Engaging pharmacy technicians for advanced clinical support tasks in community pharmacies: A cluster analysis.

OBJECTIVES: The primary objective of this study was to identify community pharmacy technicians who might be selected for engagement in advanced clinical support tasks and emerging roles. The secondary objective was to determine the demographic and work characteristics of these technicians who can be engaged in advanced roles. DESIGN: Using data from a survey of pharmacy technicians, a 2-step cluster analysis was performed with current involvement, self-efficacy, and attitude toward advanced clinical support tasks as the variables. Comparisons of the clusters were based on demographic and work-related variables (e.g., employment status, practice setting, job rank, sex, age, organization and professional commitment). Multiple regression analyses were used to identify the association between the technician's desired involvement in advanced tasks and their cluster, demographic, and work characteristics. SETTING AND PARTICIPANTS: The study included a random sample of pharmacy technicians surveyed across the United States who practiced in the community pharmacy setting. OUTCOME MEASURES: Not applicable. RESULTS: One hundred and twenty-eight pharmacy technicians formed 4 clusters. Overall, respondents were mostly female, a mean age of 36 years, working in large pharmacy organizations including chain, discount, mass merchandiser, and grocery store pharmacy, and with an average of 7 years' experience working as a technician. Self-efficacy, attitude, and current and desired involvement in clinical support tasks were significantly different (P < 0.001) among the 4 clusters. Twenty-one percent were stratified as "most ideal" technicians prepared to engage in advanced clinical support tasks and emerging roles. These technicians were the oldest in age and had the highest patient care score, and most were highly committed to remaining a technician. CONCLUSION: This study provides a method to use community pharmacy technicians' current capacity and potential to select those who can perform emerging roles and advanced clinical support tasks. The analysis identified those who might be selected first by organizations for taking up emerging roles, particularly more clinically oriented tasks. Pharmacy organizations can apply these results to workflow design and potentially to human resources management activities.

Utah pharmacists' knowledge, attitudes, and barriers regarding human papillomavirus vaccine recommendation.

OBJECTIVES: To evaluate Utah community pharmacists' knowledge and attitudes toward recommendation of human papillomavirus (HPV) vaccine, to determine whether the knowledge and attitude of pharmacists regarding the HPV vaccine influence their recommendation behaviors, and to capture any self-identified barriers to recommending the HPV vaccine. DESIGN: A cross-sectional anonymous 73-item survey was developed and administered to community, outpatient, and ambulatory care pharmacists. SETTING: Utah. PARTICIPANTS: Utah community pharmacists. MAIN OUTCOME MEASURES: Recommendation of the HPV vaccine by the pharmacist, knowledge and attitude of pharmacists regarding HPV vaccine, and barriers to vaccine receipt. RESULTS: The mean HPV vaccine knowledge score was 7.45 ± 2.15 (out of 13), and scores were higher when pharmacists had 4 to 6 technicians per day in the pharmacy and when they were residency trained. The mean attitude score was 24.26 ± 3.16 (out of 30). Positive attitudes were found if they had more than 1 pharmacist and 4 to 6 pharmacy technicians working at any given time in the pharmacy. Those who identified with "other Christianity" had a more positive attitude than Latter Day Saints. Although positive attitude toward the HPV vaccine was a predictor for recommending the vaccine to both boys and girls, higher knowledge was a significant predictor only in recommending the HPV vaccine for boys. Female pharmacists were more likely to recommend the HPV vaccine. The top 3 reported barriers included lack of parental knowledge, parental concerns and opposition, and lack of educational materials to provide parents. CONCLUSION: Although the majority of respondents perceived HPV vaccination as useful for preventing certain types of cancer, and more than one-half of respondents reported being comfortable in recommending the vaccine, only one-third actually recommended the vaccine for girls and for boys. The results indicate the need for improving knowledge about the HPV vaccine for pharmacists, patients, and parents.

Community pharmacist-led clinical services: physician's understanding, perceptions and readiness to collaborate in a Midwestern state in the United States.

OBJECTIVES: Many pharmacists are actively enhancing their role in the delivery of health care by offering a variety of pharmacist-led clinical services. The delivery of these services within community pharmacies can contribute to overcoming the cost and accessibility challenges currently facing U.S. health care, especially when pharmacist-physician collaborative efforts are utilized. The study purpose was to identify general and family practice physicians' awareness of pharmacists' delivery of clinical services, uncover their perceived barriers to collaboration with community pharmacists, and collect their input on how to overcome such barriers in order to better understand how pharmacist-led clinical services can be integrated, improved and more widely utilized as a healthcare delivery mechanism. METHODS: Semi-structured interviews were performed at the physicians' place of practice to assess (1) family practice and internal medicine physicians' knowledge of pharmacists' education, clinical training, and role in the healthcare team; (2) their perceptions and barriers towards pharmacist-delivered clinical services and physician-pharmacist collaboration; and (3) their recommendations to improve physician-pharmacist collaboration. The data were analysed qualitatively to identify and categorize themes. KEY FINDINGS: Thirteen physicians were interviewed. While nearly all physicians were aware of pharmacists' level of education, most were not aware of the level of clinical training pharmacists receive. Only half of the physicians were able to provide a definition or example of collaborative practice agreements, although most recognized value and benefit when the definition and examples were provided to them. The commonly perceived barriers for collaboration were concern over loss of communication, hesitancy to relinquish control and lack of confidence in pharmacists' clinical judgement. CONCLUSION: The study results emphasize the need to develop strategies to improve collaborative relationships between physicians and pharmacists. To encourage collaboration, pharmacists must take a proactive approach to increasing awareness of their clinical knowledge and training, the benefits and value of collaborative practice and the opportunities for it.

Adherence to Glaucoma Medications Over 12 Months in Two US Community Pharmacy Chains.

UNLABELLED: This study determined the degree of adherence to medications for glaucoma among patients refilling prescriptions in community pharmacies. METHODS: Data abstracted from the dispensing records for 3615 adult patients (18 years or older, predominantly over 45) receiving glaucoma medications from two retail pharmacy chains (64 stores in total) were analyzed. From a 24-month historic data capture period, the 12-month levels of adherence were determined using standard metrics, the proportion of days covered (PDC) and the medication possession ratio (MPR). The overall 12-month mean PDC was only 57%, and the mean MPR was 71%. Using a criterion by which 80% coverage was considered satisfactory adherence, only 30% had satisfactory overall 12-month PDC coverage, and only 37% had satisfactory overall 12-month MPR coverage. Refill adherence increased with age and was highest in the 65-and-older age group (p < 0.001). Differential adherence was found across medication classes, with the highest satisfactory coverage seen for those taking alpha2-adrenergic agonists (PDC = 36.0%; MPR = 47.6%) down to those taking direct cholinergic agonists (PDC = 25.0%; MPR = 31.2%) and combination products (PDC = 22.7%; MPR = 31.0%). Adherence to glaucoma medications in the community setting, as measured by pharmacy refill data, is very poor and represents a critical target for intervention. Community pharmacists are well positioned to monitor and reinforce adherence in this population.

Patients' needs and interests in a self-pay medication therapy management service.

OBJECTIVES: To determine patients' willingness to receive and self-pay for medication therapy management (MTM) services and to examine factors that may influence willingness to pay. METHODS: A self-administered, anonymous survey was given to a convenience sample of patients at grocery store chain pharmacies in the Chicago metropolitan area. RESULTS: 683 patients completed the survey. The average price patients were willing to pay for MTM services was $17.57. The majority of patients felt that pharmacists should provide MTM services. No correlation was found between complexity of the medication regimen and willingness to pay. Presence of certain chronic conditions and insurance status appeared to have a correlation with willingness to pay. CONCLUSION: Patients were interested in MTM services and recognize pharmacists as potential providers. Prices patients were willing to pay are similar to many prescription copay amounts.