Community Pharmacy Chapter 15

Types of Community Pharmacies Independent – Individually owned, local pharmacies Chain – Regional or national pharmacy chains such as CVS or Eckerd

Types of Community Pharmacies Mass Merchandiser – Regional or national, such as Wal-Mart or Costco. Sell various mass merchandise & have in-store pharmacies. Food Stores – Regional or national food store chains with in-store pharmacies, such as Vons.

Community Pharmacy Also called retail pharmacy Characterized by having close interaction with patients (customers). Fill almost 2/3 of all Rxs. Customer service is a major area of importance & strong interpersonal skills are required.

Government Regulation & State Regulation 1990 Omnibus Budget & Reconciliation Act (OBRA) requires pharmacists to offer counseling to all patients. Counseling & Instructions include: Name & description of medication/Generic name Dosage form, dosage, route of administration Duration of administration Special directions or precautions Common side effects/interactions & how to avoid them Proper storage What to do if they miss a dose Refill information

Government Regulation & State Regulation 1996 Health Insurance Portability & Accountability Act (HIPAA) passed. Went into effect April 2003. Requires health care providers to protect the privacy of patients. Any information related to a patient or their medical condition considered “protected health information” (PHI).

Government Regulation & State Regulation Protected Health Information (PHI) Includes (but is not limited to): Patient name & address Date of birth Diagnosis Medical history Medications

Government Regulation & State Regulations Some ways of protecting PHI include: Never discussing patients outside pharmacy setting Shredding all documents containing PHI Never yelling information relating to a patient across the room and/or speaking to patients in the most private area available. Never discussing patient information with unauthorized persons.

Government Regulations & State Regulations Community Pharmacies are most closely regulated at the state level. State regulations include: Ratio of pharmacists to technicians Scope of technician practice Record keeping Equipment Work areas

Organization Read & know the different areas within the work process of a community pharmacy. Prescription counter Sink Storage Transaction window Refrigeration Computer Equipment Rx storage bins or shelves for pick-up

Customer Service A pharmacy technician must know when to refer a customer to the pharmacist. It is a good idea to discuss such situations with the pharmacist regularly. Any time you are uncertain whether a question requires a pharmacist’s judgment, refer the question to the pharmacist.

Interpersonal Techniques At the Counter: Listen carefully Make eye contact Repeat what the customer has said Use positive language to describe what you can do

Interpersonal Techniques On the Phone Use a pleasant and courteous manner State the name of the pharmacy & your name Follow the standard procedure for your pharmacy Refer all calls that require pharmacist judgment to a pharmacist

Processing Prescriptions A major responsibility of the technician is to process new & refill prescriptions. Patient Information for a new Rx: Always ask if a patient has had Rxs filled at the pharmacy in the past. Full name of the patient Address Telephone number Date of birth Any allergies to medications

Processing Prescriptions Refill Prescriptions: be sure to get the patient’s name and the prescription number. If the Rx number is unavailable, ask for the name of the medication. Ask if the patient wants to wait or pick up the medication later (if dropping off) Ask when the patient wishes to pick up (if phone request)

Processing Prescriptions Prescription Information: Correct drug and strength (if not sure-ask!) Correct physician’s name & DEA (billing purposes) Directions for use Quantity Number of refills authorized DAW code Initials of dispensing pharmacist

Processing Prescriptions Online Billing: the majority of customers today have 3rd party insurance cards. Group number: identifies the employer group Patient Identification Number: unique ID number Patient Code: 01 Cardholder, 02 Spouse, 03 Child…….

Processing Prescriptions Refills: Most pharmacy computer programs allow looking up refill information from the number or the patient name. Make sure refills are available Take note of early refills. Safety: Show all DUR, interaction & allergy flags to the pharmacist

Preparing the Prescription Once an Rx has been entered into the computer, it’s time to fill the Rx. Measuring: If filling tablets or capsules, we use a counting tray to count out the correct amount.

Preparing the Prescription Containers: Always pick the correct container when filling (cream, liquid, tablets) see page 306 Safety Caps: All dispensed Rxs must have a safety cap unless the patient states they do not want one. Most pharmacies require a signature on record.

Preparing the Prescription Labels: The finished prescription label is placed on the product along with any auxiliary labels. Auxiliary Labels: Labels regarding specific warnings, foods or medications to avoid, & potential side effects. Take with food, May cause drowsiness

Preparing the Prescription Final check by the pharmacist: Once the Rx is complete, the pharmacist will check your work & all paperwork. Leave the stock bottle, the original Rx & all other documentation next to the final product. After the Rx is verified, it is usually the tech’s job to return stock bottles to the shelf.

Customer Pick-Up When a customer comes to pick up medication, always check that you are giving the correct medication to the correct person!!! Verify phone number, date of birth, or address Most pharmacies store waiting Rx’s on shelves or bins alphabetically by last name. Signature log – a book in which customers sign for the Rxs they receive for legal & insurance purposes.

Using a Cash Register When working in a community pharmacy, you will most likely use a register. Always follow the pharmacy’s procedures regarding the register & the handling of transactions. Read page 309

Other Duties Ordering Receiving Stickering & stocking Keeping pharmacy clean & neat Read pages 310 & 311

Chapter 15 Read chapter 15 Review Key Concepts Take Self-Test