The Increasing Role of ND Pharmacy Technicians in Prescription Counseling Tyler Rogers, PharmD, RPh
Objectives 1. Examine the new North Dakota counseling laws and regulations. 2. Differentiate between the role of a technician and pharmacist in counseling. 3. Review patient scenarios and the appropriateness of technician screening.
Poll Everywhere This CE will be using Poll Everywhere
Patient Consultation Requirements Provide consultation by a pharmacist or intern on each new prescription dispensed. Provide consultation by a pharmacist or intern on each refill prescription dispensed. Pursuant to NDAC 61-02-07.1-05, screening a patient for consultation on a refilled prescription can be completed by a registered technician. Counseling can be provided to the patient or their agent.
Patient Consultation Requirements (cont.) For a refilled prescription, when the patient or their agent is not available at the time of dispensing, the pharmacy must supply written or electronic materials and a toll free phone number for the patient or their agent to contact the pharmacist.
Patient Consultation Requirements (cont.) This section does not apply to prescriptions for patients exempted in NDCC 43-15-31.2 Failure to provide proper consultation under this section is considered unprofessional conduct by the pharmacy and pharmacist under NDAC 61-04-04-01(9) and is subject to disciplinary action
Pharmacy Technician Tasks The pharmacy technician may assess a patient receiving a refilled prescription on the need of the patient or their agent to have a consult with the pharmacist or pharmacy intern about the prescription.
Pharmacy Technician Tasks (cont.) Assessment must include a visual display of the medication Asking appropriate open ended questions on the medication and their applicable health condition. Any problematic responses must prompt the pharmacist to intervene with a consultation.
Pharmacists Role Educating patients on their medications Answering any medical/medication questions Role is staying the same as before
Technicians Role Screening/Testing patients on their knowledge of medications First line for counseling on refills Bigger role in pharmacy workflow
Open Ended Questions Cannot be answered with just one word or specific piece of information. They are designed to gage the knowledge of an individual Open ended questions do not suggest a possible answer They require longer responses compared to yes or no, but do not have to be more complicated
Examples What medications are you picking up today? How do you feel your medications are working? Do you know why you are using this medication? How are you taking this medication? Your losartan is for blood pressure, how have your numbers been?
Counseling Policy and Procedures Every pharmacy is required to have a counseling policy and procedure in place Offer to counsel is no longer acceptable This includes: Do you have any questions for the pharmacist? Have you taken this medication before? Clerk roles in the pharmacy may have to change
Old vs. New Counseling Procedure Example Every new medication must by counseled on by a pharmacist or intern On refill medications, an offer is made for the pharmacist to counsel
Old vs. New Counseling Procedure Example New prescriptions must be counseled on by a pharmacist or intern. This includes renewal of maintenance medications Technicians will screen patients or their agent on refills using questions similar to the following questions: What medications are you picking up today? Do you know what these are used for? How do you feel they are working? If the answers to these questions are concerning, the pharmacist must be called over Medications must be shown to patients while counseling/screening
Scenario #1 J.D. Is a 43 year old male. Today he is picking up refills on lisinopril 20mg daily #90 and metformin 500mg twice daily #180. What would be an appropriate first step for the technician? A. Ask if there are any questions B. Show J.D. his medications C. Call the pharmacist over to counsel
Scenario #1 (cont.) JD has confirmed that the medications he is picking up are correct. The technician then continues the screening: Q: Do you know what you are using these medications for? A: I use metformin for diabetes and lisinopril for blood pressure. What should the technician do next? A. Have the clerk finish the transaction at the till B. Call the pharmacist over C. Ask How are you taking these medications?
Scenario #1 (cont.) The technician then asks, How are you taking these medications? J.D. responds he takes both once daily The technician should: A. Call the pharmacist over B. Thank the patient for their time and call the clerk over C. Ask How are the medications working?
Scenario #2 V.E. is at the pharmacy to pick up refill medications for her husband, T.E. Should the technician conduct a screening with V.E.? A. True B. False
Scenario #2 (cont.) The technician asks V.E. if she knows what medications she is picking up. V.E. is not able to answer the question. What should the pharmacy staff do? A. Allow V.E. to pick up the prescriptions without doing anything further B. Have the pharmacist talk to V.E. C. Give handouts on medications and a phone number for the pharmacy D. B and C
Scenario #3 B.B. is a 56 year old female who came into the pharmacy to pick up her refills. The technician asks the following questions: What medications are you picking up today? What are you taking these for? How are you feeling the medications are working? B.B. has answered all questions correctly. The technician concludes the screening. Was this an appropriate screening? A. True B. False
Assessment Question #1 North Dakota counseling/screening laws state: A. Consultation must be provided on every new prescription B. Pharmacy technicians can screen patients on the use of refilled medications C. Failure to provide proper consultation can lead to disciplinary action D. All of the above
Assessment Question #2 Technicians now have the ability to: A. Counsel patients on every prescription B. Screen patients on refill medications C. None of the above
Assessment Question #3 A patient is picking up a refill on lisinopril. They are not sure why they are taking it. As a technician you should: A. Stop screening the patient B. Call the pharmacist over and inform them on the information you just learned C. Finish the transaction at the cash register D. A and B
Questions?