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ole expansion has been the
performance of BPMHs, but
several important factors
merit consideration before a
decision can be made: legality
and feasibility, accuracy and
efficiency, and patient care.
Both pharmacists and
pharmacy technicians work
in collaboration with each
other, and other members
of the interprofessional
healthcare team, to foster
a constructive work
relationship.
Legality pertains to scopes of
practice (to identify which BPMHrelated
actions are liable and
permitted), and feasibility refers to
the practicality of changing professional
roles with regard to BPMHs.
The National Association of Pharmacy
Regulatory Authorities (2009
and 2011) outlines the model
standards of practice for Canadian
pharmacists and pharmacy technicians,
allowing provinces the ability
to adapt these competencies, and
further, allowing individual hospitals
to adapt competencies. The key
responsibility of a pharmacist
is expertise in medication and
medication-use 7 , while the key
responsibility of a pharmacy technician
is expertise in drug distribution
systems 6 . Both pharmacists and
pharmacy technicians work in
collaboration with each other, and
other members of the interprofessional
healthcare team, to foster
a constructive work relationship.
According to the standards of
practice, pharmacists are responsible
for direct patient care via
medication therapy management 7 ,
while pharmacy technicians must
defer to the pharmacist in instances
that require patient “assessment,
clinical analysis, and/or the application
of therapeutic knowledge” 6 .
Although pharmacy technicians are
legally able to assist the pharmacist
in compiling BPMHs 6 , having them
conduct the patient/family interview
independently – prior to referring
certain patients to the pharmacist
– requires a level of patient
assessment that the pharmacist
would then re-assess regardless of
the pharmacy technician’s triage.
Thus, having the pharmacy technician
conduct the BPMH instead of
the pharmacist does not necessarily
allow the pharmacist to bypass
certain patients deemed by the
pharmacy technician to be ‘low risk’,
as that assessment would need to
be verified by the pharmacist before
signing off on it. As such, each
patient would be visited by two
individuals from the pharmacy team,
with no obvious practical improvement
in workflow or convenience
to the patient.
Accuracy is a measure of how
closely a BPMH resembles the
patient’s actual medication use,
and efficiency is a measure of how
quickly the BPMH is conducted.
It is important to note that in
practice, efficiency has no bearing
on its own since a quick but
inaccurate BPMH has too many
negative consequences to be
of any value. Johnston et al.
(2010) conducted a small study
in a short period of time, and
concluded that there was no
statistically significant difference
in the accuracy of the BPMHs
conducted by pharmacists as
compared to those by pharmacy
technicians. Since only 59 patients
were interviewed by the two
pharmacy technicians and three
pharmacists 4 , this small sample
size did not lend itself well to
statistical significance. Additionally,
the pharmacy technicians were
found to require less time for
the patient interview, averaging
about 2 minutes shorter than
the pharmacists 4 . The author
acknowledged that this was likely
due to pharmacists inquiring about
clinical issues 4 , but this factor
should not be so easily overlooked
since clinical intervention is an
important step that needs to be
taken. Furthermore, the pharmacy
technicians at the author’s institution
may not represent the average
pharmacy technician because
they had been involved with more
technical aspects of BPMHs in
the Emergency Department for
several years prior to this study 4 .
With greater comfort in the
acute hospital setting outside the
dispensary, and a 2-week training
program designed to improve one’s
BPMH process, the generalizability
of this finding to other hospitals is
limited [4] . With hospitals needing to
invest in the training of pharmacy
technicians to specifically conduct
PHARMACY CONNECTION ~ WINTER 2013 ~ PAGE 27