Pharmacy Technicians Advance Pharmacists' Osteoporosis Care

Well-trained pharmacy technicians can free up pharmacists’ time for osteoporosis management services by identifying patients who do not require pharmacist intervention, according to research published December 1, 2014, in the American Journal of Health-System Pharmacy.

A team of investigators from Kaiser Permanente Colorado conducted a 2-phase prospective study of more than 200 patient health records reviewed by pharmacy technicians between June 2012 and March 2013. Each phase lasted 5 months and involved female patients aged 65 years or older who had been treated for a fracture at 1 of 5 participating medical offices.

In phase 1 of the study, a primary care pharmacy technician (PCPT) reviewed 127 cases in order to classify the patient as: (1) compliant with the Healthcare Effectiveness Data and Information Set (HEDIS) osteoporosis measure, (2) not compliant and requiring intervention, or (3) not compliant and not requiring intervention.

If a patient was placed into categories 1 or 3, then the rationale was recorded by the PCPT on the original fracture report. If the patient was classified as category 2, then the PCPT filled out the “subjective” and “objective” sections of the SOAP (subjective, objective, assessment, plan) format, which included clinical risk factors for osteoporosis, current or past use of estrogen replacement therapy, past use of antiosteoporosis medications with reasons for discontinuation, past bone mineral density (BMD) scans, body mass index, 3 most recent serum creatinine values, and most recent serum calcium and vitamin D values.

Primary care clinical pharmacy specialists (PCCPSs) then assessed the PCPT’s categorization for correctness. A competency assessment of at least 90% was required from the PCPT to advance to phase 2 of the study, which evaluated PCPT involvement in categorizing 91 patients and collecting information that resulted in a reduction of pharmacist time spent on clinical pharmacy osteoporosis management service activities relative to usual care.

During phase 2, the PCPTs categorized 26 (20.3%), 30 (23.4%), and 71 (55.5%) patients into categories 1, 2, and 3, respectively. In 118 (92.9%) of those cases, the PCCPSs agreed with the PCPT’s assessment.

At the conclusion of the trial, time spent on initial evaluation and care plan development for patients in category 2 was about 13 minutes, compared with roughly 18 minutes for osteoporosis-related usual care.

“Well-trained pharmacy technicians can help advance the profession by allowing pharmacists to focus their time on clinical activities,” the authors concluded. “The study results presented here demonstrate that a pharmacy technician can review a patient’s medical record and accurately determine if he or she is a candidate for pharmacist intervention…and collect clinical information to facilitate care plan development.”