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UNlVERSITY OF UTAH COLLEGE"' PHARMACY ~ S. SKAGGS PHARMACY INSTITUTE
2q1a National Survey of Advanced . Pharmacy Technician Services ProPosal to the Utah Departmentof Professional and Occupational
I . , Licensing (Utah Board of Pharmacy) ! .
Mark·A. Munger, Pharm.D., F.C.C.P., F.A.C.C., F.H.F.S.A.
. . . Professor; Pharmacotherapy; · Adjunct Professqr, .Internal Medicine;
Associate Dean, College Affairs, College of Pharmacy University of Utah ·
and·
Mike Feehan, Ph.D.
Managing Partner, Analytics ·Practice, Kantar Millard Brown
I Prepared Jor the Utah Board of Pharmacy 05/22/2018 I
Healthcare Delivery in 2020 Closer to Patient
Emergency Care
Intensive Care
Major Surgery
Minor Surgical Procedures
Basic Diagnostics and Prescribing by MidLevel Practitioners
{(Life Checks"
Web-based Diagn (Wearables)
IT Healthcare {M.D., Rx, Personal Health
Records)
OTC drugs for chronic and non-chronic
conditions
uwellness" services
DC PREVENTATIVE HEALTH CHECKLIST
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I . . . . . • . .
Centers for Disease Control Prevention Checklist. 'http:l/www.cdc:go'v/prev~ntion/
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UNIVERSITY OF UTAH CO LUGE"' PHARMACY L. S. SKAGGS FHARMACYINSTITUTL
Pharmacist Reimbursement Activities
• Preventative Care Education and Follow-Up
• Self-Care Education and Principles .I ;
• Comprehensive Medication Management (CMM) I
• CMM was first defined in 2010 by the Patient-Centered Primary ~are Collaborative as a practice intended for high-risk, chronically ill p~tients in which pharmacists assess each patient's medications (whether they are prescription, nonprescription, alternative, traditional, vitamins~ or
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nutritional supplements) to determine that each medication is: j
• Appropriate for the patient I
• Effective for the medical condition
• Safe, given the comorbidities [concurrent medical conditions] and ot~er medications being taken I
• Able to be taken by the patient as intended
These assessments are part of an individualized care plan that includes appropriate follow-up to determine actual patient outcomes. ]
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Natio~al Health Service-UK ./.
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• NHSj England is today launching a scheme to get 1,500 more clinical pharmacists working in GP surgeries (clinics)- a move set to benefit patie/nts across the country. 12/2016
• By tdking responsibility for patients with chronic diseases, clinical pharmacists can free up GPs for other appointments and so reducing thedumbers of people presenting atA&E (emergency) departments. and ·so ease pressures on ·other parts of the health service. ·
. I . . • The iinitial £15m pliot, supported by~ Health Education England, the
RCG;P and the BMA, has proved so popular with patients and GP practices that NHS England doubled the funding to £31m in November 2015:. This led to more than 490 clinical_ pharmacists working in approximately 650. practices across 90 pilot sites.
• Applications for this next phase, worth over £100m, open next month as NHS England and its partners target a further 1 ,500 clinical phar~acists working in general practice by 2020/21- ·
• 'Theiway clinical pharmacists in general practice can help patients and support them is so important and helps prevent mc:>re ~~rio us illness."
https://www.england. nhs.uk/20 16/12/clinical-pharmacy/
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UNIVERSITY OF UTAH COLLEGE 0 ' PHARMACY L. S. S;:AGGS FHARMACYINSTIT\Jl"L
Critical Time for Advanced Service Evaluation·s of . I
Community Pharmacy Technicians to Maximlize Pharmacists Clinical Time I
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Pharmacy Technicians (Community Pharmacy) . 1·- . . ' '
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Frort-line support personnel for commu~ity phar~acy .
Mo~t frequent pharm~cy personnel that 1nteract w1th pat1ents I . .
Cutirent roles: I • Support pharmacists; __ .
• IT system prescription .input ..
• · Communicate with insurance companies;. · I . . . . . ·- . . . . I
I• Fill and label prescriptions; and
• ·Access prescriptions for completeness, accuracy, and reimbursement eligibility.
UNIVERSITY OF UTAH COLLEGE"'PHARMACY L S. SKAGGS PHARMACY INSTITUn
World H1ealth Organ~zat~on. The World Health Rep_ort 2000- Health Syste111s: _l~provi~g Performance, Geneva, Switzerland:
World Health Organrzat1on; 2000. http:/lwww:who.Jnt/whr/2000/ent . . · • · - _
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UNIVERSITY OF UTAH COLLE.GE 01 PHARMACY L. S. SKAGGS PHARMACY INSTITUl"t
. Background Literature
• Community pharmacy technicians (CPhT) started in the early 1
19th century as pharmacy assistants.
• The title of pharmacy technician was adopted around the 197~-80's with the growth of technology and prescription volume.
• Pharmacies viewed pharmacy technicians as a way to time efficiently. improve services to the patient consumer.
• Today, pharmacy technicians' job openings are greater than pharmacists.
https://www.ccitraining.edu/blog/pharmacy-technicians-the-past-present-and-future/
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Background Literature
UNIVERSITY OF UTAH COLLEGE"'PHARMACY L. S. SKAGGS PHARMACY INSTITUTL
. I - . . _. - .. . . . . . • ·With the greater need, use, and openings for pharmacy technicians.
thelpast 30 years have seen considerable international s-urvey· lite~ature _about pharmacy. technician practice. · ·: . . - · ·
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• The literature includes greater Llnderstanding of pharmacy tec~ni?ic:msatisfadio? an~ str~ss, levels of professional ..
· · co~m1tment,.profess1onallsm, 1ssues around error report1ng, and the undertainty of future ·roles of techni<;;ians. · · · · · ·
.. , ; ·, '' ... ' . ·, . . : . ' .. . . • . ·. . .. i '. . .
. . - . ; ~-· . . . . -
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Johri C et al. Res Soc Admin Pharm 2017;13:297-99. KoehlerT et al. Res SocAdminPharm 2017;13:?97-99. Oeselle SP. Am J Ph arm Assoc 2005;45(3):458-65. Deselle SP. Am J Pharm Assoc 2005;45(4):676-83.
·Schmitt MR et aL J Pharm Techno/2009;25(1):79~88. · · Deselle $P et al. Am J Pharm Assoc 2007;47:58-72. Desselle SP Am J Health Syst Ph arm 2005;62: 1992-7. Schmitt MR, et aL J Pharm Techno/ 201 0;26(4):340.;51. Raymond CS, et aL Can J Hosp Pharm 2011 ;64(3):218-20.
-Totton JS, et al. Can JHosp Pharm 2008;61(2):133-7 .. ·. FrostTP et al. JAm PharmAssoc 2016;:1-5. · Odukoya OK, et al. Pharmacy (Basel) 2015;3(4):330-43, Shireman Tl, et al. JAm Pharm Assoc 2016:56:389-96.
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UNIVERSITY OF UTAH COLLEGE"'PHARMACY L. S. SKAGGS FHARMACY INSTITUTE
Background Literature
Studies have also shown that pharmacists have greater confidenbe in delegating tasks to CPhTs.
• In Canada under a collaborative care model, pharmacists provide medication management and patient health outcomes, and pharrhacy
· technicians focus on medicine distribution. i • A recent _study exami!'led supe_rvi~ion of pharmacy te~hnicians ·b~
pharmacists from a d1stance, f1ndmg that use of on-s1te pharmacy technicians led to an increase in the number of clinical interventions and a decrease in pharmacist time require to provide the interventions.
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• Obtained medical histories & tracked laboratory test results allo~ing pharmacists greater time for collaborative practice. . '
• •
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Transcribe pharmacist interventions .
Seventeen states allow pharmacy technicians to accept verbal prescriptions called in by a prescriber or prescriber's agent, or transfer a prescription order. I
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Safety net for pharmacists in e-prescribing. i
Measure blood pressure in a randomized, practice-based intervehtion community-based study to improve blood pressure control in African American patients. · . I
· References Slide #~ I 10 I
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2018 National Survey of Advanced Pharma Technician Services
i -- UNMET NEED
• ThJre is a clear need to appraise and willingness of Pharmacy Tedhnicians to participate in Advanced Practice Services to ma~imize Pharmacist Clinical Time - - - . ·
I - - . -• Important information for employers, community pharmacists,
I . . . - . . .
regulators, and payers. -
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UNIVERSITY OF UTAH COLLEGE or PHARMACY l. S. SKAGGS PHARMACYINSTITUTt
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Gr. UNIVERSITY OF UTAH. COLlEGE 0 'PHARMACY w L S. SKAGGS FH.\RMACYINSTITUTt
2018 National Survey of Advanced Pharmacy Technician Services
• Objectives . I
• Determine pharmacy technicians appraisal of fixed scenarios highlighting new delivery services; 1
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• Understand pharmacy technician attitudes regarding the profession and their organization; and
• Characterize pharmacy technicians responses by demographic, attitudinal, and occupational practice characteristics.
• Methods
• 1000 Certified Pharmacy Technicians
• Pharmacy Technician Certification Board Database
• Consistent employment as CPhT for 2 years
• Part-time (> 20hours/week) or Full-time employment at < 2 lo~ations
• Not enrolled in ;3n accredited Pharm.D. program I
• Distributed across the United States and rurality pattern
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I . 201 S National Survey o.f Advance·d Pharmacy Tec~nician Services ·.. .
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• Me~hods • Data Collection (20-30 minute on-line survey)
• Place of employment
• Method of pharmacy technician training
UNIVERSITY OF UTAH COLLEGE m PHARMACY l. S. SKAGGS PHARMACY IN!ITITUTE
• Perceived level of involvement and importance to the organization collected across wide variety of current (see slide #13) and advanced services (below)
• Short Batteries of Satisfaction and Stress with current·employment
• Advanced Service Buckets Physical Assessment ·
Prescription taking Authority
Technician verification .of Prescriptions
Inventory Control Methods
Obtaining Patient History
Supervisioq of other Pharmacy Personnel
Patient Educatio-n Practices
Obtaining . Laboratory Tests
Providing Preventative Care Measures
Information Technology System Managen1er:tt
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2018 National Survey of Advanced Pharmacy Technician Services
• Deliverables (University of Utah and Kantar Millward Brown)
• Screener- and Questionnaire
• Regular Field Updates
• Final Powerpoint-Siide Deck of Methods and Results
• , Raw Data ( de~indentified) ·.
• Compl~ted within 3-4 months of funding
• Abstract(s): [2019 APhA Annual Meeting]
• Manuscript(s): [JAPhA or Annals of Pharmacotherapy]
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UNIVERSITY OF UTAH COLLEGE oiPHARMACY L. S. SKAGGS PHARMACY INSTITUTE
• All publications identified with: Fuhded by U~a-h:State Departrl]lent of Professional and Occupationai:,Licensing·and Utah Board of Pharmacy
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