COMMUNITY PHARMACY

1. CHAPTER 15 COMMUNITY PHARMACY

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

3. 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.

4. 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

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

6. 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

7. 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

8. 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

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

10. 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)

11. 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

12. 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

13. 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

14. 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

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

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

17. 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

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

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

20. 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

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

22. CUSTOMER PICK-UP • Alphabetized prescription bins • Signature logs

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

24. ORDERING STOCK • Transmitting drug orders to a drug wholesaler • Receiving drug orders from a drug wholesaler

25. 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

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