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Meadors C, McPheeters C, Maier C, O'Reilly E. Health-system specialty pharmacy: Overview of a hybrid clinical model. Am J Health Syst Pharm 2024; 81:e256-e260. [PMID: 38146967 DOI: 10.1093/ajhp/zxad333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Indexed: 12/27/2023] Open
Abstract
PURPOSE The prevalence of specialty pharmacies has grown, especially within the hospital setting. These pharmacies have shown benefits in the areas of patient education and adherence, financial support, and patient and provider satisfaction. Currently, there are gaps in literature describing use of a hybrid clinical model in health-system specialty pharmacies. SUMMARY The UofL Health - UofL Hospital Specialty Pharmacy (UofL Health SP) is attached to a retail pharmacy in a larger health system. Pharmacists in the UofL Health SP utilize a hybrid clinical model in which they split their time between working in a specialty clinic and staffing in the specialty pharmacy. The specialty pharmacy and its oncology satellite pharmacy each have a primary staffing pharmacist, and 5 other pharmacists participate in this hybrid clinical model. In addition to the specialty pharmacists, pharmacy technicians and patient care advocates support the operations of the specialty pharmacy and ensure financial access to medications for patients. CONCLUSION With the hybrid clinical model at UofL Health SP, there is increased workflow efficiency and better communication between specialty clinics and the specialty pharmacy, which results in a streamlined patient experience. Additionally, there has been an increase in specialty pharmacy prescriptions dispensed in the specialty pharmacy since the implementation of this hybrid clinical model.
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Affiliation(s)
- Crystal Meadors
- UofL Health - UofL Hospital Specialty Pharmacy, Louisville, KY, USA
| | | | - Chelsea Maier
- UofL Health - UofL Hospital Specialty Pharmacy, Louisville, KY, USA
| | - Emily O'Reilly
- UofL Health - UofL Hospital Specialty Pharmacy, Louisville, KY, USA
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Blum K. ASHP Pharmacy Technician Forum Executive Committee. Am J Health Syst Pharm 2024; 81:e154-e155. [PMID: 38363982 DOI: 10.1093/ajhp/zxae018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024] Open
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3
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Hettinger KN, Adeoye-Olatunde OA, Russ-Jara AL, Riley EG, Kepley KL, Snyder ME. Preparing community pharmacy teams for health information exchange (HIE). J Am Pharm Assoc (2003) 2024; 64:429-436.e2. [PMID: 38081515 DOI: 10.1016/j.japh.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 11/29/2023] [Accepted: 12/06/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND Health information exchanges (HIEs) facilitate health care professionals' electronic sharing of patient information across different organizations. When community pharmacists have access to HIE, they can further contribute to improved patient outcomes. However, several implementation challenges are noted, which impede sustained pharmacist access to HIE. To our knowledge, no bidirectional HIE interface design and pharmacy team-informed implementation process has been documented. In response, our research team designed and developed an HIE interface prototype for use specifically by community pharmacy teams to access local HIE data through their pharmacy dispensing software. OBJECTIVES To 1) identify barriers, facilitators, and recommendations for using HIE data in community pharmacies and 2) create a curated list of resources addressing identified implementation needs to aid future implementation of a fully functional, bidirectional HIE interface by community pharmacy teams. METHODS Pharmacists, pharmacy technicians, and patients from three pharmacy sites within the Community Pharmacy Enhanced Services Network of Indiana participated in individual semi-structured interviews. Interview questions were mapped to select constructs across all domains of the Consolidated Framework for Implementation Research. Interview transcripts were deductively coded. A subset of participants participated in Evidence-Based Quality Improvement sessions to iteratively update planned resource items needed to support future HIE implementation. RESULTS We interviewed 23 total participants: 8 pharmacists, 8 pharmacy technicians, and 7 patients. Five facilitators, four barriers, and two recommendations were identified. These were further characterized into four key implementation needs: instruction on how to use HIE; guidance on workflow and team roles; resources that are patient-facing; and resources that are provider-facing, resulting in 16 planned implementation resources. CONCLUSION Our study provides the first-of-its-kind list of pharmacy team-informed resources to facilitate sustainability and scalability of HIE implementation in community pharmacies.
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Abbasi A, Franz N. Assessment of technology-assisted technician verification of compounded intravenous sterile preparations versus pharmacist verification. Am J Health Syst Pharm 2024; 81:129-136. [PMID: 37879887 DOI: 10.1093/ajhp/zxad269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Indexed: 10/27/2023] Open
Abstract
PURPOSE This study is an evaluation of technology-assisted technician verification (TATV) of the compounded sterile product (CSP) preparation process as an alternative to final verification by a pharmacist. METHODS A 2-phase, single-center noninferiority study was conducted to assess the accuracy and CSP processing time with TATV versus pharmacist verification. Phase I of the study was a validation of the internal pharmacist accuracy rate in which 2 pharmacists checked each CSP. In phase II, prepared CSPs were first checked by a technician and then checked by a pharmacist. Technicians were required to complete baseline credentialing and training requirements to participate in the study. The primary outcome was the error rate for the pharmacist check in phase I and the error rate of the technician check in phase II. Secondary outcomes included total verification time and total dose processing time in each phase. The Farrington-Manning test was used for noninferiority assessment of accuracy, and the Wilcoxon rank sum test was used to detect a difference between the processing times. RESULTS A total of 4,000 doses were checked in each phase. Pharmacist accuracy was 99.600% in phase I, compared to TATV accuracy of 99.575% in phase II. TATV of CSPs was noninferior to pharmacist verification (absolute difference in accuracy, 0.025%; 95% CI, -0.26% to 0.31%; P = 0.0016). Total verification time and total dose processing times were significantly lower in Phase II. CONCLUSION This study showed that TATV of CSPs is noninferior to pharmacist final verification and does not negatively impact the time to check CSPs or total CSP processing time.
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Affiliation(s)
- Aimen Abbasi
- Northwestern Memorial Hospital, Chicago, IL, USA
| | - Noah Franz
- Froedtert & the Medical College of Wisconsin, Milwaukee, WI, USA
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Blum K. ASHP Pharmacy Technician Forum Executive Committee. Am J Health Syst Pharm 2024; 81:85. [PMID: 38071667 DOI: 10.1093/ajhp/zxad296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024] Open
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Traynor K. Pharmacy Technician Excellence Award. Am J Health Syst Pharm 2024; 81:e63. [PMID: 37672363 DOI: 10.1093/ajhp/zxad204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023] Open
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Khan A, Dignos PN, Papadopoulos A, Nowrouzi-Kia B, Sivanthan M, Gohar B. Unmasking the Unrecognized: Exploring Registered Pharmacy Technicians' Stressors During COVID-19 Through a Demands-Resources Inquiry and Looking Ahead. Inquiry 2024; 61:469580241241391. [PMID: 38523405 PMCID: PMC10962027 DOI: 10.1177/00469580241241391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/29/2024] [Accepted: 03/05/2024] [Indexed: 03/26/2024]
Abstract
Canadian registered pharmacy technicians (RPTs) were vital in supporting pharmacy operations during the pandemic. However, they have received little attention during or pre-pandemic. This study aimed to identify and understand the stressors experienced by Canadian RPTs during the pandemic and gain insights on lessons learned to help improve the profession. Through a descriptive qualitative design, virtual semi-structured focus groups were conducted with RPTs who were recruited through various sampling methods across Canada. Data were inductively analyzed and then deductively; themes were categorized using the Job Demands-Resources (JD-R) model. We reached data saturation after 4 focus group sessions with a total of 16 participants. As per the JD-R model, job demands included: (1) increased work volume and hours to meet patient demand; (2) drug shortages and managing prescriptions increased due to influx of orders coinciding with restricted access to medications; (3) fear of the unknown nature of COVID-19 met with frequent change in practices due to protocol changes and ineffective communication; and, (4) the pandemic introduced several factors leading to increased staff shortages. Themes pertaining to resources included: (1) poor incentives and limited access to well-being resources; (2) limited personal protective equipment delaying work operations; (3) and a general lack of knowledge or appreciation of the profession impacting work morale. Lessons learned from the pandemic were also provided. Overall, our findings revealed an imbalance where RPTs experienced high job demands with limited resources. Improved leadership within pharmacies, including improved communication between team members, is required. Furthermore, efforts to highlight and recognize the work of RPTs to the public is important to help improve enrollment, especially with their recent scope of practice expansion.
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Affiliation(s)
| | | | | | - Behdin Nowrouzi-Kia
- University of Toronto, Toronto, ON, Canada
- Laurentian University, Sudbury, ON, Canada
| | | | - Basem Gohar
- University of Guelph, Guelph, ON, Canada
- Laurentian University, Sudbury, ON, Canada
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Johnson JL, Blefari C, Marotti S. Application of the COM-B model to explore barriers and facilitators to participation in research by hospital pharmacists and pharmacy technicians: A cross-sectional mixed-methods survey. Res Social Adm Pharm 2024; 20:43-53. [PMID: 37813706 DOI: 10.1016/j.sapharm.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 09/17/2023] [Accepted: 10/02/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND Combining research and clinical practice is crucial for advancing evidence-based healthcare and improving pharmacy service delivery. While hospital pharmacists report significant interest in research, this does not translate to high levels of research engagement. Furthermore, little is known regarding barriers and motivators for pharmacy technician involvement in research. OBJECTIVE To characterise the barriers and enablers to engaging in practice-based research reported by hospital pharmacy staff using the Capability, Opportunity, Motivation - Behaviour (COM-B) framework. METHODS An online cross-sectional survey, using the validated Research Capacity in Context tool, was sent to all employees of a statewide hospital pharmacy service. Respondent characteristics and quantitatively reported barriers and motivators were analysed using descriptive statistics. Qualitative data from open text responses were analysed through inductive thematic analysis. Results were mapped to the components of the COM-B framework at individual, team and organisation levels. RESULTS 278 responses were received (response rate 43.3%) from pharmacists (68.0%) and pharmacy assistants/technicians (28.4%) across 19 hospitals. Research behaviour was influenced by factors linked to five of six COM-B subdomains. Reflective motivation, linked to a desire to improve practice and patient care, self-development, and recognition, indicates pharmacy staff would like to engage in research. However, barriers related to physical opportunity (lack of time for research, other work roles that take priority) and psychological capability (lack of skills and mentorship) hindered involvement. Social opportunity and automatic motivation, tied to managerial support, role perceptions and departmental research culture were also reported facilitators. Subtle differences in the factors that motivate hospital pharmacists and pharmacy technicians were identified. CONCLUSIONS Mapping factors associated with research participation by hospital pharmacy staff to the COM-B model is an important step towards identifying evidence-based intervention types that could form the basis of strategies to optimise hospital pharmacy staff engagement with practice-based research, using the behaviour change wheel.
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Affiliation(s)
- Jacinta L Johnson
- SA Pharmacy, SA Health, PO Box 287 Rundle Mall, Adelaide, SA, 5000, Australia; UniSA Clinical and Health Sciences, Level 6, HB Building, City West Campus, University of South Australia, Adelaide, SA, 5000, Australia.
| | - Concettina Blefari
- UniSA Clinical and Health Sciences, Level 6, HB Building, City West Campus, University of South Australia, Adelaide, SA, 5000, Australia.
| | - Sally Marotti
- SA Pharmacy, SA Health, PO Box 287 Rundle Mall, Adelaide, SA, 5000, Australia; UniSA Clinical and Health Sciences, Level 6, HB Building, City West Campus, University of South Australia, Adelaide, SA, 5000, Australia.
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Yoon HS, Teshome BF, Eisenbeis A, Micek ST. Pharmacy technicians trained as community health workers: A prospective multicenter cohort study. J Am Pharm Assoc (2003) 2024; 64:47-54.e1. [PMID: 37673283 DOI: 10.1016/j.japh.2023.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Community health workers (CHWs) are health professionals who are experts in linking patients to health resources. Although CHWs are employed in a variety of health institutions, access to their services may be challenging for patients in underserved locations. Community pharmacies are uniquely positioned to mitigate this barrier as they provide readily accessible care for patients residing in these areas. OBJECTIVES To 1) quantify and report the CHW services provided by certified pharmacy technicians (CPhTs) in an underserved population and 2) provide an initial framework for the implementation of CHW services in community pharmacies or similar health care settings. METHODS This prospective cohort study reports the findings of training CPhTs as CHWs in 3 independent community pharmacies from January 1, 2021 to July 1, 2021. CPhT-CHWs conducted monthly visits by phone, patient home, or pharmacy and documented services using a standardized assessment form. Descriptive statistics were used to summarize the baseline characteristics of the patient population, service codes, types of services and referrals made, and time spent per visit by CPhT-CHWs. RESULTS A total of 198 patient visits by phone, patient home, or at the pharmacy were completed in a 6-month timespan. During these visits, the CPhT-CHW provided 351 services (203 primary services and 149 secondary services) and completed 51 referrals. The average time spent per visit (standard deviation) was 15.5 (11.5) 68.9 (35.4), and 30.6 (16.8) minutes for phone, home, and pharmacy visits, respectively. Patient home visits resulted in the highest average primary services per visit, longest time spent with the patient, and accounted for a majority of social services. CONCLUSION CPhT-CHWs were able to use various methods to contact these patients to further develop patient-to-provider and patient-to-pharmacy relationships. Training CPhTs as CHWs can be an effective way to increase patient contact and provide additional health services.
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Blum K. ASHP Pharmacy Technician Forum Executive Committee. Am J Health Syst Pharm 2023; 80:1771. [PMID: 37935404 DOI: 10.1093/ajhp/zxad266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023] Open
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11
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Fuschetto KS, Amin KA, Gothard MD, Merico EM. Evaluating the Role of Pharmacy Technician-Administered Vaccines. J Pharm Pract 2023; 36:1383-1391. [PMID: 35938480 DOI: 10.1177/08971900221117893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
Background: Before the COVID-19 pandemic, most states limited administration of vaccines to trained pharmacists and pharmacy interns. In October 2020 due to the public health emergency, the Federal Public Readiness and Emergency Preparedness Act (PREP Act) authorized qualified pharmacy technicians to administer vaccines nationally. Currently available research on the perception of pharmacy technician-administered vaccines is limited. Objectives: The primary objective was to evaluate the perceptions of licensed pharmacists and pharmacy technicians regarding pharmacy technician-administered vaccines. The secondary objective was to analyze correlations between demographic data and the perceptions of respondents. Methods: An anonymous, 24-question survey including 5-point Likert-scale and ranking type questions was distributed using Qualtrics® survey software to licensed pharmacists and pharmacy technicians in the state of Ohio. Results: Total of 52,240 pharmacists and pharmacy technicians were invited to participate in the survey, 26,226 viewed the e-mail and 2179 responses were collected, yielding a response rate of 8.3%. Results showed 65.9% (n = 365) of pharmacists and 76.2% (n = 675) of pharmacy technicians agreed that trained pharmacy technicians should be able to administer vaccines post-COVID-19 pandemic. Conclusion: Licensed pharmacists and pharmacy technicians in the state of Ohio support the continued administration of vaccines by trained pharmacy technicians fostering the need for legislative change.
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Affiliation(s)
| | - Kunal A Amin
- Northeast Ohio Medical University, Rootstown, OH, USA
| | | | - Erin M Merico
- Northeast Ohio Medical University, Rootstown, OH, USA
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12
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Leslie KF, Waltz P, DeJarnett B, Fuller LZ, Lisenby S, Raake SE. Evaluation of technician immunization administration. J Am Pharm Assoc (2003) 2023; 63:1715-1721. [PMID: 37541392 DOI: 10.1016/j.japh.2023.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/27/2023] [Accepted: 07/27/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVES To (1) assess technician and supervising pharmacists' attitudes and perceptions toward technicians administering immunizations after a technician training initiative, (2) describe the public health impact of technician-administered COVID-19 immunizations, and (3) describe best practices for technician-administered immunizations. DESIGN A mixed-methods study collected quantitative and qualitative data. SETTING AND PARTICIPANTS Kentucky technicians who completed an immunization administration training, and their supervising pharmacists. OUTCOME MEASURES Surveys were administered to Kentucky technicians who completed immunization administration training between January and September 2021. Surveys assessed the effectiveness of the training, integration of technicians in the immunization workflow, and impact of technicians in their organization's immunization efforts. Similar surveys were deployed to supervising pharmacists. Response frequencies were recorded for each question and descriptive statistics were calculated for each item included in the survey. Key informant interviews were conducted with technicians and pharmacists to further explore study concepts, assess needs, and discuss best practices for implementation. Interviews were audio recorded, transcribed verbatim, and analyzed using inductive thematic analysis. RESULTS Fifty-seven technicians and 37 pharmacists responded to the survey. Technicians were easily integrated into community pharmacy immunization workflow that allowed for increased immunization administration. Ninety-four percent of supervising pharmacists and 98% of technicians supported the use of technicians in the immunization workflow beyond the pandemic. Twenty-seven interviews were conducted. Major themes that emerged from the data included using the "right" technicians, role delineation and collaboration, policies, logistics, financial implications, and public health impact. CONCLUSION The utilization of pharmacy technicians in administration helped to accelerate the immunization process, alleviate the burden on pharmacists and other health care professionals, and ensure widespread vaccine distribution to combat the pandemic.
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Brown H, Finch M. Implications of a technician-led pharmacy service on a day case unit in a tertiary oncology centre. J Oncol Pharm Pract 2023; 29:1702-1707. [PMID: 36573000 DOI: 10.1177/10781552221147659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
INTRODUCTION Medicines Management Technicians have been shown to be an underused resource in medicines optimisation and medicines waste. In the United Kingdom, there are national recommendations for the clinical pharmacy service in cancer services ambulatory units, despite these recommendations, there was no clinical pharmacy service on the day case unit at a specialist tertiary centre in England. A lot of the patient pathways had been in place for many years and had not progressed with the changes in the clinical pathways. The main objectives of this study were to analyse how a medicines management technician could reduce medicines waste, improve the current pathway, increase medicines optimisation and ultimately improve the patient experience in an oncology day case unit at a specialist tertiary centre in England. METHODS A prospective mixed methods study was carried out at Weston Park Hospital. Descriptive statistical analysis was conducted on the quantitative data collected, and thematic analysis was carried out on the qualitative data collected by questionnaire to staff members and patients. RESULTS This study has shown that a medicines management technician can complete some of the tasks more traditionally done by the chemotherapy nurses on the day case unit, increasing their capacity for more clinically appropriate tasks. A medicines management technician can work as part of the wider multidisciplinary team on a day case unit contributing to medicines optimisation and cost savings for the oncology directorate. CONCLUSIONS This study has shown that a medicines management technician can act as a valued member of the wider multidisciplinary team, improving communication and patient pathways, improving medicines optimisation and contributing to cost saving initiatives. Further studies are required to assess whether a medicines management technician role can be of the same value on a haematology day case unit.
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Affiliation(s)
- Harriet Brown
- Pharmacy Technician, West 5 Primary Care Network, Sheffield, England
| | - Milly Finch
- Oncology Pharmacist, Calderdale and Huddersfield NHS Foundation Trust, England
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Halvorson D, Eukel HN, Gilbraith M, Schaper T, Miller DR. Design and Implementation of Tech-Check-Tech Programs in North Dakota Pharmacies. J Pharm Pract 2023; 36:1102-1107. [PMID: 35417659 DOI: 10.1177/08971900221088787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Tech-check-tech (TCT) programs in pharmacies are beneficial in facilitating a transition from fee for service dispensing tasks to advanced patient care, but they are underutilized. Objective: To describe the design, implementation, and evaluation of a transferable TCT program in several North Dakota pharmacies, with the goal of facilitating future efforts in other states. Methods: We developed a universal TCT implementation toolkit, recruited 6 pharmacies to implement it, developed an educational program for the pharmacies, and worked with the pharmacies over a year to assess success of the program. Pre- and post-implementation surveys assessed pharmacist and technician responses in regards to program effectiveness. Four outcomes were measured, and included pharmacist's time savings, descriptive comments on changes in workflow, incidence of errors and near misses, and barriers to implementation. Results: The implementation of TCT was unanimously perceived as successful and increasing efficiency in the post-site surveys completed by pharmacists. All 13 technicians who participated in the post-survey indicated the methods and materials used for training were sufficient and appropriate. The most commonly cited barrier to implementation of TCT stated by technicians was incorporating TCT into their current workflow. No dispensing errors which resulted in patient impact occurred throughout the duration of this study. Conclusions: A TCT implementation template provided a successful framework for TCT in various pharmacy settings and can serve as a model for other pharmacy settings, states, or regions.
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Affiliation(s)
| | - Heidi N Eukel
- North Dakota State University School of Pharmacy, Fargo ND, USA
| | | | | | - Donald R Miller
- North Dakota State University School of Pharmacy, Fargo ND, USA
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ASHP Pharmacy Technician Forum Executive Committee. Am J Health Syst Pharm 2023; 80:1120. [PMID: 37436766 DOI: 10.1093/ajhp/zxad154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023] Open
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16
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White CR, Pham HM, Ifeji CE. Compensation for Board of Pharmacy members in the United States. J Am Pharm Assoc (2003) 2023; 63:1180-1184. [PMID: 37149140 DOI: 10.1016/j.japh.2023.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND No published data exist regarding per diem pay differences between the 50 United States Boards of Pharmacy. OBJECTIVES The purpose of this study was to quantify and compare the per diem pay rate of Board of Pharmacy members for each state in the U.S. Compensation for mileage and meals, as well as demographic information regarding U.S. Board of Pharmacy members, was also evaluated. METHODS In June 2022, each state Board of Pharmacy was contacted to gather data including per diem pay, mileage and meal compensation, number of meetings per year, number and gender of Board members, length of appointment, and regulatory statutes. RESULTS The average per diem pay for Board members was $75.86 (median = $50.00, range = $0.00-$250.00, n = 48 states). Most states report paying Board members for mileage (95.1%, n = 39 of 41) and meals (80.0%, n = 28 of 35). On average, Boards are composed of 8.3 members (median = 7.5, range = 5-17, n = 50), meet 8.3 times annually (median = 8, range = 3-16, n = 47), and have a 4.5-year length of appointment (median = 4, range = 3-6, n = 47). Men represented 61.2% of occupied Board positions, and pharmacists accounted for 74.2% of all positions. The average year for per diem pay statute update was 2002. CONCLUSION The per diem pay for U.S. Board of Pharmacy members varies from state to state, ranging from unpaid (n = 8 states) up to $250.00 per diem. Fair compensation, increased pharmacy technician and women representation, and more timely pharmacy statute updates are necessary in order to achieve inclusion, diversity, and equity across state Boards of Pharmacy.
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Gonzalez-Torres MC, Milverton E, Rowtcliff KH. Expanding the role of pharmacy technicians and foundation rotational pharmacists in delivering patient-centred care at a mental health trust: development of a Medicines Optimisation Intervention Track Tool. Eur J Hosp Pharm 2023; 30:196-201. [PMID: 34272214 PMCID: PMC10359801 DOI: 10.1136/ejhpharm-2021-002767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 06/21/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Medication has a significant role to play in any hospital admissionand in the road to recovery. Medication interventions to improve patient education are essential for better outcomes. Medication interventions in our unit have not previously followed a systematic procedure. They have not been quantified and do not encompass all patients. This study aims to develop a simple tool that can significantly help the effective prioritisation of the workload among the Medicines Optimisation Team, ensuring patient-centred care is optimised. METHODS This is an observational case series study. A basic Excel spreadsheet was designed to capture the team's daily interventions focusing on four main areas: medicines reconciliation, admission, follow-up and discharge. We named it the Medicines Optimisation Interventions Tracking Tool (MOITT). RESULTS Analysis of the data showed a good number of patients receiving interventions: 122 (92%) medicines reconciliation, 77 (58%) admission interventions, 64 (48%) follow-up interventions and 28 (21%) interventions on discharge. This quantification of work revealed factors which prevent achieving a higher percentage of interventions. The criteria to complete the spreadsheet were modified accordingly to address these factors resulting in an improvement in the design of the tool and the protocol to follow to complete it. In addition, it was encouraging to see the team's hard work portrayed in figures for the first time. CONCLUSION The MOITT developed facilitates an efficient clinical prioritisation of work for the Medicines Optimisation Team. This study has shown that this novel way of working is advantageous to record and keep track of the Medicines Optimisation Team's daily interventions on an inpatient ward, helping to set daily objectives. Implementation of this tool increases targeted patient interventions and team productivity and influences changes in practice to adapt to the service needs. The role of pharmacy technicians is critical for the implementation of this tool and patient outcomes, which is in line with the UK Hospital Pharmacy and Medicines Optimisation plan dated 2016.
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Affiliation(s)
| | - Elizabeth Milverton
- Medicines Optimisation Team, Devon Partnership NHS Trust, Barnstaple, Devon, UK
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Kiles TM, Chen C, Leibold C, Cardosi L, Hill H, Hohmeier KC. Pharmacy personnel comfort and confidence in screening for social needs: A pilot study. J Am Pharm Assoc (2003) 2023; 63:S83-S87. [PMID: 36863964 DOI: 10.1016/j.japh.2023.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Addressing social needs (such as lack of adequate housing, food, and transportation) has been shown to improve medication adherence and overall patient outcomes. However, screening for social needs during routine patient care can be challenging due to lack of knowledge of social resources and adequate training. OBJECTIVES The primary objective of this study is to explore the comfort and confidence of community pharmacy personnel in a chain community pharmacy when discussing social determinants of health (SDOH) with patients. A secondary objective of this study was to assess the impact of a targeted continuing pharmacy education program in this area. METHODS Baseline confidence and comfort were measured through a brief online survey consisting of Likert scale questions regarding various aspects of SDOH (e.g., importance and benefit, knowledge of social resources, relevant training, workflow feasibility). Subgroup analysis of respondent characteristics was conducted to examine differences between respondent demographics. A targeted training was piloted, and an optional posttraining survey was administered. RESULTS The baseline survey was completed by 157 pharmacists (n = 141, 90%) and pharmacy technicians (n = 16, 10%). Overall, the pharmacy personnel surveyed lacked confidence and comfort when conducting screenings for social needs. There was not a statistically significant difference in comfort or confidence between roles; however, subgroup analysis revealed trends and significant differences between respondent demographics. The largest gaps identified were lack of knowledge of social resources, inadequate training, and workflow concerns. Respondents of the posttraining survey (n = 38, response rate = 51%) reported significantly higher comfort and confidence than the baseline. CONCLUSION Practicing community pharmacy personnel lack confidence and comfort in screening patients for social needs at baseline. More research is needed to determine if pharmacists or technicians may be better equipped to implement social needs screenings in community pharmacy practice. Common barriers may be alleviated with targeted training programs to address these concerns.
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Traynor K. Informatics technicians fill a growing need at hospitals. Am J Health Syst Pharm 2023; 80:801-802. [PMID: 37279549 DOI: 10.1093/ajhp/zxad105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
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Blum K. ASHP Pharmacy Technician Forum Executive Committee. Am J Health Syst Pharm 2023; 80:329. [PMID: 36804671 DOI: 10.1093/ajhp/zxad029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
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Blum K. ASHP Pharmacy Technician Forum Executive Committee. Am J Health Syst Pharm 2023; 80:172-173. [PMID: 36791041 DOI: 10.1093/ajhp/zxad011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
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Traynor K. ASHP Pharmacy Technician Excellence Award. Am J Health Syst Pharm 2023; 80:97. [PMID: 36342064 DOI: 10.1093/ajhp/zxac321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Baldonedo-Mosteiro C, Mosteiro-Díaz MP, Franco-Correia S, Tardón A. Emotional Burden among Pharmacists and Pharmacy Technicians during the COVID-19 Lockdown: A Cross Sectional Study. Int J Environ Res Public Health 2022; 19:10558. [PMID: 36078274 PMCID: PMC9518200 DOI: 10.3390/ijerph191710558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/12/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
This study aims to investigate the prevalence of depression and anxiety symptoms among Spanish community pharmacists and pharmacy technicians during the coronavirus disease 2019 (COVID-19) lockdown. A descriptive cross-sectional quantitative study was designed. An online survey was administered to participants from 4 to 21 April 2020 using a questionnaire assessing sociodemographic information and the Spanish version of the Hospital Anxiety and Depression Scale (HADS). Informed consent to participate was requested. Participants comprised 1162 pharmacy staff from Spain with an average age of 39.15 ± 9.718, from 20 to 65 years old, of whom 83% were women, and 50.6% were married. More than half of the participants expressed symptoms of depression (62.7%) and anxiety (70.9%). An important prevalence of anxiety and depression symptoms has been detected among Spanish pharmacists and pharmacy technicians during the COVID-19 lockdown. Being a woman, smoking, feeling fear, feeling stress and believing that pharmacists/pharmacy technicians are very exposed to COVID-19 seem to be associated with higher HADS scores.
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Affiliation(s)
| | - María-Pilar Mosteiro-Díaz
- Grupo de Investigación INEUROPA, Departamento de Medicina, Área de Enfermería, Universidad de Oviedo, 33006 Oviedo, Spain
| | - Sara Franco-Correia
- Departamento de Medicina, Área de Enfermería, Universidad de Oviedo, 33006 Oviedo, Spain
| | - Adonina Tardón
- Departamento de Medicina, Área de Salud Pública, Health Research Institute of Investigation (ISPA) and CIBERESP, Universidad de Oviedo, 33006 Oviedo, Spain
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Foster AA, Daly CJ, Logan T, Logan R, Jarvis H, Croce J, Jalal Z, Trygstad T, Jacobs DM. Implementation and evaluation of social determinants of health practice models within community pharmacy. J Am Pharm Assoc (2003) 2022; 62:1407-1416. [PMID: 35256284 DOI: 10.1016/j.japh.2022.02.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/26/2022] [Accepted: 02/07/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND While community pharmacies are an ideal setting for social needs screening and referral programs, information on social risk assessment within pharmacy practice is limited. OBJECTIVES Our primary objective was to describe 2 social determinant of health (SDOH) practice models implemented within community pharmacies. The secondary objective was to evaluate implementation practices utilizing the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. PRACTICE DESCRIPTION Two pharmacy groups participated in a 3-month study, one in New York (9 pharmacies) and another in Missouri (1 pharmacy). The New York pharmacies implemented an SDOH specialist practice model, in which pharmacy staff members facilitate the program. The Missouri pharmacy implemented a community health worker (CHW) model by cross training their technicians. Each pharmacy developed their program using the Community Pharmacy Enhanced Services Network Care Model. PRACTICE INNOVATION Both programs expanded the technician role to take on additional responsibilities. The SDOH specialist model partnered with a local independent practice association to create a social needs referral program using a technology platform for closed-loop communication. All workflow steps of the self-contained CHW program were completed within the pharmacy, placing additional responsibility on the CHW and pharmacy staff. EVALUATION METHODS RE-AIM framework dimensions of Reach, Effectiveness, and Adoption. RESULTS Social challenges were identified in 49 of 76 (65%) generated SDOH screenings. The most prevalent social needs reported were affordability of daily needs (33%) and health care system navigation (15%). While most pharmacy staff indicated that workflow steps were clearly defined, assessments and referral tools were identified as potential gaps. While approximately 50% of pharmacy staff were comfortable with their assigned roles and in addressing SDOH challenges, physical and mental health concerns required additional education for intervention. CONCLUSION The successful implementation of community pharmacy SDOH programs connected patients with local resources. Community pharmacies are ideally positioned to expand their public health footprint through SDOH interactions that consequently improve patient care.
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Corelli RL, Merchant KR, Hilts KE, Kroon LA, Vatanka P, Hille BT, Hudmon KS. Community pharmacy technicians' engagement in the delivery of brief tobacco cessation interventions: Results of a randomized trial. Res Social Adm Pharm 2022; 18:3158-3163. [PMID: 34544660 PMCID: PMC8898316 DOI: 10.1016/j.sapharm.2021.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/31/2021] [Accepted: 09/04/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND In recent years, the role of community pharmacy technicians has expanded to include involvement in the provision of brief tobacco cessation interventions. While technicians appear to be a key component in this service, their level of engagement and associated perceptions of this new role have not been described. OBJECTIVE To compare pharmacy technicians' frequency of involvement in brief tobacco cessation interventions delivered in a community pharmacy setting, as a function of training approach, and to characterize their perceptions of this expanded role, including barriers to implementation. METHODS Twenty California-based grocery store chain pharmacies were randomized to receive (a) written training materials-only [minimal] or (b) written training materials plus live training with coaching and active monitoring by pharmacy management [intensive]. After written materials were distributed to the sites, tobacco cessation interventions were documented prospectively for 12 weeks post-training. RESULTS Over the 12-week study, technicians (n = 50) documented their involvement in 524 interventions (57.7% of 908 total), with the minimal group accounting for 56.1% and the intensive group accounting for 43.9% (p < 0.001). The number of individual technicians who reported at least one intervention was 16 (of 26; 61.5%) in the minimal group and 24 (of 24; 100%) in the intensive group (p < 0.001). At the conclusion of the study, 100% of technicians in the intensive group self-rated their ability to interact with patients about quitting smoking as good, very good, or excellent compared to 73.9% in the minimal group (p = 0.10). CONCLUSION In both study arms, technicians documented high numbers of tobacco cessation interventions. The higher proportion of technicians providing one or more interventions in the intensive group suggests a greater overall engagement in the process, relative to those receiving minimal training. Technicians can play a key role in the delivery of tobacco cessation interventions in community pharmacies.
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Affiliation(s)
- Robin L Corelli
- University of California, San Francisco School of Pharmacy, San Francisco, CA 94143, USA.
| | - Kyle R Merchant
- University of California, San Francisco School of Pharmacy, San Francisco, CA 94143, USA
| | - Katy Ellis Hilts
- Indiana University School of Nursing, Indianapolis, IN 46202, USA
| | - Lisa A Kroon
- University of California, San Francisco School of Pharmacy, San Francisco, CA 94143, USA
| | - Parisa Vatanka
- University of California, San Francisco School of Pharmacy, San Francisco, CA 94143, USA; American Pharmacists Association, Washington DC, 20037, USA
| | | | - Karen Suchanek Hudmon
- University of California, San Francisco School of Pharmacy, San Francisco, CA 94143, USA; Purdue University College of Pharmacy, Indianapolis, IN 46202, USA
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Wild D. ASHP Pharmacy Technician Forum Executive Committee. Am J Health Syst Pharm 2022; 79:1222-1223. [PMID: 35760557 DOI: 10.1093/ajhp/zxac173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Traynor K. Pharmacy technicians find influence, acceptance as pharmacy board members. Am J Health Syst Pharm 2022; 79:1221-1222. [PMID: 35760580 DOI: 10.1093/ajhp/zxac174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Wild D. ASHP Pharmacy Technician Forum Executive Committee. Am J Health Syst Pharm 2022; 79:930-931. [PMID: 35466997 DOI: 10.1093/ajhp/zxac114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Adams AJ, Bright D, Adams J. Pharmacy technician-administered immunizations: A five-year review. J Am Pharm Assoc (2003) 2021; 62:419-423. [PMID: 34857489 PMCID: PMC8590632 DOI: 10.1016/j.japh.2021.11.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 11/04/2021] [Accepted: 11/09/2021] [Indexed: 11/28/2022]
Abstract
In October 2020, the U.S. Department of Health and Human Services (HHS) issued guidance authorizing trained pharmacy technicians in all states to administer immunizations. Given that this action is temporary, it will be necessary for states to adopt their own legislation or regulations to sustain these efforts beyond the coronavirus pandemic. At least 11 different immunization administration training programs have emerged for pharmacy technicians. An increasing number of publications have emerged on pharmacy technician immunization administration, demonstrating the ability to train technicians and have them safely administer immunizations in practice. Supervising pharmacists reported initial hesitancy but strong acceptance of delegating this task after experience in practice. States should look to expand and make permanent the authority of pharmacy technicians to ensure these benefits can continue to be realized after the HHS guidance expires.
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Olson KL, Stine JM, Stadler SL, Angleson J, Campbell SM, Friesleben C, Schimmer JJ. Using pharmacy technicians and electronic health record capabilities to improve outcomes for patients with cardiovascular disease. J Am Pharm Assoc (2003) 2021; 62:604-611. [PMID: 34753672 DOI: 10.1016/j.japh.2021.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/01/2021] [Accepted: 10/14/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study aimed to compare lipid and blood pressure (BP) control before and after implementing a certified pharmacy technician (CPhT) protocol that optimized electronic health record (EHR) capabilities and shifted work from clinical pharmacy specialists (CPSs) to CPhT. SETTING Kaiser Permanente Colorado's pharmacist-managed cardiac risk reduction service (which manages dyslipidemia, hypertension, and diabetes for all patients with atherosclerotic cardiovascular disease). PRACTICE DESCRIPTION In 2019, a protocol that optimized EHR capabilities and allowed work to be offloaded from CPS to CPhT was implemented. Filtered views within the EHR were created that bucketed patients with specific lipid results criteria. The CPhT protocol provided guidance to CPhT on determining whether patients were at low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein (non-HDL) goals, on appropriate statin intensity, adherent to medications, and whether the most recent BP was controlled. The CPhT notified CPS of uncontrolled patients who would assess and manage these patients, as necessary. The CPhT notified controlled patients of their results. PRACTICE INNOVATION Data on the outcomes of incorporating pharmacy technicians to support CPS clinical activities in ambulatory clinical pharmacy are limited. EVALUATION METHODS This retrospective study compared a "Pharmacist-Driven" (index date: January 1, 2016) with a "Tech-Enhanced" (index date: January 1, 2019) group. The primary outcome was the proportion of patients at all goals defined as LDL-C < 70 mg/dL, non-HDL < 100 mg/dL, and BP < 140/90 mm Hg at 1 year after the index dates. RESULTS There were 6813 patients included (mean age: 70.2 ± 11.1 years, 71.4% male): 3130 and 3683 in the "Pharmacist-Driven" and "Tech-Enhanced" groups, respectively. The proportion of patients who attained LDL-C, non-HDL, and BP goals was higher in the "Tech-Enhanced" group (51.1% vs. 39.7%, P < 0.001) than the "Pharmacist-Driven" group. CONCLUSION A protocol integrating EHR decision support and CPhTs enabled work to shift to from CPS to CPhT and improved clinical outcomes.
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Loiacono MM, Nelson CB, Grootendorst P, Webb MD, Lee Hall L, Kwong JC, Mitsakakis N, Zulueta S, Chit A. Impact of a peer comparison intervention on seasonal influenza vaccine uptake in community pharmacy: A national cluster randomized study. J Am Pharm Assoc (2003) 2021; 61:539-546.e5. [PMID: 33931353 DOI: 10.1016/j.japh.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 04/03/2021] [Accepted: 04/05/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Seasonal influenza vaccine (SIV) uptake in the United States remains suboptimal, requiring new and innovative strategies. OBJECTIVE To evaluate the impact of a behavioral peer comparison (PC) intervention on SIV uptake in community pharmacies across the United States. METHODS A cluster randomized study was conducted across a national network of Walmart community pharmacies (> 4500 sites) during the 2019-2020 influenza season. The clusters consisted of 416 markets, each containing an average of 11 pharmacies. All pharmacies in a market were randomly assigned to either no intervention or the PC intervention, a software-delivered communication informing on-site staff, including pharmacists and pharmacy technicians, of their pharmacy's weekly performance, measured as SIV doses administered, compared with that of peer pharmacies within their market. The outcome was the pharmacy-level cumulative SIV doses administered during the intervention period (September 1, 2019,-February 29, 2020). Linear regression models were used to estimate the PC impact, with multiway cluster-robust SEs estimated by market and state. RESULTS A total of 4589 pharmacies were enrolled in the study, with 2297 (50.1%) randomized to the control group and 2292 (49.9%) randomized to the PC intervention group. Overall, compared with the control pharmacies, the PC pharmacies administered 3.7% (95% CI -0.3% to 7.9%) additional SIV doses. Among large-format pharmacies, the PC pharmacies administered 4.1% (95% CI 0.1%-8.3%) additional SIV doses compared with the controls. Historically low-performing large-format PC pharmacies administered 6.1% (95% CI 0.5%-11.9%) additional SIV doses compared with the controls. No statistically significant treatment effects were observed among small-format pharmacies. CONCLUSION Our findings demonstrate that PCs can improve SIV uptake among large-format community pharmacies, with historically low-performing pharmacies potentially exhibiting the greatest relative impact. Wide-scale implementation of PCs in community pharmacies may help to further improve SIV uptake in these settings.
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Zamani M, Chan K, Wilcox J. Pharmacy Technicians' Perceptions of Risk Reduction Strategies Implemented in Response to the Repetitive Strain Injury Associated with Sterile Compounding. Int J Pharm Compd 2021; 25:182-186. [PMID: 34125707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Following a 240% increase in the number of compounded sterile preparations between 2012 and 2013, three pharmacy technicians at a metropolitan public hospital suffered hand-related, repetitive strain injuries. This study describes the main safety measures implemented to reduce the risk of repetitive strain injuries associated with sterile compounding at the study hospital, and reports pharmacy technicians' perceptions of their effectiveness. The implemented risk reduction strategies were categorized into five domains of 1) equipment and consumables, 2) training and assessment, 3) Lean waste reduction, 4) roster and shift limits, and 5) workload allocation score. Pharmacy technicians' feedback was collected through an anonymous survey in 2020, five years after the implementation of all safety measures. Responders rated their perceived effectiveness of each strategy domain using a five-point Likert Scale, ranging from very ineffective to very effective. All pharmacy technicians who had been undertaking aseptic compounding activities for at least one year between 2015 and 2020 were invited to take the survey. The five domains of 1) equipment and consumables, 2) training and assessment, 3) Lean waste reduction, 4) roster and shift limits, and 5) workload allocation score were rated effective or very effective by 86%, 67%, 86%, 57%, and 71% of pharmacy technicians, respectively (n=7). The overall effectiveness of all interventions combined was rated effective or very effective by 72% of the participants. Pharmacy technicians' feedback indicates the majority perceive the implemented strategies effective in reducing the risk of repetitive strain injuries associated with aseptic compounding.
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Affiliation(s)
- Mazdak Zamani
- Pharmacy Department, Eastern Health, Melbourne, Victoria, Australia.
| | - Kayin Chan
- Pharmacy Department, Eastern Health, Melbourne, Victoria, Australia
| | - Julie Wilcox
- Pharmacy Department, Eastern Health, Melbourne, Victoria, Australia
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Gundrum D, Brown K, Collingridge DS. Chemotherapy order second check and error discovery rates by pharmacists and technicians. J Am Pharm Assoc (2003) 2021; 61:e132-e141. [PMID: 34023280 DOI: 10.1016/j.japh.2021.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 12/04/2020] [Accepted: 04/09/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND The American Society of Health-System Pharmacists suggests that pharmacy practice models allow pharmacists to be readily available as organizational leaders. This project aimed to identify potential process improvements to increase pharmacist availability to perform more clinical activities. OBJECTIVE We evaluated the effectiveness of pharmacy technicians performing chemotherapy second checks at an outpatient infusion clinic. PRACTICE DESCRIPTION Intermountain Medical Center is a Level 1 Trauma Center. The infusion clinic treats a variety of oncology indications, with solid organ tumors being most prevalent. At Intermountain Healthcare, a second pharmacist reverifies all chemotherapy orders for accuracy of drug, dose, preparation, and administration instructions. PRACTICE INNOVATION Pharmacy technicians are in a unique position to assist with chemotherapy second checks because they are already knowledgeable in compounding and reviewing chemotherapy. This would be particularly useful in rural settings where staffing is sparse. EVALUATION METHODS This was a single-center prospective analysis of chemotherapy second-check processes at an outpatient infusion clinic. Once chemotherapy orders were sent to the infusion clinic, first and second checks were completed to verify the correct patient, medication(s), dose calculations, diluents, administration rates, volumes, and other instructions. The chemotherapy first checks were completed by a pharmacist. The second checks were completed by a second pharmacist and a chemotherapy-trained certified pharmacy technician. The second checks by the pharmacist and technician were compared to determine if they were in agreement regarding error identification. Any disagreements found between the 2 second checks or between the first check and either of the second checks were discussed before compounding. We evaluated whether a chemotherapy-trained pharmacy technician could identify the same errors as a pharmacist. RESULTS The Cohen kappa test was used to determine rater agreement between the pharmacist and technician second checks. The kappa value measure of inter-rater reliability between pharmacist and chemotherapy-trained pharmacy technician was excellent (kappa = 0.88, P < 0.001). They agreed 96.8% of the time, with technicians correctly identifying more errors. CONCLUSION This project illustrates that chemotherapy-trained pharmacy technicians may be capable of performing chemotherapy second checks as accurately as pharmacists.
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Gadallah A, McGinnis B, Nguyen B, Olson J. Assessing the impact of virtual medication history technicians on medication reconciliation discrepancies. Int J Clin Pharm 2021; 43:1404-1411. [PMID: 33871769 DOI: 10.1007/s11096-021-01267-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 04/07/2021] [Indexed: 11/25/2022]
Abstract
Background To overcome resource limitations, Ascension hospitals have implemented a virtual pharmacy technician program to facilitate the completion of medication histories in select emergency departments. Objective This multicenter retrospective study aimed to assess the impact of taking a medication history virtually by pharmacy technicians on medication reconciliation accuracy in comparison to other clinicians. Setting Ascension Seton hospitals in Austin, Texas, United States. Method A retrospective chart review including patients above the age of 18, who were directly admitted from the emergency department between January 1, 2019 and August 31, 2019. Study investigators identified, quantified and categorized unintentional discrepancies by comparing medication histories to reconciled medication orders at admission. Descriptive analysis was applied to patient demographics. Mann-Whitney U and chi-square tests were applied to continuous and categorical outcomes, respectively. Main outcome measure The type and number of unintentional discrepancies at admission. Results In 208 patients, a total of 190 unintentional discrepancies were identified. The rate of unintentional discrepancies per medication was significantly lower for virtual pharmacy technicians than other clinicians (8.6% vs. 14.8% respectively, p < 0.0001). The most common type of unintentional discrepancies was omission in both groups. Length of stay, readmissions, and emergency department visits were similar in both groups. The rate of incomplete medication histories was significantly lower for virtual pharmacy technicians than other clinicians (6.7% vs. 62.5% respectively, p < 0.0001). Conclusion Implementing a virtual medication history technician program in the emergency department can revolutionize the medication history completion process and lower unintentional medication discrepancy rates.
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Affiliation(s)
| | - Brandy McGinnis
- Ascension Texas Department of Pharmacy, Austin, TX, USA
- University of Texas College of Pharmacy, Austin, TX, USA
| | - Brian Nguyen
- Ascension Texas Department of Pharmacy, Austin, TX, USA
| | - Jon Olson
- Ascension Texas Department of Pharmacy, Austin, TX, USA
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Carico R, West R, Miller T, Brown J, Baum D, Dunaway S, Hill A, Finley W, Bates J, Fenerty J. Evaluation of a pharmacy technician-based medication prior authorization program. J Am Pharm Assoc (2003) 2021; 61:425-431. [PMID: 33771445 DOI: 10.1016/j.japh.2021.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/12/2021] [Accepted: 02/22/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND The roles of pharmacy technicians in clinical practice are being explored. Medication prior authorizations (PAs) from insurers can lead to delays in pharmacotherapy. OBJECTIVE To assess the efficiency of our clinical pharmacy technicians in processing PAs for medications. PRACTICE DESCRIPTION Outpatient clinics in a comprehensive health care provider group. PRACTICE INNOVATION PA requests are routed to technicians for initial data collection. Clinical pharmacists can review their work before submission. EVALUATION METHODS Clinical 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. RESULTS Overall, 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%). CONCLUSION In 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.
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Ebbens MM, van Dorp ELA, Gombert-Handoko KB, van den Bemt PMLA. Pre-operative medication reconciliation by pharmacy technicians or anaesthesiologists. Eur J Anaesthesiol 2021; 38 Suppl 1:S71-S72. [PMID: 33645936 DOI: 10.1097/eja.0000000000001390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Marieke M Ebbens
- From the Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, Leiden (MME, KBG-H), Department of Pharmacy, St Jansdal Hospital, Harderwijk (MME), Department of Anesthesiology, Leiden University Medical Center, Leiden (ELAvD), Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen (PMLAvdB), Erasmus University Medical Center Rotterdam, Department of Hospital Pharmacy, Rotterdam. Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands (MME, PMLAvdB)
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Besson C, Chareyre S, Kirouani N, Jean-Jean S, Bretagnolle C, Henry A, Leboucher G, Charpiat B. [Contribution of a hospital pharmacy team to critical care of patients infected with SARS-CoV-2]. Ann Pharm Fr 2021; 79:473-480. [PMID: 33516718 PMCID: PMC7844381 DOI: 10.1016/j.pharma.2021.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 01/08/2021] [Accepted: 01/12/2021] [Indexed: 11/19/2022]
Abstract
Le circuit du médicament hospitalier le plus sûr est la dispensation journalière individuelle nominative automatisée assurée par la pharmacie. Depuis plusieurs années nous essayons de convaincre les décideurs hospitaliers de l’implanter dans notre établissement. En attendant, pour pallier les risques d’erreurs médicamenteuses encourus par les patients et les soignants, nous avons constitué plusieurs équipes de travail au sein des unités de soins. Ces équipes sont constituées d’un pharmacien et d’un ou deux préparateurs en pharmacie hospitalière qui assurent notamment la gestion des armoires à pharmacie des unités de soins. La collaboration étroite avec médecins et personnel infirmier développée au fil des années a été un élément favorable déterminant lorsqu’il a fallu doter en médicaments et en dispositifs médicaux stériles (DMS) les nouvelles unités de soins critiques face à l’afflux de patients contaminés par le SARS-CoV2. Le suivi quotidien des médicaments consommés par patient, particulièrement les curares, et des DMS en rupture d’approvisionnement a été un élément clé de la gestion des stocks et des changements de principes actifs, de conditionnements et/ou de références de matériel. Les faits relatés donnent du poids au rapport Claris qui souligne les effets positifs en termes de qualité et de sécurité de prise en charge des patients du travail des PPH et pharmaciens dans les unités de soins. Ils soulignent par ailleurs les dangers auxquels sont exposés patients et soignants samedi, dimanche et jours fériés quand la pharmacie est fermée. Ils légitiment la question de l’extension de l’ouverture de la pharmacie en équipe complète 365 jours par an.
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Affiliation(s)
- C Besson
- Service pharmaceutique, hôpital de la Croix-Rousse, groupement hospitalier nord, Hospices Civils de Lyon, 103, Grande rue de la Croix-Rousse, 69317 Lyon cedex 04
| | - S Chareyre
- Service pharmaceutique, hôpital de la Croix-Rousse, groupement hospitalier nord, Hospices Civils de Lyon, 103, Grande rue de la Croix-Rousse, 69317 Lyon cedex 04
| | - N Kirouani
- Service pharmaceutique, hôpital de la Croix-Rousse, groupement hospitalier nord, Hospices Civils de Lyon, 103, Grande rue de la Croix-Rousse, 69317 Lyon cedex 04
| | - S Jean-Jean
- Service pharmaceutique, hôpital de la Croix-Rousse, groupement hospitalier nord, Hospices Civils de Lyon, 103, Grande rue de la Croix-Rousse, 69317 Lyon cedex 04
| | - C Bretagnolle
- Service pharmaceutique, hôpital de la Croix-Rousse, groupement hospitalier nord, Hospices Civils de Lyon, 103, Grande rue de la Croix-Rousse, 69317 Lyon cedex 04
| | - A Henry
- Service pharmaceutique, hôpital de la Croix-Rousse, groupement hospitalier nord, Hospices Civils de Lyon, 103, Grande rue de la Croix-Rousse, 69317 Lyon cedex 04
| | - G Leboucher
- Service pharmaceutique, hôpital de la Croix-Rousse, groupement hospitalier nord, Hospices Civils de Lyon, 103, Grande rue de la Croix-Rousse, 69317 Lyon cedex 04
| | - B Charpiat
- Service pharmaceutique, hôpital de la Croix-Rousse, groupement hospitalier nord, Hospices Civils de Lyon, 103, Grande rue de la Croix-Rousse, 69317 Lyon cedex 04.
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Hopkins R, Josma D, Morris J, Klepser DG, Young HN, Crawford ND. Support and perceived barriers to implementing pre-exposure prophylaxis screening and dispensing in pharmacies: Examining concordance between pharmacy technicians and pharmacists. J Am Pharm Assoc (2003) 2020; 61:115-120. [PMID: 33214059 DOI: 10.1016/j.japh.2020.10.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/30/2020] [Accepted: 10/06/2020] [Indexed: 01/02/2023]
Abstract
OBJECTIVES Recent legislation to expand pre-exposure prophylaxis (PrEP) screening and dispensing in pharmacies may significantly improve PrEP access for people at a high risk of human immunodeficiency virus (HIV) transmission. Studies have shown that pharmacists show wide support for PrEP expansion in pharmacies. However, pharmacy technicians are often the first point of contact for patients in pharmacies and are required to implement many of the tasks to ensure patients of a pharmacy receive adequate services. The purpose of this study was to assess pharmacists' and pharmacy technicians' perspectives regarding the implementation of PrEP screening and dispensing. METHODS We qualitatively examined whether pharmacy technicians' (n = 6) support and perceived barriers to screening and dispensing PrEP in pharmacies were concordant with those of pharmacists (n = 7). Pharmacy staff were recruited from high-risk HIV neighborhoods in Atlanta, GA using AIDSVu (Atlanta, GA). Two independent coders used MAXQDA (Berlin, Germany) and performed thematic data analysis and unitization to determine agreement. RESULTS Pharmacists and pharmacy technicians expressed strong willingness and support for screening and dispensing PrEP in pharmacies. Both groups expressed concerns about the time and the resources needed to perform PrEP screening and dispensing. Technicians, however, also reported concerns about privacy for patients, the need for community support and awareness of pharmacy-based PrEP screening, and recommended scheduling of PrEP screening activities during a limited part of the day to facilitate screening. Pharmacists reported fewer barriers but reported a need for more training of pharmacy staff to assist with PrEP screening and dispensing implementation. CONCLUSION Pharmacy technicians discussed more barriers compared with pharmacists who were largely centered around practical considerations (i.e., logistics and workflow) that may affect the success of PrEP screening and dispensing. Given technicians' pivotal role in the pharmacy, implementation of pharmacy-based PrEP services should address technicians' perceived barriers in addition to those of pharmacists.
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Dirbas M, AbuSara AK, Whiyabi S, Harb R, Telfah S. Establishing a Structured Pharmacy Training Program in Sterile Compounding. Int J Pharm Compd 2020; 24:460-465. [PMID: 33217735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The objective of this study was to describe a structured pharmacy training program in sterile compounding in a comprehensive cancer center in Jordan. A previously performed gap analysis showed a degree of non-compliance with the international standards in certain elements of sterile compounding. A structured training program with theoretical and practical domains was developed and implemented. The trainees were required to complete a compounding competency assessment at the end of the training. A questionnaire was distributed to evaluate the trainees' satisfaction. At one year of implementation, 25 pharmacists and 7 pharmacy technicians were enrolled into the training program. A questionnaire was conducted on 26 trainees. Based on the questionnaire results, 100% of the trainees were satisfied regarding the training objectives and the instructors' performance; 11.5% of the trainees stated that more time is needed for each trainee; and 3.8% said that more time is needed for the discussion. The development and implementation of a pharmaceutical sterile compounding training program in a comprehensive cancer care center was achieved by incorporating theoretical and practical techniques, with documented competency of trainees who reported satisfaction with the program. The optimal time dedicated for this program should be evaluated in future studies.
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Affiliation(s)
- Muhannad Dirbas
- Department of Pharmacy, King Hussein Cancer Center, Amman, Jordan
| | - Aseel K AbuSara
- Department of Pharmacy, King Hussein Cancer Center, Amman, Jordan
| | - Shatha Whiyabi
- Department of Pharmacy, King Hussein Cancer Center, Amman, Jordan
| | - Rema Harb
- Department of Pharmacy, King Hussein Cancer Center, Amman, Jordan
| | - Shorouq Telfah
- Department of Pharmacy, King Hussein Cancer Center, Amman, Jordan.
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Patil T, Mummery J, Salman M, Cooper S, Williams D. "Before the training I just assumed they've done something bad": Reporting on professional training for pharmacy assistants and pharmacy dispensary technicians on medically assisted treatment of opioid dependence. Res Social Adm Pharm 2020; 17:1250-1258. [PMID: 33004304 DOI: 10.1016/j.sapharm.2020.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 08/05/2020] [Accepted: 09/10/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND A study that examined the lived experiences of Medically Assisted Treatment of Opioid Dependence (MATOD) consumers suggested that they had experienced discrimination and stigma in pharmacies in regional Victoria, Australia. To address this, the need for professional training opportunities for Pharmacy Assistants (PAs) and Pharmacy Dispensary Technicians (PTDs) had been emphasised. A research project was undertaken to develop training modules using Social Determinants of Health (SDH) for PAs and PDTs involved in providing MATOD pharmacy services in regional Victoria, and to evaluate their effectiveness. OBJECTIVES The study aimed to examine and evaluate changes in attitudes and practices amongst PAs and PDTs involved in MATOD services in regional Victoria, Australia and who had undertaken the training modules. METHODS The paper reports primarily on the in-depth qualitative interviews that were completed after the training with PAs and PTDs. Thematic analysis was employed to code the data. RESULTS Thematic analysis generated five themes: understanding of the professional role of PAs and PTDs, initial judgements concerning MATOD consumers, reflection on the SDH, training content analysis, and the post-training impact upon Professional Practice. These themes reflected participants' insights with regards both to MATOD consumers and the impact the training itself had had on their professional practice. CONCLUSION "Consciousness-raising" from participation in the training can positively influence the development of participants' professional attitudes and practices with regards to MATOD service delivery. This development supports that training informed by SDH and ideas of critical reflection can help facilitate the creation of knowledge around the social construction of health and increased understanding of the impacts of language-use, attitudes and behaviour.
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Affiliation(s)
| | - Jane Mummery
- School of Arts, Federation University, Australia.
| | | | - Simon Cooper
- School of Arts, Federation University, Australia.
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Aly M, Schneider CR, Sukkar MB, Lucas C. Educational needs of community pharmacy staff in minor ailment service delivery: A systematic scoping review. Curr Pharm Teach Learn 2020; 12:1269-1287. [PMID: 32739065 DOI: 10.1016/j.cptl.2020.05.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 03/11/2020] [Accepted: 05/29/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Minor ailment services (MASs) are structured, protocol driven pharmacy services established locally or nationally. Community pharmacy staff may benefit from education and training to deliver MASs. Our objective was to examine the evidence regarding training, education, and assessment requirements associated with the delivery of MASs by community pharmacists and other community pharmacy staff. METHODS Two independent literature search strategies were conducted to examine the grey literature and scientific literature. Inclusion criteria consisted of English written literature related to the training of pharmacists, medicine counter assistants (MCAs), pharmacy technicians, and pharmacy students in the context of MASs. RESULTS Sixty-six grey literature records (n = 57) and scientific articles (n = 9) met inclusion criteria. Most trainings targeted community pharmacists and focused on clinical care aspects that did not include guidance on service parameters and MAS delivery. Training lacked uniformity and varied in terms of time commitment, cost, curricula, and assessment processes. Limited training was identified for community pharmacy staff, particularly MCAs. IMPLICATIONS MAS training is primarily provided for community pharmacists, with scant MAS training for community pharmacy support staff. Furthermore, existing training for any stakeholder group did not include guidance pertaining to service delivery. A structured training approach for the entire community pharmacy team is recommended to promote MAS outcomes and deliver a robust, high quality service. Detailed protocols and guidelines may be needed to ensure skilled MAS providers can deliver quality patient care.
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Affiliation(s)
- Mariyam Aly
- Graduate School of Health (Pharmacy), University of Technology Sydney, 2007 Sydney, New South Wales, Australia.
| | - Carl R Schneider
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Sydney, New South Wales, Australia.
| | - Maria B Sukkar
- Graduate School of Health (Pharmacy), University of Technology Sydney, 2007 Sydney, New South Wales, Australia.
| | - Cherie Lucas
- Graduate School of Health (Pharmacy), University of Technology Sydney, 2007 Sydney, New South Wales, Australia.
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Crul M, Hilhorst S, Breukels O, Bouman-d'Onofrio JRC, Stubbs P, van Rooij JG. Occupational exposure of pharmacy technicians and cleaning staff to cytotoxic drugs in Dutch hospitals. J Occup Environ Hyg 2020; 17:343-352. [PMID: 32633703 DOI: 10.1080/15459624.2020.1776299] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Many studies into surface contamination of hospital environments have demonstrated that occupational exposure to cytotoxics through the dermal route remains a possible risk. In this study, we assess the actual dermal exposure of the hands of pharmacy technicians and cleaning personnel in a panel of hospitals performing tasks that pose a risk of exposure. We compare the dermal exposure to a tentative limit value for cyclophosphamide. Pharmacy technicians and cleaning personnel were asked for hand rinsing after performance of nine tasks previously identified as posing a risk of occupational exposure. All samples were analyzed for the presence and quantity of eight antineoplastic drugs. By using data on both the frequency of the performance of the tasks and the measured dermal contamination during these tasks, weekly exposure to the marker drug (cyclophosphamide) was calculated. In five Dutch hospitals, 70 hand rinse samples and 8 blanks were collected. These were analyzed and results were used to calculate weekly exposure. The tentative limit value used was 0.74 µg of cyclophosphamide. For cleaning personnel, all results remained below this threshold value. For pharmacy technicians, the compounding itself also remained well below the limit; however, the task involving preparatory work, as well as the checking of compounded drugs, had a 13% chance of exceeding the limit. All of the highest values were found when employees were not wearing gloves on these tasks. Cleaning personnel and pharmacy technicians compounding cytotoxic drugs in our study were sufficiently protected from occupational exposure. In contrast, pharmacy technicians who perform preparatory and finishing tasks (before and after the actual compounding) are not protected enough when they do not wear gloves.
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Affiliation(s)
- Mirjam Crul
- Department of Clinical Pharmacology and Pharmacy, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Simone Hilhorst
- Department of Human Resources, Occupational Health Services, Ziekenhuis de Gelderse Vallei, Ede, The Netherlands
| | - Oscar Breukels
- Department of Hospital Pharmacy, Meander Medical Center, Amersfoort, The Netherlands
| | | | - Percival Stubbs
- Department of Human Resources, Healthteam, Haaglanden Medical Center, The Hague, The Netherlands
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Novais T, Chomel M, Dauphinot V, Mouchoux C. Caregiver in Alzheimer's disease, pharmacist, and pharmacy technician attitudes and knowledge about caregiver burden screening in community pharmacies. Ann Pharm Fr 2020; 78:199-205. [PMID: 32037030 DOI: 10.1016/j.pharma.2019.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/25/2019] [Accepted: 12/05/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To explore caregiver, pharmacist and pharmacy technician attitudes toward burden screening in community pharmacies and assess caregiver burden in community pharmacies. METHODS Descriptive cross-sectional study conducted in 10 community pharmacies in France. Pharmacists, pharmacy technicians and caregivers of patients with Alzheimer's disease were included in this study. Two self-reported questionnaires were used to explore attitudes of participants toward the burden screening in community pharmacy and to assess the caregiver burden in community pharmacy. The short version of the Zarit Burden Interview (range 0-7) was used for the burden screening. RESULTS Fifty-two pharmacists and pharmacy technicians, and 20 caregivers (61.8±13.7years) participated in this study. Seventy percent of caregivers and 96% of pharmacists/pharmacy technicians stated that caregiver burden screening should be conducted in community pharmacies. 65% of caregivers reported their caregiver status to their community pharmacist. Eighty-two percent of pharmacist/pharmacy technicians thought they had to inform the caregiver's general practitioners (GP) about the detected burden level. Of the 20 included caregivers, 18 had a perception of burden. The mean caregiver burden score detected in this exploratory study was 4.0±1.7, corresponding to a moderate to severe burden. CONCLUSIONS According to caregivers' opinion, community pharmacists and pharmacy technicians represent accessible health care professionals in primary care to quantify caregiver burden. The burden screening can be easily incorporated into clinical service offerings in community pharmacy practice. It provides a valuable opportunity to identify high-risk caregivers with the aim of referring them to their GP to prevent the caregiver's frailty.
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Affiliation(s)
- T Novais
- EA-7425 HESPER, Health Services and Performance Research, université de Lyon, 69003 Lyon, France; Service pharmaceutique, hôpital des Charpennes, hospices civils de Lyon, 69100 Lyon, France; Université Lyon 1, 69000 Lyon, France.
| | - M Chomel
- Université Lyon 1, 69000 Lyon, France
| | - V Dauphinot
- Centre mémoire ressource et recherche de Lyon (CMRR), hôpital des Charpennes, hospices civils de Lyon, 69100 Lyon, France
| | - C Mouchoux
- Service pharmaceutique, hôpital des Charpennes, hospices civils de Lyon, 69100 Lyon, France; Université Lyon 1, 69000 Lyon, France; Équipe dynamique cérébrale et cognition, Inserm U1028, CNRS UMR5292, centre de recherche en neuroscience de Lyon, 69000 Lyon, France
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Hohmann LA, Hastings TJ, Ha DR, Garza KB, Huston SA, Chen L, Westrick SC. Impact of a multi-component immunization intervention on pneumococcal and herpes zoster vaccinations: A randomized controlled trial of community pharmacies in 2 states. Res Social Adm Pharm 2019; 15:1453-1463. [PMID: 30777645 DOI: 10.1016/j.sapharm.2019.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 12/02/2018] [Accepted: 01/09/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND The purpose of this study was to assess the impact of the We Immunize Program on structures, processes, and outcomes of pneumococcal and herpes zoster pharmacy-based immunization services. METHODS Pharmacy-technician pairs from 62 Alabama and California community pharmacies participated in a 6-month randomized controlled trial (intervention = 30/control = 32). All received immunization update training; intervention participants also received practical strategies training and monthly telephonic expert feedback. Completion of immunization service structure and process activities were analyzed using Fisher's Exact and one-way Mann-Whitney U tests. The primary outcome, change in number of pneumococcal, herpes zoster, and total vaccine doses administered, was assessed using one-way Wilcoxon signed rank and Mann-Whitney U tests. Associations between program and vaccine doses across time were explored using generalized estimating equations (GEE). RESULTS Intervention pharmacies completed more structure (median 12.00 versus 9.00, p = 0.200) and process activities (median 8.00 versus 7.00, p = 0.048) compared to control. Statistically significant increases in the median number of pneumococcal vaccine doses (7.50-12.00 doses, p = 0.007), and total vaccine doses (12.50-28.00 doses, p = 0.014) were seen from baseline to post-intervention within the intervention group. However, these changes were not statistically significant when compared to the control group (pneumococcal p = 0.136, total p = 0.202). Changes in median herpes zoster vaccine doses did not reach significance among intervention (8.50-9.00, p = 0.307) or control (9.00-13.00, p = 0.127) pharmacies. CONCLUSIONS Practical strategies training combined with tailored expert feedback enhanced existing pneumococcal immunization services in community pharmacies. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02615470.
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Affiliation(s)
- Lindsey A Hohmann
- Auburn University Harrison School of Pharmacy, Department of Health Outcomes Research and Policy, 020 James E. Foy Hall, Auburn, AL, 36849, USA.
| | - Tessa J Hastings
- Auburn University Harrison School of Pharmacy, Department of Health Outcomes Research and Policy, 020 James E. Foy Hall, Auburn, AL, 36849, USA.
| | - David R Ha
- Keck Graduate Institute School of Pharmacy, 535 Watson Drive, Claremont, CA, 91711, USA.
| | - Kimberly B Garza
- Auburn University Harrison School of Pharmacy, Department of Health Outcomes Research and Policy, 020 James E. Foy Hall, Auburn, AL, 36849, USA.
| | - Sally A Huston
- Keck Graduate Institute School of Pharmacy, 535 Watson Drive, Claremont, CA, 91711, USA.
| | - Li Chen
- Auburn University Harrison School of Pharmacy, Department of Health Outcomes Research and Policy, 020 James E. Foy Hall, Auburn, AL, 36849, USA.
| | - Salisa C Westrick
- Auburn University Harrison School of Pharmacy, Department of Health Outcomes Research and Policy, 020 James E. Foy Hall, Auburn, AL, 36849, USA.
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Wigmore BC, Collins JC, Schneider CR, Arias D, Moles RJ. Ability of Pharmacy Students, Pharmacists and Pharmacy Support Staff to Manage Childhood Fever via Simulation. Am J Pharm Educ 2018; 82:6445. [PMID: 30643307 PMCID: PMC6325453 DOI: 10.5688/ajpe6445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 11/16/2017] [Indexed: 06/09/2023]
Abstract
Objective. To ascertain how pharmacy students (novices) and pharmacy staff (experts) respond to a childhood fever scenario. Methods. Data were collected from 65 second year students and 51 fourth (final) year students in an over-the-counter fever scenario during assessment tasks. Data from pharmacy staff were collected via mystery shopping conducted over nine weeks between March and October 2015. All encounters were immediately scored by the trained simulated client, and immediate feedback was provided for pharmacy staff and fourth year students. Questioning scores and proportions of competent participants were collected in all groups. Statistical comparative analyses were made between fourth year students and pharmacy staff. Pharmacy staff scores were also tracked over time. Results. Second year students performed well, achieving a median questioning score of 100%. Conversely, pharmacy staff scored 22%. A large proportion of the fourth year students and pharmacy staff achieved appropriate outcomes (92% and 65%, respectively); however, a smaller proportion of second year students performed well (52%). The pharmacy staff achieved statistical improvements over time for median questioning scores. Conclusion. Protocol compliant questioning appears to decline with experience. However, experienced counselors are more likely to provide appropriate patient advice. Further improvements in outcomes can also occur when staff are provided feedback and coaching. Mystery shopping simulations can be used as a valuable educational tool.
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Affiliation(s)
- Beatrice C. Wigmore
- King’s College, London, United Kingdom
- The University of Sydney, Sydney, Australia
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Gebresillassie BM, Belachew SA, Tefera YG, Abebe TB, Mekuria AB, Haile KT, Erku DA. Evaluating patients', physicians' and pharmacy professionals' perception and concern regarding generic medicines in Gondar town, northwest Ethiopia: A multi-stakeholder, cross-sectional survey. PLoS One 2018; 13:e0204146. [PMID: 30403668 PMCID: PMC6221256 DOI: 10.1371/journal.pone.0204146] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 09/03/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Generic medicine prescribing has become common practice in many countries. However, data regarding the perceptions of stakeholders (patients, prescribers and dispensers) regarding generic medicines in Ethiopia is scarce. The present survey aimed to investigate the perception of patients, physicians and pharmacy professionals regarding generic medicines in Ethiopia. METHODS A quantitative cross-sectional survey was conducted in Gondar town, Northwest Ethiopia between January 1 and February 1, 2017. The questionnaire, comprised of 5-point Likert scale items on perception and concerns regarding generic medicine, was administered to patients, physicians and pharmacy professionals working in the community drug retail outlets. Frequencies, percentages, and median were calculated using Statistical Package for the Social Sciences (SPSS) software version 21.0 for Windows to describe different variables. RESULTS The survey was completed by 612 participants. More than half of patients, 56% (n = 219) knew about the term brand and generic medicines and 38.7% (n = 151) of patients agreed/strongly agreed that brand medicines are more effective. Nearly half, 47% (n = 184) of patients agreed that they should have the option of choosing between generic and brand medicines and 61.4% (n = 240) of patients believed that cost should be considered before a medicineis prescribed. The majority of physicians 70.6% (n = 101) indicated a very low generic medicine prescription rate. 56% (n = 130) of physicians and 87.2% (n = 68) of pharmacy professionals agreed that they need a standard guideline to both prescribers and pharmacists on brand substitution process. Furthermore, 39.9% (n = 57) of the physicians and 87.2% (n = 68) of pharmacy professionals agreed that drug advertisements by the manufacturers would influence their prescribing/dispensing practice. CONCLUSIONS Overall, our findings demonstrate a knowledge gap among patients towards the perception of generics, perceiving generics are less effective and inferior in quality compared to their branded equivalents. The majority of physicians reported a very low generic medicine prescribing rate and the majority pharmacy professionals' dispensing practice was influenced by drug advertisements. Hence, a customized educational program should be developed and implemented to patients, prescribers and dispensers so as to boost the acceptability of generic medicines and increase generic prescribing and/or substitution.
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Affiliation(s)
- Begashaw Melaku Gebresillassie
- Clinical Pharmacy Departments, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Sewunet Admasu Belachew
- Clinical Pharmacy Departments, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yonas Getaye Tefera
- Clinical Pharmacy Departments, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tamrat Befekadu Abebe
- Clinical Pharmacy Departments, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abebe Basazn Mekuria
- Pharmacology Department, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kaleab Taye Haile
- Pharmaceutics and Social Pharmacy Department, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Daniel Asfaw Erku
- Clinical Pharmacy Departments, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Campmans Z, van Rhijn A, Dull RM, Santen-Reestman J, Taxis K, Borgsteede SD. Preventing dispensing errors by alerting for drug confusions in the pharmacy information system-A survey of users. PLoS One 2018; 13:e0197469. [PMID: 29813099 PMCID: PMC5973570 DOI: 10.1371/journal.pone.0197469] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 05/02/2018] [Indexed: 11/25/2022] Open
Abstract
Introduction Drug confusion is thought to be the most common type of dispensing error. Several strategies can be implemented to reduce the risk of medication errors. One of these are alerts in the pharmacy information system. Objective To evaluate the experiences of pharmacists and pharmacy technicians with alerts for drug name and strength confusion. Methods In May 2017, a cross-sectional survey of pharmacists and pharmacy technicians was performed in community pharmacies in the Netherlands using an online questionnaire. Results Of the 269 respondents, 86% (n = 230) had noticed the alert for drug name confusion, and 26% (n = 67) for drug strength confusion. Of those 230, 9% (n = 20) had experienced that the alert had prevented dispensing the wrong drug. For drug strength confusion, this proportion was 12% (n = 8). Respondents preferred to have an alert for drug name and strength confusion in the pharmacy information system. ‘Alert fatigue’ was an important issue, so alerts should only be introduced for frequent confusions or confusions with serious consequences. Conclusion Pharmacists and pharmacy technicians were positive about having alerts for drug confusions in their pharmacy information system and experienced that alerts contributed to the prevention of dispensing errors. To prevent alert fatigue, it was considered important not to include all possible confusions as a new alert: the potential contribution to the prevention of drug confusion should be weighed against the risk of alert fatigue.
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Affiliation(s)
- Zizi Campmans
- Department of Clinical Decision Support, Health Base Foundation, Houten, the Netherlands
- Department of PharmacoTherapy, -Epidemiology & -Economics (PTEE), University of Groningen, Groningen, the Netherlands
| | - Arianne van Rhijn
- Portal for patient safety/Central Medication incidents Registration, Utrecht, the Netherlands
| | - René M. Dull
- SAL pharmacy Schuytgraaf, Arnhem, the Netherlands
| | | | - Katja Taxis
- Department of PharmacoTherapy, -Epidemiology & -Economics (PTEE), University of Groningen, Groningen, the Netherlands
| | - Sander D. Borgsteede
- Department of Clinical Decision Support, Health Base Foundation, Houten, the Netherlands
- Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, the Netherlands
- * E-mail:
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Gurusamy KS, Best LMJ, Tanguay C, Lennan E, Korva M, Bussières J. Closed-system drug-transfer devices plus safe handling of hazardous drugs versus safe handling alone for reducing exposure to infusional hazardous drugs in healthcare staff. Cochrane Database Syst Rev 2018; 3:CD012860. [PMID: 29582940 PMCID: PMC6360647 DOI: 10.1002/14651858.cd012860.pub2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Occupational exposure to hazardous drugs can decrease fertility and result in miscarriages, stillbirths, and cancers in healthcare staff. Several recommended practices aim to reduce this exposure, including protective clothing, gloves, and biological safety cabinets ('safe handling'). There is significant uncertainty as to whether using closed-system drug-transfer devices (CSTD) in addition to safe handling decreases the contamination and risk of staff exposure to infusional hazardous drugs compared to safe handling alone. OBJECTIVES To assess the effects of closed-system drug-transfer of infusional hazardous drugs plus safe handling versus safe handling alone for reducing staff exposure to infusional hazardous drugs and risk of staff contamination. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, OSH-UPDATE, CINAHL, Science Citation Index Expanded, economic evaluation databases, the World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov to October 2017. SELECTION CRITERIA We included comparative studies of any study design (irrespective of language, blinding, or publication status) that compared CSTD plus safe handling versus safe handling alone for infusional hazardous drugs. DATA COLLECTION AND ANALYSIS Two review authors independently identified trials and extracted data. We calculated the risk ratio (RR) and mean difference (MD) with 95% confidence intervals (CI) using both fixed-effect and random-effects models. We assessed risk of bias according to the risk of bias in non-randomised studies of interventions (ROBINS-I) tool, used an intracluster correlation coefficient of 0.10, and we assessed the quality of the evidence using GRADE. MAIN RESULTS We included 23 observational cluster studies (358 hospitals) in this review. We did not find any randomised controlled trials or formal economic evaluations. In 21 studies, the people who used the intervention (CSTD plus safe handling) and control (safe handling alone) were pharmacists or pharmacy technicians; in the other two studies, the people who used the intervention and control were nurses, pharmacists, or pharmacy technicians. The CSTD used in the studies were PhaSeal (13 studies), Tevadaptor (1 study), SpikeSwan (1 study), PhaSeal and Tevadaptor (1 study), varied (5 studies), and not stated (2 studies). The studies' descriptions of the control groups were varied. Twenty-one studies provide data on one or more outcomes for this systematic review. All the studies are at serious risk of bias. The quality of evidence is very low for all the outcomes.There is no evidence of differences in the proportion of people with positive urine tests for exposure between the CSTD and control groups for cyclophosphamide alone (RR 0.83, 95% CI 0.46 to 1.52; I² = 12%; 2 studies; 2 hospitals; 20 participants; CSTD: 76.1% versus control: 91.7%); cyclophosphamide or ifosfamide (RR 0.09, 95% CI 0.00 to 2.79; 1 study; 1 hospital; 14 participants; CSTD: 6.4% versus control: 71.4%); and cyclophosphamide, ifosfamide, or gemcitabine (RR not estimable; 1 study; 1 hospital; 36 participants; 0% in both groups).There is no evidence of a difference in the proportion of surface samples contaminated in the pharmacy areas or patient-care areas for any of the drugs except 5-fluorouracil, which was lower in the CSTD group than in the control (RR 0.65, 95% CI 0.43 to 0.97; 3 studies, 106 hospitals, 1008 samples; CSTD: 9% versus control: 13.9%).The amount of cyclophosphamide was lower in pharmacy areas in the CSTD group than in the control group (MD -49.34 pg/cm², 95% CI -84.11 to -14.56, I² = 0%, 7 studies; 282 hospitals, 1793 surface samples). Additionally, one interrupted time-series study (3 hospitals; 342 samples) demonstrated a change in the slope between pre-CSTD and CSTD (3.9439 pg/cm², 95% CI 1.2303 to 6.6576; P = 0.010), but not between CSTD and post-CSTD withdrawal (-1.9331 pg/cm², 95% CI -5.1260 to 1.2598; P = 0.20). There is no evidence of difference in the amount of the other drugs between CSTD and control groups in the pharmacy areas or patient-care areas.None of the studies report on atmospheric contamination, blood tests, or other measures of exposure to infusional hazardous drugs such as urine mutagenicity, chromosomal aberrations, sister chromatid exchanges, or micronuclei induction.None of the studies report short-term health benefits such as reduction in skin rashes, medium-term reproductive health benefits such as fertility and parity, or long-term health benefits related to the development of any type of cancer or adverse events.Five studies (six hospitals) report the potential cost savings through the use of CSTD. The studies used different methods of calculating the costs, and the results were not reported in a format that could be pooled via meta-analysis. There is significant variability between the studies in terms of whether CSTD resulted in cost savings (the point estimates of the average potential cost savings ranged from (2017) USD -642,656 to (2017) USD 221,818). AUTHORS' CONCLUSIONS There is currently no evidence to support or refute the routine use of closed-system drug transfer devices in addition to safe handling of infusional hazardous drugs, as there is no evidence of differences in exposure or financial benefits between CSTD plus safe handling versus safe handling alone (very low-quality evidence). None of the studies report health benefits.Well-designed multicentre randomised controlled trials may be feasible depending upon the proportion of people with exposure. The next best study design is interrupted time-series. This design is likely to provide a better estimate than uncontrolled before-after studies or cross-sectional studies. Future studies may involve other alternate ways of reducing exposure in addition to safe handling as one intervention group in a multi-arm parallel design or factorial design trial. Future studies should have designs that decrease the risk of bias and enable measurement of direct health benefits in addition to exposure. Studies using exposure should be tested for a relevant selection of hazardous drugs used in the hospital to provide an estimate of the exposure and health benefits of using CSTD. Steps should be undertaken to ensure that there are no other differences between CSTD and control groups, so that one can obtain a reasonable estimate of the health benefits of using CSTD.
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Affiliation(s)
- Kurinchi Selvan Gurusamy
- University College LondonDivision of Surgery and Interventional Science9th Floor, Royal Free HospitalRowland Hill StreetLondonUKNW3 2PF
| | - Lawrence MJ Best
- Royal Free Campus, UCL Medical SchoolDepartment of SurgeryRowland Hill StreetLondonUKNW32PF
| | - Cynthia Tanguay
- CHU Sainte‐JustineUnité de Recherche en Pratique Pharmaceutique3175 Côte Sainte‐CatherineMontrealQuebecCanadaH3T 1C5
| | - Elaine Lennan
- University Hospital SouthamptonDepartment of ChemotherapySouthamptonUK
| | - Mika Korva
- Finnish Institute of Occupational HealthTurkuFinland
| | - Jean‐François Bussières
- CHU Sainte‐JustineUnité de Recherche en Pratique Pharmaceutique3175 Côte Sainte‐CatherineMontrealQuebecCanadaH3T 1C5
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De Weerdt E, De Rijdt T, Simoens S, Casteels M, Huys I. Time spent by Belgian hospital pharmacists on supply disruptions and drug shortages: An exploratory study. PLoS One 2017; 12:e0174556. [PMID: 28350827 PMCID: PMC5370124 DOI: 10.1371/journal.pone.0174556] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 03/10/2017] [Indexed: 12/02/2022] Open
Abstract
Introduction Supply problems of drugs are an increasing and worldwide problem, also in Belgium. Hospital pharmacists try to manage drug supply problems to minimize the impact on patient care. This study aims to quantify in a detailed manner how much time employees of 17 Belgian hospital pharmacies spend on drug supply problems. Methods During six months, employees of Belgian hospital pharmacies filled in the daily time spent on drug supply problems using a template containing all steps which can be executed to manage drug supply problems. Additionally, Belgian hospital pharmacists were asked to report the drugs which experienced drug supply problems together with the solution for this problem. Results Hospital pharmacists spent a median of 109 minutes a week on drug supply problems, with a minimum of 40 minutes per week and a maximum of 216 minutes per week. Fifty-nine percent of the total time spent on drug supply problems was executed by hospital pharmacists, 27% by pharmacy technicians; the rest was performed by logistic or administrative personnel. About one third of the total time spent was invested in gathering information on the supply problem. About two third of the supply disruptions caused drug shortages, meaning there was a need to switch to another (generic) therapeutic alternative. For most drug shortages, a Belgian generic medicine could be found. However in some cases, the alternative had to be ordered abroad or for some drug shortages, no alternative was available. Conclusion These exploratory results on time spent by hospital pharmacists on drug supply problems in Belgium highlight the economic impact of drug supply problems for hospital pharmacies. A fully reliable, daily updated list on the federal agencies websites would be a major help to hospital pharmacists.
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Affiliation(s)
- Elfi De Weerdt
- KU Leuven, Dept. Pharmaceutical and Pharmacological Sciences, Herestraat, Leuven, Belgium
- * E-mail:
| | - Thomas De Rijdt
- University Hospitals Leuven, Pharmacy department, UZ Herestraat, Leuven, Belgium
| | - Steven Simoens
- KU Leuven, Dept. Pharmaceutical and Pharmacological Sciences, Herestraat, Leuven, Belgium
| | - Minne Casteels
- KU Leuven, Dept. Pharmaceutical and Pharmacological Sciences, Herestraat, Leuven, Belgium
| | - Isabelle Huys
- KU Leuven, Dept. Pharmaceutical and Pharmacological Sciences, Herestraat, Leuven, Belgium
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Tanigawa K. [Avoidance of Adverse Drug Reactions by Pharmacists (Through the PreAVOID Report)]. Rinsho Byori 2016; 64:1082-1084. [PMID: 30609463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
As a method to visualize the professional competence of pharmacists, the Japanese Society of Pharmacists has collected and analyzed PreAVOID [be prepared to avoid adverse drug reactions (ADRs) I reports. PreAVOID reports, which refer to cases where ADRs were avoided, are classified into reports of ADR pre- vention and those of the avoidance of ADR aggravation. In the former, pharmacists predicted the develop- ment of ADRs based on their history, a decrease in physical function, the influences of medical treatment, blood drug concentration, and medication history, and made inquiries about prescriptions or gave prescription suggestions to physicians, resulting in avoidance of the development of ADRs before drug administration. In the latter, pharmacists evaluated ADRs that developed in the early stage based on patients' complaints, clini- cal symptoms, and laboratory examination values, and avoided their aggravation. In 2014, the number of PreAVOID reports was 33,348, which consisted of 32,587 reports of ADR prevention and 761 reports of the avoidance of ADR aggravation. Objective evaluation of the reports of the avoidance of ADR aggravation showed pharmacists' marked contribution in about 50%. If pharmaceutical care had not been performed, marked direct health damage may have occurred. ADRs could be prevented or avoided based on laboratory examination values in 32.4%, and patients' complaints in 34.9%. (Review].
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