Community pharmacist perceptions of increased technician responsibility

Australian Community Pharmacists' Preparedness to Offer and Discuss Hepatitis C Testing and Treatment With Pharmacy Clients: A Representative Cross-Sectional Survey

The World Health Organisation (WHO) has set goals to eliminate hepatitis C (HCV) as a global health threat by 2030. To meet this goal, Australia must increase testing and diagnosis, including expanding access to care through community pharmacists. This study aims to explore community pharmacists' preparedness to discuss and offer HCV testing and treatment. Australian community pharmacists from four states completed an online anonymous quantitative survey between August and October 2023. Pharmacists were asked about their experiences of, comfort discussing and willingness to host outreach HCV testing or treatment. Predictors of each outcome were examined using logistic regression. In total, 530 pharmacists participated in the study. One in five pharmacists stocked HCV medications (22%), half (48%) were willing/somewhat willing to host an outreach HCV testing and treatment team, while 36% strongly agreed/agreed they were comfortable discussing HCV testing and treatment. Willingness to host an outreach HCV team was associated with pharmacists working in rural/remote settings (95% CI: 1.04-2.35, p = 0.032), providing opioid agonist treatment (95% CI: 1.16-2.49, p = 0.006) and comfort discussing overdose prevention (95% CI: 1.31-2.80, p = 0.001). Pharmacists with ≥ 15 years' experience (95% CI: 0.44-0.94, p = 0.022) were less willing to host outreach HCV testing. Females were significantly less comfortable discussing HCV testing (95% CI: 0.45-0.98, p = 0.039) compared to males. This is the first Australian study to explore community pharmacists' preparedness to discuss and offer HCV testing and treatment. In light of research showing that community pharmacy models of care can help meet HCV elimination targets, ongoing engagement with pharmacists is needed to increase their preparedness to provide this care.

Changes in provision of extended community pharmacy services in Aotearoa New Zealand, 2018 to 2022

BACKGROUND

Recognition is growing of the contributions community pharmacists make to the primary health care team, as their role shifts from a traditional dispensing focus to greater emphasis on fully applying their clinical skills. Some extended pharmacist services (e.g., vaccinations) are becoming increasingly common in New Zealand (Aotearoa). Community pharmacies provided key services during the COVID-19 response.

METHODS

An online survey was sent to community and intern pharmacists in 2022, regarding delivery of extended services and enablers and barriers to service provision, to look at changes since a 2018 survey. New questions were included regarding pharmacy services during the COVID-19 pandemic. Descriptive analyses were conducted, and comparisons made between reported proportions in the 2018 and 2022 surveys. For questions related to attributes of pharmacies rather than pharmacists, we weighted the data by the inverse of the number of pharmacists in the pharmacy.

RESULTS

A total of 64 pharmacists and 25 interns responded to the survey. The most common services for which pharmacists were accredited were the provision of the emergency contraceptive pill (95%), sildenafil (94%), trimethoprim (88%) and immunisations (80%). There was an increase from 2018 to 2022 in the proportion of pharmacists who were accredited to provide selected oral contraceptives and immunisations. As in 2018, interns showed strong interest in gaining accreditation for all extended services. Enablers and barriers to offering extended services did not change materially between 2018 and 2022, other than a greater proportion of pharmacists reporting that they were too busy dispensing to offer more services (an increase from 46 to 63%, P = 0.033). Almost all (98%) reported that "COVID increased the levels of stress at work", 94% that "workload has increased", and 90% that "home delivery services increased." Sixty-nine percent of pharmacists and 73% of interns reported work stress negatively affecting their wellbeing.

CONCLUSIONS

Most pharmacists want to work at the top of their scope of practice and are accredited to offer a range of extended services. However, their ability to focus on more patient-facing roles continues to be constrained by the time they spend dispensing. Adequate remuneration for services provided remains a concern.

Pharmacy Technician Efficacies and Workforce Planning: A Consensus Building Study on Expanded Pharmacy Technician Roles

The expansion of pharmacy technician scope of practice in recent years, though remaining somewhat contentious, has afforded multiple opportunities for pharmacy technicians to provide additional assistance within the pharmacy. However, much of the research examining this growth has focused on specific tasks, which were determined by either the researchers themselves or the respective state boards of pharmacy. This study aimed to gain a better understanding of what expanded tasks pharmacists believe technicians should have an increased role in performing. A consensus-building research methodology was used to survey practicing pharmacists to determine which tasks those pharmacists believed technicians should take an increased role in performing. This study used modified Delphi techniques to build consensus among panels of both hospital and community pharmacists regarding 20 setting-specific technician tasks. Results of our study indicated that both hospital and community pharmacists believed technicians should have an increased involvement in performing tasks which are more related to the operations of the pharmacy rather than tasks which are more clinical in nature. This finding illustrates a belief among a segment of pharmacists that expanded roles for technicians should do more to alleviate the managerial and operational burden placed on pharmacists, potentially allowing pharmacists to take on increased clinical roles.

Cultures of support and resilience are associated with certified pharmacy technicians embracing new roles

BACKGROUND

Various technological, economic, and regulatory factors are creating opportunities for pharmacy technicians to take on additional responsibilities. Technicians in the broader sense have indicated a preference for expanded scope of duties; however, it is not known what drives technicians' greater inclinations to accept these new roles.

OBJECTIVE

The purpose of this study was to determine the association of various work-related factors, such as co-worker support, pharmacist-leadership style, future uncertainty, their own organizational commitment, and personal characteristics of technicians, including their resilience, on pharmacy technicians' willingness to take on emerging responsibilities in pharmacy.

METHODS

A self-administered questionnaire survey was disseminated through email to a national, randomized sample of 3000 technicians certified through the National Healthcareer Association (NHA). The questionnaire solicited data on willingness to participate in either of 13 emerging responsibilities as well as resilience, perceived transformative leadership behaviors of supervising pharmacists, future uncertainty, coworker support, organizational commitment, and various personal and practice-related variables. Following the use of principal component analyses for item purification and summation of various scale responses, inferential analyses were conducted via independent sample t-tests, one way analyses of variance, and Pearson's product moment correlation, as appropriate.

RESULTS

From 2906 surveys delivered, 878 were returned, with 745 of them providing completed responses on willingness to participate in emerging responsibilities. Willingness on most items/responsibilities was highly rated, with many means being at least 4 on a 5-point scale, though some were lower and perhaps a reflection of less exposure to these by way of their personal experience orpractice setting. Technicians' resilience, their coworker support, organizational commitment, and perceived transformative behaviors undertaken by their supervising pharmacists were all highly associated with willingness to engage.

CONCLUSIONS

Pharmacists, pharmacy technician peers, and organizations can contribute to a culture that is supportive for pharmacy technicians and may serve to encourage commitment, resilience, and willingness to embrace new, or emerging responsibilities.

The role of pharmacy technicians in vaccination services: a scoping review

BACKGROUND

A busy pharmacy workload may limit a pharmacist's ability to meet the needs of vaccine-willing patients and also contribute to missed opportunities to engage with vaccine hesitant individuals. Opportunities for pharmacy technicians to support vaccination services may play a role in addressing increasing patient vaccination needs.

PURPOSE

This research aims to review the role of pharmacy technicians in vaccination services that is supported by pharmacy practice research to date.

METHODS

In compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocols, systematic searches were performed in PubMed, Embase, International Pharmaceutical Abstracts, Scopus, and CINAHL. Articles published through June 2020, in French, English, and Spanish, were screened for eligibility. Two independent reviewers screened titles and abstracts for inclusion. Data extraction of included study methodologies and results was performed by one reviewer and verified by a second reviewer.

RESULTS

A total of 656 records were identified through the search of published literature. Full-text screening of 145 records identified 14 articles for inclusion. Most articles evaluated emerging pharmacy technician roles in patient screening (n = 8, 53%) and vaccine administration (n = 5, 36%). Implementation of both emerging roles demonstrated positive patient outcomes (n = 10, 72%). Screening activities were complicated by the complexity of the role, as well as its potential to increase overall time spent on vaccination services. Pharmacists and technicians advocated for accredited vaccine administration training owing to consistent benefits in pharmacy workflow efficiency, pharmacist clinical time, and pharmacy technician job satisfaction.

CONCLUSION

This review supports the effective deployment of pharmacy technicians in delivering vaccination services. Despite pharmacy technician vaccine administration roles being highly regulated, professional advocacy by pharmacists and technicians can use the advantageous training, workflow, and patient outcomes benefits presented in this review. Early adopters of professional practice advancements for pharmacy technician vaccine administration may expand vaccination service capacity efficiently and safely, thereby reaching more patients.