin to children. Methods: Pilot online survey of Atlanta area and National Community Pharmacists Association pharmacists or pharmacy technicians that self-reported dispensing amoxicillin suspension. Questions regarding liquid amoxicillin dispensing practices and other open comments were asked about suggestions to decrease amoxicillin waste from March 13 to April 5, 2023. Results: Among 68 pharmacy staff that participated, over 90% reported dispensing extra liquid amoxicillin to patients for more than 10% of the doses they dispensed. Twenty-seven respondents (39.7%) felt that amoxicillin waste was a problem; waste was most often due to package/bottle sizing issues (n = 64 of 67 responses, 95.5%). Respondents reported instructing families to dispose of extra medication in the trash (n = 51, 75%); 11 (16.2%) instructed pour the remaining in the sink; none reported requesting return to the pharmacy, and 6 (8.8%) reported other instructions. Community pharmacists observed that computerized algorithms create odd dosing amounts and that some prescribers add to the overall amount needed routinely. Conclusion: Community pharmacists in this pilot survey observed prescribing conventions, manufacturing, regulatory, and electronic medical record constraints that lead to liquid amoxicillin waste or confusing amounts for families to use.

PJ view: Pharmacy technicians are vital in efforts to rescue pharmacists from their workload

PJ view: Pharmacy technicians are vital in efforts to rescue pharmacists from their workload

Pharmacy technicians enabled to administer and supply medicines under patient group directions

Pharmacy technicians enabled to administer and supply medicines under patient group directions

Opportunities and challenges lie ahead for pharmacy technicians

Opportunities and challenges lie ahead for pharmacy technicians

RPS calls for authorisation of pharmacy technicians to supervise pharmacies to be documented

RPS calls for authorisation of pharmacy technicians to supervise pharmacies to be documented

NHS England launches community pharmacy technician apprenticeship programme

NHS England launches community pharmacy technician apprenticeship programme

Pharmacists and pharmacy technicians to be able to supply naloxone without a prescription

Pharmacists and pharmacy technicians to be able to supply naloxone without a prescription

A third of pharmacy technicians close to changing career, survey reveals

A third of pharmacy technicians close to changing career, survey reveals

Making skill mix a reality: the advancing role of pharmacy technicians

Making skill mix a reality: the advancing role of pharmacy technicians

Successful examples of asynchronous teaching in Polish interactive remote medical education

A thorough theoretical and practical preparation is crucial in the education of medical professionals. Present-day knowledge recipients expect a broad range of multimedia and interactive resources in the consumed media. The article discusses examples of such implementations for the nationwide education of a pharmacy technician, massage technician, medical sterilization technician, and occupational therapy technician. These examples were created for the Integrated Education Platform of the Ministry of Education and Science in Poland, as part of an EU-funded project. This study delineates the characteristics of e-materials, such as instructional and educational videos, film sequences, scenario-based learning games, interactive documentation, 3D animations, simulators and virtual tours. We prepared a learner benefit analysis based on the e-materials discussed. We aimed to formulate recommendations and guidelines for designing and developing multimedia and interactive resources, paying special attention to educational values and content for the medical industry. Regardless of the type of multimedia, profession and content, materials should prioritize realism, interactivity and detailed presentation of the situations/cases. The same multimedia rarely achieve different learning objectives and learning outcomes. To design and produce high-quality multimedia, it is necessary to know their characteristics and to work with a team of subject matter experts experienced in e-learning development.

Evaluating the role of primary care pharmacy technicians in antimicrobial stewardship (AMS) and acne management using TARGET resources.

Inappropriate antibiotic prescribing is accelerating antimicrobial resistance (AMR) (Antibiotic resistant infections and associated deaths increase https://www.gov.uk/government/news/antibiotic-resistant-infections-and-associated-deaths-increase). Pharmacy professionals (pharmacists and pharmacy technicians) promote good antibiotic prescribing practice. The traditional role of pharmacy technicians in supporting pharmacists and patients has expanded alongside the clinical expansion of pharmacist roles. (Boughen M, Fenn T. Practice, skill mix and education: the evolving role of pharmacy technicians in Great Britain. Pharmacy (Basel) 2020; 8(2): 50. doi:10.3390/pharmacy8020050) This paper focuses on the opinion of pharmacy technicians and their role in the review of acne management and the evaluation of the UKHSA TARGET acne 'How to…' review resources. To explore the impact of the TARGET resources on the capability, opportunity and motivation of pharmacy technicians in general practice in managing patients with acne.To evaluate the usefulness of the acne 'How to…' review resources. A primarily quantitative study using an electronic survey asking UK-based pharmacy technicians to rate their agreement on a five-point Likert scale with 21 predefined statements, themed on the COM-B model and usefulness of the TARGET resources for acne. The survey found that capability and opportunity in managing acne in the group familiar with TARGET resources was higher than the group not familiar with TARGET resources. Scores for motivation in both groups were high; pharmacy technicians have the motivation to undertake infection management roles, whether or not they are familiar with the TARGET toolkit.The acne 'How to…' review resources were overall rated as useful in supporting the review of patients with acne. The TARGET materials are effective resources that helps to upskill pharmacy technicians in the area of AMS, increasing capability and opportunity in the management of acne.

Developing And Implementing an Interdisciplinary Quality Program In A Rehabilitation Hospital

Background: Quality programs that step into the intrinsic motivation of healthcare providers (HCPs) are believed to be effective in improving quality of care. The fact that they are not part of an external regulatory or performance management process seems to be crucial. We therefore aimed to develop a quality program based on internal workflows and HCPs feedback.
 Methods: The project took place at the rehabilitation hospital Koningin Elisabeth Instituut (RH-KEI) in Oostduinkerke (Belgium) during the years 2017-2022. A quality coordinator (QC) was appointed who subsequently developed and implemented an interdisciplinary quality program in concordance with the care strategic plan. The quality program was optimized through surveys among patients and caretakers on the one hand and employees on the other. Involved employees were physicians, nurses, physiotherapists, pharmacists and pharmacy technicians, occupational therapists, psychologists, speech therapists and employees of the facility departments (such as maintenance staff).
 Results: The QC had to be an individual that could coach teams and would be trusted by all departments. This person also embodies independence from and neutrality towards staff and management, so HCPs would feel free to discuss any (institutional) hurdles towards quality of care. The developed quality program was subdivided in four domains with three key strategic objectives. This included that (1) RH-KEI ensures a continuous and dynamic improvement of quality of care based on a set of indicators, (2) RH-KEI holds a culture of quality that is actively supported by all involved employees and (3) RH-KEI continuously improves and guarantees patient safety by developing a well-functioning safety management system. The program was first developed in 2017 for the period 2018 up to and including 2022. After five years, quality and safety is embedded in the culture of RH-KEI. Employees are proud of the progress and work together on an integrated quality story. As well, RH-KEI renewed the quality project for the period 2023-2027, with an even greater focus on patient and caretaker participation, care experience, communication and digitalization.
 Conclusion: The active support by all involved employees turned out to be essential to secure the set objectives on the work floor and to make them part of the daily routine.

Development and Implementation of an Integrated Pharmaceutical Care Program for patients with COPD in a Rehabilitation Hospital.

Background: Chronic obstructive pulmonary disease (COPD) is a progressive disease associated with airflow limitation and prolonged respiratory problems. The treatment requires an interdisciplinary approach with a holistic view of the patient. A cornerstone of the treatment consists of inhalation therapy. Inhalation errors are abundant and medication adherence towards inhalation therapy is low. We aimed (1) to develop a standardized pharmaceutical care protocol for hospitalized patients with COPD and (2) to evaluate the effect and feasibility of protocol implementation.
 Methods: This study took place at the rehabilitation hospital Koningin Elisabeth Instituut (RH-KEI) in Oostduinkerke, Belgium from January 2021 to April 2022. The protocol was based on the PHARMACOP protocol, tailored to the specific setting using in-depth interviews with all HCPs involved in the pharmaceutical care of patients with COPD (physicians, pharmacists, pharmacy technicians, nurses, physiotherapists and an occupational therapist). The finalized protocol consisted of six additional patient contacts (3 evaluation moments, 2 educational moments and 1 evaluation moment two weeks after discharge), mainly between the hospital pharmacist and the patients. Consequently, from January 2022 to April 2022, adult patients with COPD were included to follow the complete protocol. Patient outcomes were evaluated using standardized questionnaires (i.e. mMRC, BMQ, CAT, EQ-D and EQ-VAS). The feasibility was assessed during a focus group discussion with all involved HCPs and a patient survey after discharge.
 Results: Before the start of the study, the hospital pharmacist in RH-KEI had no patient contact and there were no (recurrent) training sessions about inhaler use. The in-depth interviews elucidated that most involved health care providers (HCPs) had insufficient knowledge of the correct use of inhalers. This is however needed as 37% of included patients made at least one critical inhalation error at hospitalization. The adapted PHARMACOP protocol was tested in 13 patients, after which a significant improvement was noted in mMRC (p = 0.047), BMQ concerns (p = 0.011) and CAT score (p = 0.002). A trend towards improvement was noted in the EQ-5D and EQ-VAS score (resp. p = 0.065, p = 0.590). Finally, mean inhalation technique scores had significantly improved (p = 0.003). Transferring information to primary care HCPs seemed difficult as only a third of patients had handed over their discharge letter to their community pharmacist. The in-hospital HCPs concluded that the protocol was feasible for implementation with some adjustments, such as a more prominent role of the (hospital) pharmacist, the possibility to tailor the program to the patient and a set timing for interdisciplinary (patient) discussions. 
 Conclusion: An interdisciplinary pharmaceutical care program can improve outcomes in patients with COPD. Additional attention should be given to the inclusion of primary care HCPs to guarantee continuity of care concerning inhalation therapy for COPD management.

Non-allergist healthcare workers views on delivering a penicillin allergy de-labelling inpatient pathway: identifying the barriers and enablers.

Non-allergist delivered PADL is supported by UK and World Health Organization guidelines but is not yet routine in UK hospitals. Understanding the views of healthcare workers (HCWs) on managing patients with penA records and exploring perspectives on delivering a PADL inpatient pathway are required to inform the development of non-allergist delivered PADL pathways. To explore the perspectives of non-allergist HCWs working in medical specialties on managing patients with penA records, and to explore the enablers and barriers to embedding PADL as a standard of care for inpatients. Semi-structured interviews with doctors, nurses, pharmacists and medicines optimization pharmacy technicians working in a district general hospital in the UK. Thematic analysis was used to analyse the data. The PADL pathway was considered a shared responsibility of the multidisciplinary team, which needed to be structured and supported by a framework. PADL aligns with HCW roles but time to deliver PADL was a barrier. Training for HCWs on the benefits of PADL and delivering PADL for those patients where a penicillin might be beneficial during the current episode of care would both motivate HCWs to deliver PADL. The PADL pathway was acceptable to HCWs and aligned with their roles and current healthcare processes but their capacity to deliver PADL in a time pressured environment was a significant barrier.

Implementation of a technician success and onboarding coordinator to reduce technician turnover.

This article provides an overview of changes implemented at an academic medical center to reduce pharmacy technician turnover. Pharmacy technician turnover has been a problem for years. Technicians come and go; they move on to other positions, and continuous turnover is an avoidable expense. With greater focus on creating a successful onboarding experience for newly hired technicians, turnover should decrease and satisfaction and engagement should increase. When a newly hired technician leaves a department within the first year, it can have a negative impact on the engagement of the remaining technicians who spent time training new hires in how to complete tasks, mentoring them, and incorporating them into the team. Creating a positive onboarding experience will decrease expenses accrued and minimize wasted resources and staff time dedicated to a technician who will not be around in 6 months to 1 year. At M Health Fairview, a Minneapolis, MN-based health system, technician retention has been improved through a standardized approach to onboarding and orientation, including creation of the new staff role of technician success and onboarding coordinator (TSOC). A standard approach to onboarding pharmacy technicians and integrating them into the pharmacy department has proven to be essential to technician retention at M Health Fairview. To get started, it is important to find the right person for the TSOC role to coordinate successful onboarding of newly hired pharmacy technicians. That person should be an individual with passion to engage and inspire newly hired technicians, with several years of experience, and with the ability to cascade knowledge.

IMPLEMENTING AN AREA AGENCY ON AGING COMMUNITY CARE TRANSITION INITIATIVE: FACILITATORS AND BARRIERS

Abstract The Michigan Region VII Area Agency on Aging (AAA) implemented a Community Care Transition Initiative (CCTI) for rural hospitalized older adults at high risk for readmission. After discharge home, AAA CCTI participants received a home visit by an AAA-trained pharmacy technician community health worker (CHW), a telehealth AAA pharmacist medication review, assessments by the CHW and pharmacist, education, primary care follow-up coaching, and referrals. As part of a program evaluation, we conducted six interviews with AAA key informants (e.g., pharmacist, director, CHWs). A semi-structured interview guide was piloted and revised to assess implementation, processes, impact, and future directions. Interviews were conducted via Zoom, recorded, transcribed, and checked for accuracy. Thematic analysis was used to identify implementation facilitators, barriers, and areas for program refinement. Three researchers coded the transcripts, developed a codebook, and resolved discrepancies by consensus. NVivo 14® was used for data management and analysis. Barriers to AAA CCTI implementation included unknowns at project start and need for procedures, anxiety about entering a client’s house, client’s lack of familiarity with technology, lack of perceived pharmacist benefit, limited personnel, and billing or financial reimbursement. Facilitators identified were the AAA’s reputation and backing, relationships built between healthcare providers, referral processes (e.g., community mental health), and pharmacist telehealth visit efficiency. Program refinements included shortened follow-up time and tailored visits to different client situations and needs. The results provide insights into the design of implementation strategies to disseminate the AAA CCTI to meet rural older adults’ health and social needs after hospitalization.

Knowledge, attitude and practice of community pharmacists toward irritable bowel syndrome, Sudan

Irritable Bowel Syndrome (IBS) is a common disorder affecting around 20% of the populations worldwide. Treatment of IBS typically focuses on managing predominant symptoms and the pathophysiology, such as the visceral hypersensitivity. This study was conducted to assess community pharmacist knowledge, attitude and practice of Irritable Bowel Syndrome in Khartoum locality.A descriptive cross-sectional study was done. The study was performed among all community pharmacist working at the pharmacies in the study area. Ethical approval from the Ministry of health was first granted (NUSU2021/3-5), then approvals was obtained from each of pharmacy administration. Pharmacists that were registered by Sudan medical counsel, while pharmacy technician and other staff were excluded. Association among variables was assessed through chi-square test, all tests were considered significant when p <0.05.Most of the pharmacist were females (68%, n= 70). Fifty-eight percent (n=60) had good knowledge about IBS. Ninety-three percent (n=96) knew the common symptoms. Eighty-six percent (n=89) of the participants reported that the diagnosis of IBS was based on symptoms. Although the knowledge score was good, but their knowledge about medications and lifestyle modifications was poor. Good attitude was noticed in 55% (n= 57) of the pharmacists. Sixty-one percent (n=63) of pharmacists agree with that they need courses regarding IBS. Fifty-one percent (n= 53) of them agreed with IBS has become one of the most health problems they were involved. Also fifty-one percent (n=53) of them agree with that the symptoms of IBS never disappear. Regarding practice, 63% (n= 65) of pharmacists had good practice.Majority of the participants had good knowledge and attitude and practice about IBS. The need for continuous education was recommended by the participants.

Utilization of Immunization Information Systems (IIS) among independently owned community pharmacies: A national survey

Background/ObjectiveImmunization information systems (IIS) consolidate provider-submitted immunization information. We reassessed independently owned community pharmacies’ IIS enrollment, verification of immunizations needs via IIS records retrieval, and immunization records reporting to IISs following post-pandemic shifts in community pharmacy operations. MethodsA cross-sectional online survey of National Community Pharmacists Association pharmacist, pharmacy owner, and pharmacy technician members was conducted in Fall 2022. Results202 complete responses were analyzed. Margin of error was an estimated 7 %. Respondents were: 53.2 % female, ∼87 % White, 69.8 % managers, and 86.1 % practicing in standalone community pharmacies. Almost all (91.6 %) were enrolled in IIS. About two-thirds frequently or always utilized IIS to retrieve immunization records prior to immunization. On average, 81.2 % of influenza and 83.5 % of non-COVID/non-influenza vaccination records were submitted. ConclusionsEnrollment rates are high among studied pharmacies, as are records reporting rates. However, records retrieval rates are suboptimal. Future work should focus on addressing suboptimal retrieval rates within immunization-providing pharmacies.

Understanding the Information Needs of Pharmacy Staff Using CancelRx: A Qualitative Study of the Use of Prescription E-cancellation

BackgroundAlthough electronic prescription cancellation such as via CancelRx can facilitate critical communication between prescribers and pharmacy staff about discontinued medications, there is little work that explores whether CancelRx meets the needs of pharmacy staff users. ObjectiveThis study leverages qualitative interviews with pharmacy staff to address the following question: When medication changes are made by a prescriber using CancelRx, what information is needed by pharmacy staff to make correct and effective decisions in their roles in medication management? MethodsWe conducted an inductive thematic analysis of interviews with 11 pharmacy staff members (pharmacists and pharmacy technicians) across three outpatient community pharmacy sites within an academic health care system. ResultsThree information needs themes were consistently identified by both pharmacists and pharmacy technicians: prescriber intent when initiating the CancelRx, clinical rationale for the medication change, and intended medication regimen. Notably, both pharmacists and pharmacy technicians often reported seeking multiple information needs not fully addressed by CancelRx in the electronic health record (EHR) to achieve the shared goals of correct dispensing of medications and supporting patient self-management. ConclusionsOur qualitative analysis reveals that outpatient community pharmacy staff in an academic health care system often seek additional information from the (EHR) following medication changes communicated by CancelRx to meet their information needs. Ideally, the prescriber would provide sufficient information through CancelRx to automatically identify all discontinued prescriptions. These limitations highlight the need for design features that support routine communication of needed information at the time of a medication change, such as structured data elements.

Vaccine administration by pharmacy technicians: Impact on vaccination volume, pharmacy workflow and job satisfaction

BackgroundImmunizing pharmacy technicians (IPTs) have become more prevalent in recent years, but their impact on community pharmacy practice has yet to be determined. ObjectivesDetermine the impact of implementing IPTs on vaccination volume in a community pharmacy chain and assess pharmacy staff's perspectives on the clinical abilities of IPTs and their impact on pharmacy workflow and job satisfaction. MethodsRetrospective data analysis comparing the number of vaccines administered in a supermarket pharmacy chain from September to March 2019–2020 and 2020–2021 in pharmacies with IPT(s) versus those without IPT(s). For the secondary objective, investigators developed and deployed two role-based mixed quantitative/qualitative surveys among pharmacy staff. ResultsPharmacies with IPT(s) observed a greater mean increase in vaccination volume from 2019–2020 to 2020–2021 versus those without IPTs (+159.35 vs. +104.57, p = 0.011). Among IPT survey respondents, 50/75 (66.7%) felt more satisfied with their job after receiving immunization training. Among pharmacist respondents, 80/119 (67.3%) felt that IPTs positively impacted their job satisfaction and 61.7% felt that pharmacist clinical services were either somewhat positively affected, or positively affected. ConclusionImplementing IPTs can increase the volume of vaccines administered in a chain pharmacy and may positively affect job satisfaction and pharmacy workflow.