Despair and hope: Is the retail community pharmacy workforce in danger of becoming a monopsony labor market?

OBJECTIVE: Mergers of big chain retail community pharmacies can affect the competitiveness of the pharmacy workforce to negotiate better wages and work conditions. However, it is unclear whether these types of mergers are generalizable to the U.S. pharmacy workforce. We should observe this effect when comparing annual wage trends between retail community pharmacy workers and nonretail community pharmacy workers. In the absence of this effect, annual wage trends would be similar. To examine this theory, annual wage trends for community pharmacy workers were compared with hospital pharmacy workers between 2012 and 2022. DESIGN, SETTING AND PARTICIPANTS: A serial cross-sectional study was performed to compare the annual wages between retail community pharmacy workers and hospital pharmacy workers between 2012 and 2022 using data from the U.S. Bureau of Labor and Statistics (BLS). Pharmacy workforce was categorized as pharmacists, pharmacy technicians, and pharmacy aides (clerks) and grouped into retail or hospital pharmacy settings based on the North American Industry Classification System. Pharmacy workers' annual wages were based on the U.S. BLS Quarterly Census of Employment and Wages data. OUTCOME MEASURES: Annual wages. RESULTS: Between 2012 and 2022, statistically significant annual wage reduction was greater among pharmacists in the retail than pharmacists in the hospital setting by -$1974 (95% CI -$2921 to -$1026) per year. However, these trends were not statistically significant among pharmacy technicians and pharmacy aides. Pharmacy technicians in the retail and hospital settings had a 3.4% and 7.0% increase in average annual wages, respectively. Pharmacy aides in the retail and hospital settings had a 16.8% and 21.6% increase in average annual wages, respectively. CONCLUSION: Although pharmacists' annual wages decreased, it is unclear whether this was caused by the monopsony labor market. These findings suggest that there may be inefficiencies in the retail community pharmacy labor market, which may stimulate policies to improve pharmacy workforce conditions and patient safety.

A cross-sectional survey of the pharmacy workforce in general practice in Scotland.

BACKGROUND: In Scotland, there has been significant investment in pharmacy teams in general medical practices over recent years, aligned to current government policy. OBJECTIVES: To characterize the national pharmacy workforce including activities undertaken, perceived competence and confidence, as well as perception of integration of the intervention. METHODS: A cross-sectional survey of all pharmacists and pharmacy technicians in general practices. Survey items were demographics, activities undertaken and experiences. The NoMAD tool (Improving the Normalization of Complex Interventions) was included as a measure of perspectives of implementation. Post-piloting, a questionnaire link was sent to all pharmacists (n = 471) and pharmacy technicians (n = 112). A total NoMAD score was obtained by assigning 1 (strongly disagree) to 5 (strongly agree) to each item. RESULTS: Responses were received from 393 (83.4%) pharmacists and 101 (91.8%) pharmacy technicians. Three quarters of pharmacists (74.6%) and pharmacy technicians (73.3%) had been qualified for over 10 years. Two-thirds of pharmacists (68.4%) were independent prescribers, with three quarters (72.3%) currently prescribing. Respondents worked in a median of two practices and were providing a range of activities including medication/polypharmacy reviews, medicines reconciliation, prescribing efficiencies and training. Respondents reported high levels of competence and confidence (median 8, scale 0-10 highest). Median NoMAD total score (scale 20-100 highest, Cronbach's alpha 0.89) was 80 for pharmacists and 75 for pharmacy technicians, P ≤ 0.001. CONCLUSIONS: The general practice pharmacy workforce in Scotland is experienced, well-qualified and integrated within general practices, delivering a range of activities. These findings have implications for workforce planning and future education and training.

Pharmacy Technicians Are People, Too! Let's Consider Their Personal Outcomes Along With Other Pharmacy Outcomes.

Studies have found that expanded pharmacy technician roles can help "free up" pharmacist time, leading to role optimization. However, these studies and the positions taken by many are quite pharmacist-centric. We seem to have underestimated the importance of support staff in pharmacy operations. If research demonstrates that technicians can perform a function safely and effectively, that alone should compel the function's allowance in practice. Freeing up pharmacist time for higher-order care is a positive corollary to technician advancement, but it need not be a precondition for it.

Evaluating the implementation and impact of a pharmacy technician-supported medicines administration service designed to reduce omitted doses in hospitals: a qualitative study.

BACKGROUND: Of the various types of medication administration error that occur in hospitals, dose omissions are consistently reported as among the most common. It has been suggested that greater involvement from pharmacy teams could help address this problem. A pilot service, called pharmacy TECHnician supported MEDicines administration (TECHMED), was introduced in an English NHS hospital for a four-week period in order to reduce preventable medication dose omissions. The objective of this study was to evaluate the implementation, delivery and impact of the pilot TECHMED service using qualitative methods. METHODS: Semi-structured interviews with pharmacy technicians, nursing staff and senior management involved with the pilot service were undertaken to evaluate TECHMED. Interviews were transcribed verbatim and analysed using the framework approach, guided by Weiss's Theory Based Evaluation model. RESULTS: Twenty-two stakeholder interviews were conducted with 10 ward-based pharmacy technicians, nine nurses and three members of senior management. Most technicians performed a range of activities in line with the service specification, including locating drugs from a variety of sources, and identified situations where they had prevented missing doses. Nurses reported positive impacts of TECHMED on workload. However, not all technicians fully adhered to the service specification in regard to directly following nursing staff during each medication round, citing reasons related to productivity or perceived intrusiveness towards nursing staff. Some participants also reported a perceived lack of impact of TECHMED on medicine omissions. Seventeen of the 22 interviewees supported an extension of the service. There were however, concerns about the impact on technician workload and some participants advocated support for targeted service extension to wards/rounds with high schedule dose volumes and omitted dose rates. CONCLUSIONS: The findings of this study suggest that the implementation of a pharmacy technician-supported medicines administration scheme to reduce omitted doses may be acceptable to staff in an NHS hospital, and that issues with service fidelity, staff resource/capacity and perceived interventions to avoid dose omissions have important implications for the feasibility of extending the service. The study has identified targets for future development in relation to individual and system factors to improve operationalisation of technician-led initiatives to reduce medicines omissions.

Assessing pharmacy technician certification: A national survey comparing certified and noncertified pharmacy technicians.

OBJECTIVES: To compare viewpoints of nationally certified and noncertified technicians and explore the perceived value of technician certification in the job performance domains of medication safety, skills and abilities, experience, engagement and satisfaction, and productivity. METHODS: A cross-sectional survey of pharmacy technicians, from 6 states representing 4 regions of the United States, was conducted. Technician mailing lists were purchased from Boards of Pharmacy, and randomly selected technicians were sent survey invitations. Surveys were completed via Qualtrics and analyzed with the use of SAS. RESULTS: Six hundred seventy-six technicians (547 certified, 103 noncertified, and 26 previously certified) responded to the survey (9.4% response rate). Certified technicians reported significantly higher confidence rating for desire to take on new responsibilities (P < 0.01; Cohen d 0.45) and plans to remain in the pharmacy field (P = 0.01, Cohen d 0.35), lower rating for leaving the job in the next 12 months (P < 0.01; Cohen d 0.35), and perceived lower rate of medication errors (P < 0.01; Cohen d 0.35) compared with other technicians in the work setting. The majority of respondents stated confidence in performing the "final check" on another technician's preparation of a new or refill medication if allowed. Both certified and noncertified technicians noted dissatisfaction with pay. The majority of respondents reported that they spent none of or less than 10% of their workday assisting pharmacists with medication therapy management (MTM) sessions, immunizations, or point-of-care tests; however, 71 respondents specifically described how they assist pharmacists with MTM. CONCLUSION: Results from our survey sample indicate that certified technicians have a stronger organizational and career commitment and desire to take on new roles. A majority of respondents noted dissatisfaction with pay but feel a sense of pride in their work. Both groups were confident in their abilities needed for tech-check-tech product verification.

Attitudes and perceptions of naloxone dispensing among a sample of Massachusetts community pharmacy technicians.

OBJECTIVES: There is limited research on the attitudes of pharmacy technicians toward pharmacy naloxone provision, despite their widespread role in the pharmacy. We examined attitudes and perceptions of pharmacy technicians in the provision of naloxone in a sample of Massachusetts pharmacies. DESIGN: Thirty-nine community retail pharmacies from 1 U.S. chain were purposely sampled in 13 municipalities across Massachusetts. Pharmacies were divided into high-risk municipalities (HRMs) versus low-risk municipalities (LRMs) based on the state average opioid-related death rate from 2011 to 2015. SETTING AND PARTICIPANTS: A pharmacy technician working in each pharmacy was administered an in-person survey. Survey topics included technician beliefs about current naloxone provision practices; patient groups at greater risk of overdose; whether individuals filling prescriptions would benefit from naloxone; and whether individuals purchasing syringes would benefit from naloxone. OUTCOME MEASURES: Closed-ended responses were analyzed by Mann-Whitney U, Fisher exact, and chi-square tests. Open-ended responses were summarized for themes and then contrasted by municipality risk status. RESULTS: Technician participation was 100% (n = 39). Technicians in both groups believed they could identify patient groups at risk of overdose in their practice, but HRM technicians recognized the need for naloxone for more of their at-risk patients (81% in HRM vs. 33% in LRM believed > 25% of patients need naloxone, P < 0.01). A willingness to provide naloxone was high (> 89%) in both groups. Open-ended responses revealed commonalities between groups, including the belief that patients need lower-cost naloxone, and a lack of patient and technician awareness that naloxone could prevent overdose in individuals at risk through use of prescription opioids not just through use of illicit drugs. CONCLUSION: Pharmacy technicians would benefit from overdose prevention training and are well positioned to recognize overdose risk and offer preventive interventions, such as naloxone. Among technicians, there is a high willingness to be involved in implementing broader naloxone access in pharmacies.

Advancing the role of the pharmacy technician: A systematic review.

OBJECTIVES: To summarize the findings of a literature search on advancing the role of pharmacy technicians, including the types of training identified and the potential costs and benefits to both the technician and the pharmacy. DATA SOURCES: A literature search of Scopus, Embase, and Medline was conducted on January 11, 2017. STUDY SELECTION: Original research, research reports, case studies, or association reports were included for review. Articles were considered to be relevant based on identification of an advanced pharmacy technician role or addressing additional training/education for technician functions. DATA EXTRACTION: A standard data extraction form was used to collect study authors, article title, year published, journal title, study design, brief description of methods, primary outcome measures, advanced technician roles identified, additional education or training addressed, and additional costs and benefits identified in each article. RESULTS: A total of 33 articles were included for full review and data extraction. Study design varied, with 17 (52%) quantitative, 1 (3%) qualitative, 5 (15%) mixed-method, and 10 (30%) case study designs. Seventeen (52%) of the studies included were published after 2006. The mechanism of training was primarily through supervised on-the-job training, allowing technicians to assume administrative-based positions that facilitated a pharmacist-led clinical service, with either the pharmacist or the pharmacy receiving the greatest benefits. CONCLUSION: Although the literature supports technicians performing advanced roles in the pharmacy, resulting in either improved patient outcomes or opportunities for pharmacists to engage in additional clinical services, the benefits to the technician were primarily indirect, such as an increase in job satisfaction or a more desirable work schedule. If a technician is to take on additional roles that require completion of a formalized training or educational program, benefits that are more tangible may help to inspire technicians to pursue these roles.

What predicts medication therapy management completion rates? The role of community pharmacy staff characteristics and beliefs about medication therapy management.

OBJECTIVES: To model the association between pharmacy technicians' attitudes and planned behaviors toward participating in medication therapy management (MTM) and MTM completion rates. Secondary objectives included 1) to compare pharmacy technician and pharmacist attitudes and planned behaviors toward participating in MTM and 2) to identify respondent and pharmacy demographic factors associated with MTM completion rates. DESIGN: A 27-item survey, adapted from a previously published survey tool based on the Theory of Planned Behavior (TPB), was used to collect respondent perceptions of MTM. Study procedures were approved by the institutional review board. SETTING AND PARTICIPANTS: Pharmacy technicians and pharmacists representing 116 Midwestern community pharmacy locations within a national supermarket chain were eligible to complete a telephone survey during February to May 2017. MAIN OUTCOME MEASURES: MTM completion rates were recorded during the 6-month time frame before survey administration. Unique, nonmeaningful survey codes were used to link responses from respondents to their store's MTM completion rates. Multivariate linear regression analysis was used to model the association between survey responses, pharmacy and staff demographics, and MTM completion rates. RESULTS: Of the 116 eligible pharmacy technicians and 114 pharmacists, 77 pharmacy technicians and 99 pharmacists completed the survey yielding response rates of 66.4% and 86.8%, respectively. Pharmacy technicians held significantly more positive perceptions about MTM delivery, particularly regarding adequate time and support. However, pharmacy technicians reported having the necessary knowledge and skills significantly less frequently compared with pharmacists. TPB variables for pharmacy technicians were not significant predictors of MTM completion rates. However, pharmacist attitudes, pharmacy technician education, and number of technician hours worked per week were positively associated with MTM completion rates. CONCLUSION: Pharmacists' attitudes, pharmacy technician level of education, and number of technician hours worked per week were associated with MTM completion rates.

Influences on the frequency and type of community pharmacy services.

OBJECTIVES: To describe services provided by community pharmacies and to identify factors associated with services being provided in community pharmacies. DESIGN: Cross-sectional national mail survey. SETTING AND PARTICIPANTS: Pharmacists actively practicing in community pharmacies (independent, chain, mass merchandisers, and supermarkets). OUTCOME MEASURES: Frequency and type of pharmacy services available in a community pharmacy, including medication therapy management, immunization, adjusting medication therapy, medication reconciliation, disease state management, health screening or coaching, complex nonsterile compounding, and point-of-care testing. RESULTS: With a 48.4% response rate, the survey showed that community pharmacies offered on average 3 of the 8 services studied. Pharmacy chains and supermarket pharmacies reported providing significantly more services than did mass merchandise pharmacies. The number of pharmacy services provided was positively associated with involvement in an interprofessional care team, innovativeness, and perceived workload. The number of pharmacy services was negatively correlated with having 3.5 or more pharmacy technicians on duty. CONCLUSION: Pharmacy chains and supermarkets are providing the most pharmacy services among community pharmacy settings. The number of services provided was associated with innovativeness, technician staffing, and perceived workload. Also, involvement with an interprofessional care team supported greater service delivery. Community pharmacies vary in their provision of services beyond dispensing.

SIMulation of Medication Error induced by Clinical Trial drug labeling: the SIMME-CT study.

OBJECTIVE: To assess the impact of investigational drug labels on the risk of medication error in drug dispensing. DESIGN: A simulation-based learning program focusing on investigational drug dispensing was conducted. SETTING: The study was undertaken in an Investigational Drugs Dispensing Unit of a University Hospital of Lyon, France. PARTICIPANTS: Sixty-three pharmacy workers (pharmacists, residents, technicians or students) were enrolled. INTERVENTION: Ten risk factors were selected concerning label information or the risk of confusion with another clinical trial. Each risk factor was scored independently out of 5: the higher the score, the greater the risk of error. From 400 labels analyzed, two groups were selected for the dispensing simulation: 27 labels with high risk (score ≥3) and 27 with low risk (score ≤2). Each question in the learning program was displayed as a simulated clinical trial prescription. MAIN OUTCOME MEASURE: Medication error was defined as at least one erroneous answer (i.e. error in drug dispensing). For each question, response times were collected. RESULTS: High-risk investigational drug labels correlated with medication error and slower response time. Error rates were significantly 5.5-fold higher for high-risk series. Error frequency was not significantly affected by occupational category or experience in clinical trials. CONCLUSIONS: SIMME-CT is the first simulation-based learning tool to focus on investigational drug labels as a risk factor for medication error. SIMME-CT was also used as a training tool for staff involved in clinical research, to develop medication error risk awareness and to validate competence in continuing medical education.

SafeMed: Using pharmacy technicians in a novel role as community health workers to improve transitions of care.

OBJECTIVES: To describe the design, implementation, and early experience of the SafeMed program, which uses certified pharmacy technicians in a novel expanded role as community health workers (CPhT-CHWs) to improve transitions of care. SETTING: A large nonprofit health care system serving the major medically underserved areas and geographic hotspots for readmissions in Memphis, TN. PRACTICE INNOVATION: The SafeMed program is a care transitions program with an emphasis on medication management designed to use low-cost health workers to improve transitions of care from hospital to home for superutilizing patients with multiple chronic conditions and polypharmacy. EVALUATION: CPhT-CHWs were given primary responsibility for patient outreach after hospital discharge with the use of home visits and telephone follow-up. SafeMed program CPhT-CHWs served as pharmacist extenders, obtaining medication histories, assisting in medication reconciliation and identification of potential drug therapy problems (DTPs), and reinforcing medication education previously provided by the pharmacist per protocol. RESULTS: CPhT-CHW training included patient communication skills, motivational interviewing, medication history taking, teach-back techniques, drug disposal practices, and basic disease management. Some CPhT-CHWs experienced difficulties adjusting to an expanded scope of practice. Nonetheless, once the Tennessee Board of Pharmacy affirmed that envisioned SafeMed CPhT-CHW roles were consistent with Board rules, additional responsibilities were added for CPhT-CHWs to enhance their effectiveness. Patient outreach teams including CPhT-CHWs achieved increases in home visit and telephone follow-up rates and were successful in helping identify potential DTPs. CONCLUSION: The early experience of the SafeMed program demonstrates that CPhT-CHWs are well suited for novel expanded roles to improve care transitions for superutilizing populations. CPhT-CHWs can identify and report potential DTPs to the pharmacist to help target medication therapy management. Critical success factors include strong CPhT-CHW patient-centered communication skills and strong pharmacist champions. In collaboration with state pharmacy boards and pharmacist associations, the SafeMed CPhT-CHW model can be successfully scaled to serve superutilizing patients throughout the country.

Community pharmacy staff perceptions on preventing alcohol and medication interactions in older adults.

OBJECTIVES: To examine rural and urban pharmacy staff perceptions on messaging, barriers, and motivators for preventing alcohol and medication interactions (AMI) in older adults (≥65 years of age). METHODS: A survey was distributed through the local pharmacist association and statewide pharmacy registry in Kentucky. A total of 255 responses were received from pharmacists, pharmacy technicians, and pharmacy students. RESULTS: Across rural and urban regions alike, among the AMI prevention messages provided, participants identified the most important messages to be: AMI can be potentially dangerous and life threatening; emergency rooms should be used when experiencing an AMI; and doctors and pharmacists should be consulted about AMI. The most common AMI prevention barriers indicated were stigma, costs, and low perceived risks. The most common AMI prevention motivators indicated were physical health improvement, promoting a healthy lifestyle, convenient setting, and financial incentives. CONCLUSION: Regardless of geography, participants similarly rated the presented AMI prevention messages, barriers, and motivators. With the use of these findings, the development of an AMI prevention program is suggested to use messaging about AMI threat, behavioral management, and behavioral prevention.

Advice on stroke provided by pharmacies in the United States: implications for treatment and care.

OBJECTIVES: Studies have found that some health lines and physician's offices have provided treatment advice other than "call 9-1-1 for an ambulance" to patients who present with a stroke scenario. We assessed the treatment advice given by selected pharmacies in the United States regarding stroke. METHODS: The investigators called 73 randomly selected pharmacies and informed respondents that the caller's mother had experienced stroke-like symptoms several days earlier. Respondents were asked what should be done if the symptoms returned in the future and then debriefed on the deception afterward. RESULTS: Seventy-one of the 73 pharmacies participated and only 20% (95% confidence interval 12-30) of respondents gave the ideal advice "call 9-1-1 for an ambulance." CONCLUSIONS: One out of every five pharmacy respondents across the United States recommended advice other than calling emergency medical services for a potential stroke scenario.

[Perception of body weight by pharmacists and pharmaceutical laboratory assistants in Slovakia II]. / Vnímání telesné hmotnosti lékárníky a farmaceutickými laboranty na Slovensku II.

The paper presents the results of a questionnaire poll carried out in the workers in pharmacies in the Slovak Republic in the year 2012. A number of 250 respondents (50.8%) were satisfied with their weight, 242 (49.2%) were not satisfied; 190 (38.6%) of them attempted to decrease the weight, 52 (10.6%) did not; 94 persons (49.5 %) attempted to decrease weight more than 3 times. 110 respondents (57.9%) actively searched for the possibilities of treatment of overweight and obesity. The most frequent source of information was the Internet (64; 57.7%). Only 43 (22.6%) participants decided to solve their problem of overweight/obesity in cooperation with an expert. As many as 127 (66.8%) respondents stated that the physician did not draw their attention to the need of decreasing their weight. The most widely used method of slimming in the workers in pharmacies was modification of eating habits (162, 84.4%). A number of 108 (56.8%) respondents reported that they were able to maintain the loss of weight.

[Perception of body weight by pharmacists and pharmaceutical laboratory assistants in Slovakia I]. / Vnímání telesné hmotnosti lékárníky a farmaceutickými laboranty na Slovensku I.

The paper presents the results of a questionnaire poll carried out in the workers in pharmacies in the Slovak Republic in the year 2012. Altogether 1,884 questionnaires were distributed, of which 492 (26.1%) were returned. The poll aimed to find the perception of and attitudes to overweight and obesity in pharmacists and pharmaceutical laboratory assistants. The average BMI values in pharmacists were 25.08, in pharmaceutical laboratory assistants 24.86. Overweight and/or obesity were recorded in 36.6% of respondents, BMI 25 was found in 5.2 % men and 33.7% women. An absence of a chronic disease was reported in 61.8% of respondents, and 38.8% of respondents reported medication - most frequently administration of antihistamines, hormones of the thyroid gland, and antihypertensive drugs. In 220 (44.7%) of respondents, overweight/obesity existed in the family. Physical exercise carried out more than 3 times a week was reported by 9.6% of respondents. Drinking regime was evaluated as good in 52.1% of respondents, and 14.6% of participants compensated stress with food.

Administrative practices of health professionals and use of artesunate-amodiaquine by community members for treating uncomplicated malaria in southern Ghana: implications for artemisinin-based combination therapy deployment.

OBJECTIVE: To investigate the use of artemisinin-based combination and monotherapy by community members and the administrative practices of health professionals in treating malaria in Ghana. METHOD: This study is a community-based cross-sectional survey in 11 rural and urban areas in southern Ghana. Using the interviewer method, close-ended questionnaires were administered to community members. Similar questionnaires were also administered in health facilities, community pharmacies and licensed chemical shops. RESULTS: A total of 1085 individuals comprising 959 non-health professionals and 126 health professionals were interviewed. Fifty-seven per cent of the community members visit pharmacies/drug stores as the first point of call when they suspect malaria. According to the participating drug sellers, artemether-lumefantrine (AL) is the most prescribed/sold anti-malarial drug (59.2%), followed by dihydroartemisinin (35%), sulfadoxine-pyrimethamine (33.0%) and artesunate-amodiaquine (AS-AQ) (27.2%). The majority of customers who visit pharmacies or drug stores without prescription have their anti-malarial drug selected by the shop attendant; in situations like that, dihydroartemisinin and artesunate monotherapies are sold just as AS-AQ and AL. Chloroquine is still sold by some drug vendors, 5 years after its proscription. CONCLUSION: Whereas the use of AS-AQ and AL are acceptable, the frequent use of dihydroartemisinin and artesunate monotherapy threatens the future of ACTs.

Pharmacy provision of emergency contraception to men: a survey of pharmacist attitudes in Rhode Island.

OBJECTIVE: To describe pharmacy staff members' attitudes and practices related to male emergency contraception (EC) requests, as well as the occurrence of male purchases in Rhode Island. DESIGN: Cross-sectional study. SETTING: Pharmacies throughout Rhode Island during April to August 2008. PARTICIPANTS: 226 pharmacists and pharmacy technicians. INTERVENTION: Participants were mailed a 21-item closed-ended questionnaire. MAIN OUTCOME MEASURES: Demographics, EC provision practices, recall of male EC purchases, and attitudes toward male EC access. RESULTS: Of 151 pharmacies surveyed, 91 responded, providing 226 individual pharmacy staff member surveys. Among this population, 95.6% sold EC. Although 59.7% believed male EC purchases occurred rarely, 63.3% sold EC to a man in the previous year. Ten (4.4%) respondents refused sale of EC to a man. Respondents were less likely to agree that men should always have access if they also believed that access would decrease regular contraceptive use (P = 0.008) and if they could not verify the female recipient's consent (P < 0.001). CONCLUSION: Pharmacists and technicians commonly believed that male EC purchases did not occur or occurred rarely; however, more than one-half of this population sold EC to men. Although the majority expressed personal reservations against providing EC to men, they still agreed that men should have access to EC. These findings suggest that pharmacies are an acceptable setting for male EC access and that although refusal exists, it may not be a barrier to access.

Workload of pharmacists and the performance of pharmacy services.

OBJECTIVE: To evaluate the influence of pharmacists' dispensing workload (PDW) on pharmacy services as measured by prescription suggestion rate (PSR) and dispensing error rate (DER). METHOD: This was an observational study in northern and southern Taiwan's two largest medical centers, from 2012 to 2018. We calculated monthly PDW as number of prescriptions divided by number of pharmacist working days. We used monthly PSR and DER as outcome indicators for pharmacists' review and dispensing services, respectively. We used Poisson regression model with generalized estimation equation methods to evaluate the influence of PDW on PSR and DER. RESULTS: The monthly mean of 463,587 (SD 32,898) prescriptions yielded mean PDW, PSR and DER of 52 (SD 3) prescriptions per pharmacist working days, 30 (SD 7) and 8 (SD 2) per 10,000 prescriptions monthly, respectively. There was significant negative impact of PDW on PSR (adjusted rate ratio, aRR: 0.9786; 95%CI: 0.9744-0.9829) and DER (aRR: 0.9567; 95%CI: 0.9477-0.9658). Stratified analyses by time periods (2012-2015 and 2016-2018) revealed the impact of PDW on PSR to be similar in both periods; but with positive association between PDW and DER in the more recent one (aRR: 1.0086, 95%CI: 1.0003-1.0169). CONCLUSIONS: Reduced pharmacist workload was associated with re-allocation of pharmacy time to provide prescription suggestions and, more recently, decrease dispensing errors. Continuous efforts to maintain appropriate workload for pharmacists are recommended to ensure prescription quality.

Self-assessment of Polish pharmacy staff's readiness to promote health.

Background Nowadays, pharmacists are expected to focus not only on dispensing medicines but also on the wellness of the patient. In some developed countries a pharmacist is clearly defined as a health care professional that can make a contribution to improving the general health of the population. Objective To assess the readiness of Polish pharmacy staff to engage in health promotion and educational activities. Setting Community pharmacies in Poland. Method The study group consisted of 308 pharmacy staff (248 pharmacists and 60 pharmacy technicians) employed in Polish pharmacies. The survey questionnaire referred to three domains: systemic solutions for health promotion, readiness of pharmacy staff as a professional group to promote health, personal readiness to promote health. Responses about pharmacy staff's readiness to promote health were scored using a 10-point scale. Scale reliability for all items (overall readiness), and for items within the three domains separately, were tested using Cronbach's α and average inter-correlation coefficient among the items. Main outcome measure Pharmacy staff's readiness to promote health (the questionnaire containing 32 items). Results The overall readiness of pharmacy staff to promote health was rather low (average of 4.6 ± 1.5 in 1-10 scale). The highest scores were obtained for pharmacy staff's personal readiness to promote health (average of 5.5 ± 1.8) which was neutral on the scale. The lowest scores were obtained for systemic solutions for health promotion (average of 3.6 ± 1.4). Readiness of pharmacy staff as a professional group was ranked in the middle (average 4.8 ± 1.8). Surveyed pharmacy staff rated their readiness to promote health in the work environment significantly higher than promoting health in the local community. Female and younger pharmacy staff as well as those with job seniority of less than 5 years, or pharmacy technicians assessed their readiness to promote health significantly higher than others. Readiness to promote health was higher among pharmacy staff working in pharmacies employing up to 3 staff members and at pharmacies with over 200 customers daily. Conclusions The overall readiness of pharmacy staff to promote health was low, especially in the domain of systemic solutions in health promotion.

Factors influencing acceptance of robotics in hospital pharmacy: a longitudinal study using the Extended Technology Acceptance Model.

OBJECTIVES: To explore factors influencing hospital pharmacy staff acceptance of a pharmacy robotic dispensing system during implementation and over time. METHODS: A single centred, prospective, longitudinal cohort quantitative study was conducted in an Australian tertiary public hospital using the Extended Technology Acceptance Model (ETAM). Staff were surveyed during the implementation of a pharmacy dispensing robot (May 2016) and again after working with the system for fifteen months (August 2017). Fishers exact test and correlation analysis of paired responses were used to identify significant factors influencing use of the system between the two time points. KEY FINDINGS: Sixty four respondents completed surveys during implementation (n=64) and 34-paired surveys were collected fifteen months later. Respondents were predominantly young, female with a tertiary qualification. Initial perceptions did not change over time, with the exception of reliability. Departmental leaders had greatest influence on technology acceptance during implementation and over time. Other key factors correlating with acceptance included: how useful the robot was perceived to be; ease of use and how relevant the robot was for an individual role. Higher levels of education had a negative association with usage during implementation and age was not a factor. CONCLUSION: This study identified critical insights influencing staff acceptance of pharmacy robots that will help inform future implementation. The influence of pharmacy leaders emerged as key influence on technology acceptance. Leveraging on this influence a communication strategy prior to implementation should include information on useful functions and known benefits of the system customised for individual roles.