Expanded Roles for Pharmacy Technicians in the Medication Reconciliation Process: A Qualitative Review

Exploring the Roles of Nurses in Medication Reconciliation for Older Adults at Hospital Discharge: A Narrative Approach

Medication reconciliation (MR) is the process of comparing a patient's medication orders to all of the medications that the patient has been taking in order to identify and resolve medication discrepancies. It is an effective means of risk management to avoid medication errors (eg, omissions, duplication, dosage errors, or drug interactions). Some guidelines explicitly state that MR is a pharmacist-led transition of care; however, there is a shortage of qualified pharmacists to meet the increasing clinical needs, and clinical nurses' roles have not been clearly described. This paper aimed to enable nurses to gain confidence in contributing to MR at discharge and to make the industry aware of the potential risks if nurses do not actively intervene in this area. A narrative approach was used to introduce experiences in identifying discrepancies and medication errors through MR at discharge in a geriatric ward of an academic medical center hospital in China. The nurses' main roles in MR involve chasing, checking, and education. Clinical nurses, an untapped hospital resource, can actively engage in MR at discharge if they receive effective training and motivation. Multidisciplinary collaboration at discharge allowed many discrepancies to be reconciled before harming older patients. It is worth conducting further research in MR when discharging older adults, such as the cost-effectiveness of nurses' efforts, the value of electronic tools and the impact of MR-targeted education and training for nursing students and nursing staff.

Comparison between proactive and retroactive models of medication reconciliation in patients hospitalized for acute decompensated heart failure

BACKGROUND

Most research on the impact of medication reconciliation on patient safety focused on the retroactive model, with limited attention given to the proactive model.

OBJECTIVE

This study was conducted to compare the proactive and retroactive models in patients hospitalized for acute decompensated heart failure.

METHODS

This prospective, quasi-experimental study was conducted over six months, from June to November 2022, at the cardiology unit of an academic hospital in Iran. Eligible patients were those hospitalized for acute decompensated heart failure using a minimum of five regular medications before admission. Medication reconciliation was performed in 81 cases using the proactive model and in 81 using the retroactive model.

RESULTS

556 medications were reconciled using the retroactive model, and 581 were reconciled using the proactive model. In the retroactive cases, 341 discrepancies (both intentional and unintentional) were identified, compared to 231 in the proactive cases. The proportion of patients with at least one unintentional discrepancy was significantly lower in the proactive cases than in the retroactive cases (23.80% versus 74.03%). Moreover, the number of unintentional discrepancies was significantly lower in the proactive cases compared to the retroactive cases (22 out of 231 discrepancies versus 150 out of 341 discrepancies). In the retroactive cases, medication omission was the most frequent type of unintentional discrepancy (44.00). About, 42.70% of reconciliation errors detected in the retroactive cases were judged to have the potential to cause moderate to severe harm. While the average time spent obtaining medication history was similar in both models (00:27 [h: min] versus 00:30), the average time needed to complete the entire process was significantly shorter in the proactive model compared to the retroactive model (00:41 min versus 00:51).

CONCLUSION

This study highlighted that the proactive model is a timely and effective method of medication reconciliation, particularly in improving medication safety for high-risk patients.

Insights into British Columbian Hospital Pharmacists Perspectives on the Discharge Process

Background: Transitions of care represent a vulnerable time for patients where unintended therapeutic changes are common and inadequate communication of information frequently results in medication errors. Pharmacists have a large impact on the success of patients during these care transitions; however, their role and experiences are largely absent from the literature. Objectives: The purpose of this study was to gain a greater understanding of British Columbian hospital pharmacists' perceptions of the hospital discharge process and their role in it. Methods: A qualitative study utilizing focus groups and key informant interviews of British Columbian hospital pharmacists was conducted from April to May 2021. Questions asked during interviews were developed following a detailed literature search and included questions regarding the use of frequently studied interventions. Interview sessions were transcribed and then thematically analyzed using both NVivo software and manual coding. Results: Three focus groups with a total of 20 participants and one key informant interview were conducted. Six themes were identified through data analysis: (1) overall perspectives; (2) important roles of pharmacists in discharges; (3) patient education; (4) barriers to optimal discharges; (5) solutions to current barriers; and (6) prioritization. Conclusions and Relevance: Pharmacists play a vital role in patient discharges but due to limited resources and inadequate staffing models, they are often unable to be optimally involved. Understanding the thoughts and perceptions of pharmacists on the discharge process can help us better allocate limited resources to ensure patients receive optimal care.

Evaluating advanced pharmacy technician roles in the provision of point-of-care testing

OBJECTIVES

Assess the impact of pharmacy technician-supported point-of-care testing (POCT), including sample collection, on the number of cholesterol screenings performed in a community pharmacy setting. Secondary objectives include assessment of provider perceptions and patient satisfaction of POCT when executed by a technician.

PRACTICE DESCRIPTION

Thirty-two community pharmacies in 1 regional division of a large community pharmacy chain in Tennessee; 16 participated in a certified pharmacy technician (CPhT) training program, and 16 did not.

PRACTICE INNOVATION

CPhTs supported POCT service delivery limited to the nonprofessional, technical tasks (e.g., sample collection, quality assurance).

EVALUATION

The primary objective was evaluated by comparing the total number of screenings for control and intervention sites. Descriptive and inferential statistics were used. Both secondary measures were assessed via anonymous, Likert-type scale questionnaires.

RESULTS

Intervention pharmacies performed 358 screenings, whereas control pharmacies performed 255 screenings (16.8% difference). The patient perception survey found that 94% (149 of 159) of those who received screening with CPhT involvement agreed or strongly agreed that the service was valuable, and 70% (111 of 159) reported that they are likely to follow up with their primary care providers to discuss the results. Furthermore, most patients were in agreement that they were overall satisfied with the screening services provided by the CPhT (94%, 149 of 159), and the CPhT was professional while performing the screening (95%, 151 of 159). The provider perceptions survey on service implementation found that most pharmacy personnel agreed or strongly agreed that CPhTs performing POCT was feasible, appropriate, and acceptable.

CONCLUSION

This study provided preliminary data that technician-supported POCT may positively impact the number of screenings provided. In addition, provider perceptions were positive, and patients felt satisfied with the studied technician model.

Comparing medication histories obtained by pharmacy technicians and nursing staff in the emergency department

BACKGROUND

An accurate medication history is crucial for maintaining continuity of care. There are numerous opportunities for discrepancies to occur, such as medication omissions, commissions, incorrect dosing, incorrect frequencies, or incorrect formulations. Medication discrepancies may prolong hospital length of stay, increase the number of future emergency department (ED) visits, and increase hospital readmissions. Numerous studies have established the advantages of utilizing pharmacy technicians to complete medication histories. This study aimed to compare the accuracy of obtaining medication histories through pharmacy technicians compared to nursing staff.

OBJECTIVE

To compare the accuracy of obtaining medication histories through pharmacy technicians compared to nursing staff in the emergency department.

METHODS

This was a single-center, retrospective, observational analysis of patients presenting to the ED between December 2018 through January 2019. A pharmacy technician received on-site training on how to properly obtain a medication history and performed medication histories on the days the pharmacy resident was present between 10:00 and 18:00. Medication histories were obtained by nurses on the days the pharmacy technician was not present. All study medication histories were reviewed for discrepancies by the pharmacy resident.

RESULTS

Medication histories conducted by a pharmacy technician (n = 102) resulted in a greater number of accurate medication histories [96 (94.1%) versus 59 (57.8%); p < 0.01] when compared to those conducted by nurses (n = 102). A total of seven discrepancies were found in the pharmacy technician group compared to 131 in the nursing group (p < 0.01). There was also a statistically significant lower amount of high impact discrepancies in the pharmacy technician group compared to nursing (1 versus 15; p < 0.01).

CONCLUSIONS

Pharmacy technicians in the ED provided more accurate medication histories when compared to nursing staff, thereby reducing potential medication errors.

A meta-analysis of pharmacists and pharmacy technicians' accuracy checking proficiency

BACKGROUND

Delegating the accuracy checking task to appropriately trained pharmacy technicians is desirable in all pharmacy settings, however it requires rigorous evidence prior to implementation to ensure safety. The delegation of accuracy checking has a twofold benefit, it frees time for pharmacists to undertake clinical activities and creates an advanced scope role for pharmacy technicians. Institutions also experience economic benefits when tasks can be reallocated to a lower-cost workforce.

OBJECTIVE

To perform a meta-analysis of pharmacist and technician accuracy rates when completing the final accuracy check on a prepared item.

METHODS

A systematic literature search was conducted to identify articles that reported the accuracy rates for the final check on prepared items. PubMed, EMBASE, CINAHL, Scopus, and Web of Science were used to retrieve articles. No limit was placed on publication year or item type. Once identified, data were extracted regarding study characteristics and accuracy rates. A meta-analysis was conducted using a random effects model.

RESULTS

Twelve articles were located which reported that 96.23-99.78% of items were accurately checked by pharmacists, and 98.25-99.95% of items were accurately checked by pharmacy technicians. The meta-analysis calculated the pharmacist accuracy rate for 216402 items to be 99.27% (95% CI: 98.77-99.64) and 99.72% (95% CI: 98.60-99.81) for 563296 items for pharmacy technicians. The difference between the two groups was statistically significant at a level of p < 0.0001.

CONCLUSIONS

Pharmacy technicians demonstrated a higher level of accuracy, and a lower variation in accuracy rates reported between studies. Improving checking accuracy and pharmacist availability for other clinical tasks is desirable for workforce efficiency and patient safety. These empirical accuracy rates of pharmacy technicians performing accuracy checking could be used by legislative and regulatory bodies to supplement necessary policy changes that improve the safety of the dispensing process.

Perceived Roles of Independent Community Pharmacists and Pharmacy Technicians in Patient Referrals to Community Resources: A Study from the Medication Safety Research Network of Indiana (Rx-SafeNet)

INTRODUCTION

Referrals to community resources represent one element of the Chronic Care Model, however, little is known about the perceived role of community pharmacy staff in referring patients to community resources.

OBJECTIVES

The objective of this study was to describe community pharmacists', community pharmacy technicians', and patients' perceptions of pharmacist referrals to community resources.

METHODS

Semi-structured interviews were conducted with community pharmacists, pharmacy technicians, and patients from community pharmacies that are members of the Medication Safety Research Network of Indiana (Rx-SafeNet). Qualitative analysis was conducted to identify emergent themes.

RESULTS

A total of 37 participants, including six community pharmacists, one pharmacy student completing an advanced pharmacy practice experience, 15 community pharmacy technicians, and 15 patients across four independently-owned community pharmacies were interviewed. Themes included: 1) Need to build on a foundation of strong patient-community pharmacist relationships to clearly define the pharmacist's role in referrals, 2) Need to improve familiarity with community resources, 3) Need to clearly delineate and support the role for pharmacy technicians in making referrals, and 4) Need to follow-up on referrals.

CONCLUSION

To enhance community pharmacy staff provision of referrals to community resources, interventions are needed to improve patient and pharmacist familiarity with available resources, patients' perception of the pharmacist's role outside of prescription fulfillment, and follow-up on referrals. Moreover, pharmacy technician education and training could be expanded to optimize their role in supporting community pharmacists in making referrals.

Documentation in the Patient's Medical Record by Clinical Pharmacists in a Canadian University Teaching Hospital

BACKGROUND

In many studies on documentation, the data are self-reported, which makes it difficult to know the actual level of documentation by pharmacists in patients' medical records. The literature assessing documentation by clinical pharmacists in health care centres is limited.

OBJECTIVE

To assess the level of documentation in patients' medical records by clinical pharmacists at one large urban hospital.

METHODS

This retrospective observational study included all patients who were followed by a clinical pharmacist during their stay in the Centre hospitalier de l'Université de Montreal between July 1 and October 31, 2016. The primary outcome, the level of documentation in patients' medical records, was categorized as minimal, sufficient, or extensive. The quality of notes and the impact of pharmacy students and residents on documentation were evaluated as secondary outcomes.

RESULTS

A total of 779 patient charts from 4 inpatient units were included in the analysis. Of these, 563 (72.3%) were considered to have minimal documentation (at least 1 intervention described in writing), 432 (55.5%) had sufficient documentation (at least 1 note written during the patient's hospitalization), and 81 (10.4%) had extensive documentation (appropriate number of notes in relation to duration of hospitalization). Medication reconciliation performed by pharmacists at the time of admission was documented in 696 (89.3%) of patients' records. The presence of students or residents on a clinical unit was associated with a significant increase in the percentage of charts with at least 1 follow-up note (23.6% [120/508] with students/residents versus 12.5% [34/271] without students/residents; p < 0.001) and the mean number of followup notes (0.59 versus 0.23, respectively; p < 0.001) but had no effect on other variables. Of a total of 777 notes written by a pharmacist, the overall conformity with pre-established criteria was 56.8% (441/777), and conformity was 43.4% (139/320), 75.1% (272/362), and 31.6% (30/95) for admission, follow-up, and discharge notes, respectively.

CONCLUSIONS

Documentation by clinical pharmacists in patients' medical records could be improved to achieve the stated goal of the American Society of Health-System Pharmacists and the Canadian Society of Hospital Pharmacists, that all significant clinical recommendations or interventions should be documented.

Change in Proportion of Days Covered for Statins Following Implementation of a Pharmacy Student Adherence Outreach Program

BACKGROUND

Nearly half of statin users discontinue therapy within the first year of treatment. Nonadherence to statin therapy may lead to an increased risk of atherosclerotic cardiovascular disease and, thus, higher costs due to hospitalizations. Value-based care models, such as accountable care organizations (ACO), are measured on adherence rates to statins through proportion of days covered (PDC). However, there is little research describing pharmacy student-based interventions within value-based care models.

OBJECTIVES

To (a) identify mean change in PDC for statins following implementation of a pharmacy student adherence outreach program and (b) identify the proportion of patients converted to PDC ≥ 0.80 following the implementation of the outreach program.

METHODS

This single-center retrospective quasi-experimental study included patients actively enrolled in a Humana Medicare Advantage Prescription Drug (MA-PD) plan who completed at least 1 adherence outreach telephone call performed by a pharmacy student between January 1, 2017, and December 31, 2017.

RESULTS

99 patients met inclusion criteria. Atorvastatin was the most commonly prescribed statin (43%), followed by simvastatin (38%). Sixty-four percent of patients had a baseline PDC of < 0.80. Mean (SD) PDC was 0.66 (±0.24) before the pharmacy student adherence outreach intervention, and 0.79 (± 0.23)-a 0.13 increase-after the pharmacy student adherence outreach intervention (P < 0.001). Among patients who had PDC < 0.80 at baseline, 35% of patients (n = 35) were converted to PDC ≥ 0.80 (P < 0.001), and 5% of patients with a baseline PDC ≥ 0.80 had a decrease in PDC to < 0.80 following the intervention.

CONCLUSIONS

Among patients enrolled in a Humana MA-PD plan within an ACO, mean PDC for statins increased following exposure to a pharmacy student adherence outreach program. One third of patients converted their PDCs to ≥ 0.80 following the intervention. Value-based care programs may consider incorporating pharmacy student services to improve adherence to statins.

DISCLOSURES

No outside funding supported this research. The authors have no financial conflicts of interest to disclose. At the time of conducting this research, all authors were employed at Nova Southeastern University. Preliminary results were presented as a poster at the AMCP Managed Care & Specialty Pharmacy Annual Meeting; April 23-26, 2018; Boston, MA.

[Involvement of hospital pharmacy technician for expanding medication reconciliation process in France: Actors' willingness and opinions]

OBJECTIVES

Medication reconciliation is widely promoted by international health authorities. Its expansion requires human resources, which are limited and unequally distributed among health care facilities. Recent international studies support the involvement of pharmacy technician in the medication reconciliation process but his role remains unstructured in France. We aimed to assess pharmacy technicians' opinions and willingness to be involved in the medication reconciliation process expansion and to identify the levers and barriers of the project.

METHODS

A field study was conducted among health facilities of our territory hospital group. Semi-structured interviews were carried out with different pharmacy technicians. Data were analyzed using a qualitative thematic analysis approach.

RESULTS

Overall, 12 pharmacy technicians from 5 hospitals were interviewed and almost all assumed their rightful place in the medication reconciliation process (n=11), with a view to revaluating tasks. For all pharmacy technicians, the main barriers to participate in medication reconciliation were the lack of time and training. The spread of a "patient culture", the supervision by pharmacists, the desire to be part of the care team in the ward and additional training requests were major levers of change.

CONCLUSIONS

Pharmacy technicians' role in expanding medication reconciliation process is legitimate and must be standardized in France. The deployment of the project requires to be formalized within a territory and should consider and develop local organisations.

Impact of pharmacist care provision in value-based care settings: How are we measuring value-added services?

OBJECTIVES

To discuss the current state of measuring value-added services in emerging value-based payment practice models and their impact on the pharmacy profession.

SUMMARY

Value-based care models require a focus on population health. In value-based care settings, providers are held accountable for risk that goes beyond the clinic encounter, and payment is tied to quality measures that reflect clinical and humanistic outcomes across the health care spectrum. This creates opportunities for pharmacist integration into value-based care settings through addressing gaps in care, optimizing medication use, and developing physician-pharmacist team-based care practice models.

CONCLUSION

Scalable and sustainable pharmacist integration into value-based care settings should involve expansion of preventive care into the community. The need for measurement of the value added by pharmacy services is a priority.

Improving Medication History at Admission Utilizing Pharmacy Students and Technicians: A Pharmacy-Driven Improvement Initiative

BACKGROUND

Because of the frequency of medication errors related to care transitions, patient-safety initiatives have recently focused on improving the patient medication list. Pharmacy student and technician participation in the medication-history process has been shown to improve the quality of medication histories. To improve patient care, a pharmacy-driven medication-history service utilizing a unique hybrid team of pharmacy students and technicians was launched at Inova Loudoun Hospital (ILH).

OBJECTIVE

The objective of the service was to improve patient safety and therapy by providing the Best Possible Medication History (BPMH) for admitted acute-care patients.

METHODS

Data for the medication-history service was collected for six months from July 2015 to January 2016. The service included pharmacy technicians and fourth-year pharmacy students using the BPMH approach to verify patients' allergies, medications, doses, and frequencies, and to ensure optimal documentation in the Electronic Health Record (EHR). Data on types and numbers of discrepancies and interventions were collected during the process. Readmission rates for the study group were calculated and compared to readmission rates for all patients.

RESULTS

Out of 4,070 patients interviewed, 77.7% (3,162) had at least one discrepancy in their medication list. Per patient, the average number of medications was 7.47, with an average of 1.8 discrepancies. Pharmacy students identified more discrepancies per patient than pharmacy technicians, 2.3 versus 1.5, respectively. Readmission rates for patients interviewed by the medication-history team was lower than for all patients during the same period, as well as for all patients during the same period in the previous year.

CONCLUSION

This pharmacy-driven medication-history service, staffed with pharmacy technicians and students using a structured BPMH approach, increased the accuracy of home-medication lists on patient admission. The service demonstrated a difference in the types of interventions provided by pharmacy students and technicians. Readmission rates were also lower for patients with completed BPMH.

Highlighting a gap in student pharmacist training: Intraprofessional education with pharmacy technicians

INTRODUCTION

The Accreditation Council for Pharmacy Education (ACPE) Accreditation Standards suggest integration and inclusion of interprofessional education in doctor of pharmacy programs. Although not directly mentioned by these Standards, intraprofessional education between student pharmacists and student pharmacy technicians may provide valuable preparation for comradery in practice.

COMMENTARY

Given the prevalence of collaboration between pharmacists and pharmacy technicians in pharmacy practice, lack of intraprofessional education could be a vital gap in current programs. There have been previous calls within academic pharmacy and from key stakeholder groups for greater involvement of the profession in the training and education of pharmacy technicians, yet literature is sparse on successful models. This commentary includes a discussion of why intraprofessional training is vital, a brief commentary on example intraprofessional activities, as well as strategies for collaboration.

IMPLICATIONS

A series of questions with the intention of evoking further conversations and awareness within academic pharmacy completes the commentary.

Improving admission medication reconciliation with pharmacists or pharmacy technicians in the emergency department: a randomised controlled trial

BACKGROUND

Admission medication history (AMH) errors frequently cause medication order errors and patient harm.

OBJECTIVE

To quantify AMH error reduction achieved when pharmacy staff obtain AMHs before admission medication orders (AMO) are placed.

METHODS

This was a three-arm randomised controlled trial of 306 inpatients. In one intervention arm, pharmacists, and in the second intervention arm, pharmacy technicians, obtained initial AMHs prior to admission. They obtained and reconciled medication information from multiple sources. All arms, including the control arm, received usual AMH care, which included variation in several common processes. The primary outcome was severity-weighted mean AMH error score. To detect AMH errors, all patients received reference standard AMHs, which were compared with intervention and control group AMHs. AMH errors and resultant AMO errors were independently identified and rated by ≥2 investigators as significant, serious or life threatening. Each error was assigned 1, 4 or 9 points, respectively, to calculate severity-weighted AMH and AMO error scores for each patient.

RESULTS

Patient characteristics were similar across arms (mean±SD age 72±16 years, number of medications 15±7). Analysis was limited to 278 patients (91%) with reference standard AMHs. Mean±SD AMH errors per patient in the usual care, pharmacist and technician arms were 8.0±5.6, 1.4±1.9 and 1.5±2.1, respectively (p<0.0001). Mean±SD severity-weighted AMH error scores were 23.0±16.1, 4.1±6.8 and 4.1±7.0 per patient, respectively (p<0.0001). These AMH errors led to a mean±SD of 3.2±2.9, 0.6±1.1 and 0.6±1.1 AMO errors per patient, and mean severity-weighted AMO error scores of 6.9±7.2, 1.5±2.9 and 1.2±2.5 per patient, respectively (both p<0.0001).

CONCLUSIONS

Pharmacists and technicians reduced AMH errors and resultant AMO errors by over 80%. Future research should examine other sites and patient-centred outcomes.

TRIAL REGISTRATION NUMBER

NCT02026453.

Implications of involving pharmacy technicians in obtaining a best possible medication history from the perspectives of pharmaceutical, medical and nursing staff: a qualitative study

OBJECTIVES

In recent years, the involvement of pharmacy technicians in medication reconciliation has increasingly been investigated. The aim of this study was to assess the implications on professional roles and collaboration when a best possible medication history (BPMH) at admission is obtained by pharmacy technicians.

DESIGN

Qualitative study with semistructured interviews. Data were analysed using a qualitative content analysis approach.

SETTING

Internal medicine units in two mid-sized Swiss hospitals.

PARTICIPANTS

21 staff members working at the two sites (6 pharmacy technicians, 2 pharmacists, 6 nurses, 5 physician residents and 2 senior physicians).

RESULTS

Pharmacy technicians generally appreciated their new tasks in obtaining a BPMH. However, they also experienced challenges associated with their new role. Interviewees reported unease with direct patient interaction and challenges with integrating the new BPMH tasks into their regular daily duties. We found that pharmacists played a key role in the BPMH process, since they act as coaches for pharmacy technicians, transmit information to the physicians and reconcile preadmission medication lists with admission orders. Physicians stated that they benefitted from the delegation of administrative tasks to pharmacy technicians. Regarding the interprofessional collaboration, we found that pharmacy technicians in the study acted on a preliminary administrative level and did not become part of the larger treatment team. There was no direct interaction between pharmacy technicians and physicians, but rather, the supervising pharmacists acted as intermediaries.

CONCLUSION

The tasks assumed by pharmacy technicians need to be clearly defined and fully integrated into existing processes. Engaging pharmacy technicians may generate new patient safety risks and inefficiencies due to process fragmentation. Communication and information flow at the interfaces between professional groups therefore need to be well organised. More research is needed to understand if and under which circumstances such a model can be efficient and contribute to improving medication safety.

Comparison of Medication History Accuracy Between Nurses and Pharmacy Personnel

PURPOSE:

To evaluate the differences in medication history errors made by pharmacy technicians, students, and pharmacists compared to nurses at a community hospital.

METHODS:

One hundred medication histories completed by either pharmacy or nursing staff were repeated and evaluated for errors by a fourth-year pharmacy student. The histories were analyzed for differences in the rate of errors per medication. Errors were categorized by their clinical significance, which was determined by a panel of pharmacists, pharmacy students, and nurses. Errors were further categorized by their origin as either prescription (Rx) or over the counter (OTC). The primary outcome was the difference in the rate of clinically significant errors per medication. Secondary outcomes included the differences in the rate of clinically insignificant errors, Rx errors, and OTC errors. Differences in the types of errors for Rx and OTC medications were also analyzed. Additionally, the number of patients with no errors was compared between both groups.

RESULTS:

The pharmacy group had a lower clinically significant error rate per medication (0.03 vs 0.09; relative risk [RR] = 0.66; 95% confidence interval [CI]: 0.020-0.093; P = .003). For secondary outcomes, the pharmacy group had a lower total error rate (0.21 vs 0.36, RR = 0.58; 95% CI: 0.041-0.255; P = .007), Rx error rate (0.09 vs 0.27, RR = 0.44; 95% CI: 0.071-0.292; P = .002), and OTC error rate (0.24 vs 0.46; RR = 0.52; 95% CI: 0.057-0.382; P = .009) per medication. The pharmacy group completed 20% more medication histories without Rx errors ( P = .045) and 25% more histories without OTC errors ( P = .041).

CONCLUSION:

This study demonstrated that expanded use of pharmacy technicians and students improves the accuracy of medication histories in a community hospital.