Tip of the Week: Pharmacy Technicians Can Obtain Patient Medication Histories

Pharmacy technicians have seen momentous growth in their job scopes and responsibilities in recent years, but they still remain a relatively untapped source for expanding patient-centered services. One potential responsibility for technicians could be obtaining patient medication histories for a variety of uses.

Obtaining medication histories from patients serves as the backbone for nearly all ensuing pharmacy services. Medication histories allow us to perform concurrent medication review, determine the appropriateness of prescribed therapy, develop patient care plans, and assess patient activation and adherence. It also allows for the performance of medication reconciliation (MR) in the hospital and other settings. The Centers for Medicare and Medicaid Services (CMS) incorporated a measure in 2018 for MR, stating that an eligible hospital receiving a patient from another setting of care should perform MR and mandating MR for more than 50% of transitions of care.¹

Arrison et al conducted a study to compare medication histories obtained by pharmacy technicians versus nursing staff in the emergency department (ED).² The ED is a pivotal time and place to obtain a medication history, as many inpatients are admitted through the ED. However, there are barriers to obtaining accurate medication histories there, including staffing issues, patients suffering from trauma and altered mental status, language barriers, time constraints, and patients using multiple outpatient pharmacies for their previous sources of medications.

Outside sources can be utilized to help obtain medication histories, such as contacting the patient’s pharmacy. However, this may be time-consuming, so pharmacy technicians have an opportunity to step in. The researchers examined and classified medication history discrepancies into 5 categories: drug omissions, drug commissions, incorrect or missing dose, incorrect or missing frequency, and incorrect formulation. They classified these further based on whether they have a high impact.²

The pharmacy technicians received onsite training by a pharmacy resident and technicians obtained medication histories in the ED on days when an emergency medicine pharmacist was present. Histories were obtained by the nursing staff on days when the pharmacy technician was not present, and all medication histories were reviewed for discrepancies by the pharmacy resident.²

A total of 204 histories were evaluated, and medication histories by the pharmacy technician were considerably more accurate than those acquired by nursing staff (94.1% versus 57.8%). A total of 7 discrepancies were found in the pharmacy technician histories, compared with 131 in the nursing group. The results of the study corroborate those that have taken place in other hospital departments and compare favorably with those that examined technicians taking medication histories in the community setting. The study did not undertake a cost analysis, but with the significant reduction in medication discrepancies, the possibility of reduced patient length of stay and reduced readmissions could be momentous.²

Pharmacy technicians can help provide value-added services that save time and even promote patient safety. Incorporating pharmacy technicians into workflow designs need not be only a pharmacy-centric model. In this case, deploying pharmacy technicians can relieve nurses of a time-consuming responsibility and allow them to focus on more direct patient care activities. Pharmacy managers should think about the entire medication use process and opportunities for interdisciplinary collaboration to deploy technicians (and other pharmacy personnel) to create solutions that save money and improve patient outcomes. When all is said and done, this makes everyone in the health care delivery process look good.

Additional information about Pharmacy Technicians and Human Resources Management can be found in Pharmacy Management: Essentials for All Practice Settings, 5e.

Shane P. Desselle, RPh, PhD, FAPhA, is a professor of social and behavioral pharmacy at the Touro University California College of Pharmacy.

References

1.Department of Health and Human Services. Centers for Medicare & Medicaid Services. Rules and regulations objective 7: medication reconciliation. Fed Regist, 80(200) (2015), pp.62662-62955.

2.Arrison W, Merritt E, Powell A. Comparing medication histories obtained by pharmacy technicians and nursing staff in the emergency department. Res Social Adm Pharm. 2020; 16(10):1398-1400.