If you are a clinical pharmacist who provides cutting-edge direct patient care as a member of an interprofessional patient care team or you are a pharmacy health-system leader enjoying the success of your highly regarded department, you should pause today and thank a pharmacy technician.

Over the past several decades, the practice of pharmacy in the health-system setting has evolved from predominantly the distribution of drugs to patient care units to now incorporating the drug use expertise of pharmacists into all facets of patient care, from ambulatory patients struggling to manage their type 2 diabetes to the most critically ill patients. There have been many pioneers of clinical pharmacy who have been recognized for their contributions to expanding the practice of pharmacy. The mostly unsung heroes of this evolution of practice have been the pharmacy technicians upon whose shoulders the weight of critically necessary drug distribution has fallen as pharmacists pursued more professionally appropriate patient care activities. Without the dedication and hard work of our pharmacy technician colleagues it is unlikely that clinical pharmacy practice could have evolved and expanded to what it is today.

The contributions of pharmacy technicians have become more complex and varied over recent years, demanding an ever-greater level of education and training.Although technology, such as compounding and dispensing robots and intravenous workflow management, has a growing role in drug preparation and distribution within health systems, it is primarily pharmacy technicians who develop the expertise and technical skills to maintain and operate these types of technology. In addition, as drug therapy has become more complex and the regulatory standards more stringent, the processes involved in drug preparation and dispensing are more difficult and sophisticated. Pharmacy technicians have also assumed more specialized roles in support of pharmacy services in recent years, including serving as clinical pharmacy technicians who assist ambulatory clinical pharmacists with administrative and data collection tasks to increase pharmacist efficiency, medication access specialists with expertise in navigating insurance and patient assistance programs to assure that patients have access to high-cost specialty medications regardless of their ability to pay, and medication historians supplying accurate medication histories for use by patient care teams. These are but a few examples of specialized roles that are emerging for well-trained and experienced pharmacy technicians.

The results of a recent prospective randomized study show that admission medication histories obtained by pharmacy technicians in the emergency department were as accurate as those obtained by pharmacists, and both were far superior to the accuracy of medication histories obtained as part of routine care.1 These results are the latest of numerous ones attesting to the quality of work that properly trained pharmacy technicians contribute in increasingly specialized roles.

Pharmacy technicians who develop extensive knowledge of pharmacy operations and the business of pharmacy are also being offered other important jobs that support the mission of health-system pharmacy practice. These positions may include 340B program managers, business and financial analysts, pharmacy information analysts, and supply chain managers, to name a few. The ability to combine pharmacy expertise with educational pursuits or other interests makes these individuals highly valuable contributors to the success of many pharmacy departments.

One of the major limitations relative to the important role pharmacy technicians can play in advancing the practice of health-system pharmacy is the lack of standardization of the certification, education, licensure, registration, and training of pharmacy technicians across the United States. The Emily Jerry Foundation (emilyjerryfoundation.org/) maintains a national pharmacy technician scorecard that rates the progress of each state relative to pharmacy technician requirements. On a 35-point scale, there are still 4 states with a score of 0, meaning that there are no requirements defined for certification, education, licensure, registration, or training. I am embarrassed to admit that my home state of New York is among those 4. New York does not legally recognize the existence of pharmacy technicians, with the regulations only referring to “unlicensed persons” who assist a pharmacist. What a shameful state of affairs for the profession of pharmacy in New York. Another 13 states received a grade of D or F, showing major deficiencies in these areas of recognition and advancement of pharmacy technicians. This means that the quality and patient safety associated with the incorporation of pharmacy technicians in pharmacy departments across the country is highly dependent on institutional standards relative to certification, education, and training of competencies. This high degree of variability has a negative impact on the consistent advancement of pharmacy practice.

Health-system pharmacists must be strong advocates for very high standards for the certification, education, and training competencies of pharmacy technicians. It is in their and their patients’ best interests. If your home state has low to no standards, then it is increasingly important that you advocate for and implement high standards within your organization. Finally, we must advocate for compensation that is commensurate with those high standards to attract and retain high-quality pharmacy technicians. Your professional success depends on it. Pursuing these advocacy issues is how we best thank pharmacy technicians.
 
Curtis E. Haas, PharmD, FCCP, is the director of pharmacy for the University of Rochester health care system in New York.

References

Pevnick JM, Nguyen C, Jackevicus CA, et al. Improving admission medication reconciliation with pharmacists or pharmacy technicians in the emergency department: a randomised controlled trial. BMJ Qual Saf. 2018;27(7):512-520. doi: 10.1136/bmjqs-2017-006761.