CHAPTER 15 COMMUNITY PHARMACY

CHAPTER REVIEW Community Pharmacy Regulations Organization Customer Service Processing the Prescriptions Preparing the Prescription Customer Pick-up Using a Cash Register Other Duties Review

COMMUNITY PHARMACY The practice of providing prescription services to the public. Almost 2/3 of all prescriptions drugs in the US are dispensed by community pharmacies. One of the key characteristics of community pharmacy is the close interaction with patients.

TYPES OF COMMUNITY PHARMACIES Independent Pharmacies individually owned local pharmacies Food Store Pharmacies A&P, Giant Eagle, Kroger, Pathmark and others Chain Pharmacies CVS, Walgreens, Rite-Aid and others Mass Merchandiser Pharmacies Wal-Mart, Kmart, Costco, Target and others

RAPIDLY GROWING ASPECTS OF COMMUNITY PHARMACY Disease State Management (DSM) Medication Therapy Management (MTM) Other Clinical services and Programs

DSM One-on-one pharmacist/patient consultation sessions General medication advice and information Diabetes education and monitoring Asthma and Chronic Obstructive Pulmonary Disease (COPD) education and monitoring Anticoagualtion education and monitoring Weight loss programs Smoking cessation programs Cholesterol reductions programs

MTM Tailored to provisions of Medicare Part D 5 Core elements Medication therapy review (MTR) Personal medication record (PMR) Medication-related action plan (MAP) Intervention and/or referral Documentation and follow-up

CLINICAL SERVICES AND PROGRAMS Walk in clinics staffed with nurse practitioners Treatment for a limited number of conditions such as colds and minor injuries Pharmacist or nurse vaccination programs Influenza Herpes zoster Pnuemococcal

HOW TECHNICIANS HELP WITH PHARMACY CLINICAL SERVICES & PROGRAMS Coordinating billing Scheduling appointments Taking patient information

REGULATIONS: FEDERAL REGULATIONS AFFECTING COMMUNITY PHARMACY Omnibus Budget and Reconciliation Act (OBRA) Health Insurance Portability and Accountability Act (HIPPA) Medicare Prescription Drug Improvement and Modernization Act (Medicare Part D) Combat Methamphetamine Epidemic Act (CMEA)

REGULATIONS: WHAT STATES REGULATE Counseling Pharmacy technician certification Pharmacist to pharmacy technician ratios Scope of pharmacy technician practice Record keeping Required equipment in a pharmacy and work area requirements Scope of medication compounding

ORGANIZATION Transaction windows for pick-up and drop-off of prescriptions Pharmacist counselling area Drug Storage areas Tablets and capsules Syrups and suspensions Creams, ointments and other topicals Eye ad ear drops Rectal and vaginal preparations Injectibles Inhalers and nebulized medications Locked storage for controlled substances Refrigerated medications

ORGANIZATION CONT. Compounding area sink Prescription counter for preparing prescriptions Counting trays Vials Labels Prescription bins or shelves Completed prescriptions arranged by customer’s last name

CUSTOMER SERVICE Presenting in a calm, courteous, professional manner Listening carefully Making eye contact Repeating what the customer said Calling patients by name Knowing when to involve the pharmacist Dealing with customer complaints Positive responses vs. negative responses

PROCESSING PRESCRIPTIONS Prescription In-Take Patient drop off Faxed prescriptions E-prescriptions or electronically transferred prescriptions Telephone prescription orders

ENTERING PATIENT PROFILE INFORMATION Patient name Date of birth Current address Telephone numbers Allergy information Insurance information

ENTERING PRESCRIPTION INFORMATION Correct drug and strength Drug quantity Directions for use (the sig) Number of refills Dispense as Written (DAW) code Physician name, address, phone, and DEA number

PROCESSING REFILL PRESCRIPTIONS The prescription number Availability of refills Timeliness for refill

Filing Hard Copy Prescriptions By prescription number By class General prescriptions (non-controlled substances) Class III, IV, V controlled substances Class II controlled substances

PREPARING PRESCRIPTIONS FOR DISPENSING Generating a label Retrieving the correct medication from stock Counting or measuring Using counting trays Automated filling and measuring devices Selecting a container Safety caps Easy open caps Affixing the prescription label and auxiliary labels

PHARMACIST FINAL CHECK The final step of the prescription filling process before the prescription is bagged for patient pick up

CUSTOMER PICK-UP Alphabetized prescription bins Signature logs

USING A CASH REGISTER Scanning a price Handling payments Cash Checks Credit cards Gift cards Coupons

ORDERING STOCK Transmitting drug orders to a drug wholesaler Receiving drug orders from a drug wholesaler

OTHER GENERAL DUTIES OF A PHARMACY TECHNICIAN Assisting customers with where to find over-the-counter products Keeping the pharmacy clean, neat and in working order Cleaning counting trays and countertops Keeping disposable supplies stocked Bags, vials and bottles, labels, paper, cash register receipts Facing stock bottles Pulling soon to expire stock from shelves

SEPARATION OF TRASH Regular trash Trash containing protected health information Shredding or sending out for shredding