Patient-Interactions: Best Pharmacy Care Materials

PATIENT-FACING INTERACTIONS: PHARMACY TECHNICIANS AND PHARMACISTS OPTIMIZING CARE

Pamela Sardo, PharmD, BS

Pamela Sardo, PharmD, BS, is a freelance medical writer and currently licensed pharmacist in 3 states. She is the founder and principal at Sardo Solutions in Texas. Pam received her BS. from the University of Connecticut and her PharmD. from the University of Rhode Island. Pam’s career spans many years in retail, clinics, hospitals, long-term care, Veterans Affairs, and managed health care responsibilities across a broad range of therapeutic classes and disease states.

Topic Overview

Evidence links ineffective clinician-patient communication with increased malpractice risk, nonadherence, patient dissatisfaction, and poor patient health outcomes. Addressing interactions, including communication deficits, is paramount to the pharmacy team. Pharmacy technicians provide valuable services as part of the pharmacy team, focused on quality and safety. Pharmacy technicians’ listening skills, quality of information gathering, and attitude when interacting with diverse patient populations are important. Improving the quality of pharmacy technician-patient interactions will lead to identifying problems, gaps, and patient preferences and result in increased patient and staff satisfaction. Professional practice standards and patient-facing experiences serve as guidelines for pharmacists to oversee and guide pharmacy technicians in specific situations. Successful patient interactions and services necessary to provide optimal pharmaceutical care reveal the need for optimal pharmacist- pharmacy technician alignment.

Accreditation Statement:

RxCe.com LLC is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education.

Universal Activity Number (UAN): The ACPE Universal Activity Number assigned to this activity is 

Pharmacist  0669-0000-23-151-H04-P

Pharmacy Technician  0669-0000-23-152-H04-T

Credits: 1 hour of continuing education credit

Type of Activity: Knowledge

Media: Internet/Home study Fee Information: $4.99

Estimated time to complete activity: 1 hour, including Course Test and course evaluation

Release Date: September 16, 2023 Expiration Date: September 16, 2026

Target Audience: This educational activity is for pharmacists.

How to Earn Credit: From September 16, 2023, through September 16, 2026, participants must:

Read the “learning objectives” and “author and planning team disclosures;”

Study the section entitled “educational activity;” and

Complete the Course Test and Evaluation form. The Course Test will be graded automatically. Following successful completion of the Course Test with a score of 70% or higher, a statement of participation will be made available immediately. (No partial credit will be given.)

Credit for this course will be uploaded to CPE Monitor®.

Learning Objectives: Upon completion of this educational activity, participants should be able to:

Identify characteristics that pharmacists can mentor pharmacy technicians on that lead to successful pharmacy technician-patient interactions

Summarize potential impacts of ineffective pharmacy team-patient communication

Discuss cultural competency considerations that may impact pharmacy team-patient interactions

Identify methods during supervision of a pharmacy technician to correct technician missteps

Disclosures

The following individuals were involved in the development of this activity: Pamela Sardo, PharmD, BS. Pamela Sardo was an employee of Rhythm Pharmaceuticals until March 2022 and has no conflicts of interest or relationships regarding the subject matter discussed. There are no financial relationships relevant to this activity to report or disclose by any of the individuals involved in the development of this activity.

© RxCe.com LLC 2023: All rights reserved. No reproduction of all or part of any content herein is allowed without the prior, written permission of RxCe.com LLC.

Introduction

The scope of a pharmacy technician is diverse, rewarding, and full of opportunities to advance. Effective clinician-patient communication increases treatment adherence and patient satisfaction and improves patient health outcomes. Raising awareness of gaps in patient-pharmacy technician interactions and providing reminders, examples, and future interaction opportunities will advance patient care.

The Roles of Pharmacy Technicians

The roles of pharmacy technicians include communication with patients, healthcare providers, and insurance providers, filling prescriptions, receiving inventory, maintaining equipment, and much more.1 Pharmacy technicians work with customers and patients directly, in person, or over the phone. Depending on state laws and training, they may take written requests for prescriptions and refills. Pharmacy technicians create and update patient accounts or profiles.1 They help customers locate over-the-counter (OTC) medications and answer general questions within the guardrails of state laws, rules, employment policies, scope of practice, education, and training.

Pharmacy technician services, as part of the pharmacy team, are focused on quality and safety. As medication use becomes increasingly complex, pharmacists spend more time in patient care activities supported by competent pharmacy technicians.2 Pharmacists can mentor pharmacy technicians to teach them to demonstrate active and engaged listening skills and communicate clearly and effectively, both verbally and in writing, to optimize interactions. Pharmacy technicians demonstrate a respectful and professional attitude when interacting with diverse patient populations, colleagues, and professionals.3

Assessing and satisfying patient expectations is essential in successful patient-centered communication. Recognizing the gap between patient expectation and perception during patient interactions can help to identify problems and lead to improved communications and, ultimately, patient

outcomes.4 Published evidence links ineffective team-patient communication with increased malpractice risk, nonadherence, patient and clinician dissatisfaction, and poor patient health outcomes. Pharmacy technicians and the pharmacists supervising them must address communication skill deficits.5

Pharmacy Technician Code of Ethics Preamble6

Pharmacy Technicians are healthcare professionals who assist pharmacists in providing the best possible care for patients. The principles of this code, which apply to pharmacy technicians working in all settings, are based on the application and support of the moral obligations that, guide the pharmacy profession in relationships with patients, healthcare professionals, and society.

Principles Linked to Patient Interactions:

A pharmacy technician’s first consideration is to ensure the health and safety of the patient and to use knowledge and skills to the best of his/her ability in serving others.

A pharmacy technician respects and supports the patient’s individuality, dignity, and confidentiality.

A pharmacy technician respects the confidentiality of a patient’s records and discloses pertinent information only with proper authorization.

Developing Pharmacy Technician Competencies

Training

There are several training levels and key elements for entry-level and advanced pharmacy technicians. Skills, functions, and behaviors associated with patient-facing interactions are foundational. Pharmacy technician training programs emphasize a respectful and professional attitude when interacting with diverse patient populations, colleagues, and professionals. Pharmacy technicians must apply self-management skills, including strategies for stress. Pharmacy technicians must exhibit interpersonal skills, including negotiation skills, conflict

resolution, customer service, and teamwork, and demonstrate problem-solving skills. They also demonstrate the ability to understand applicable state and federal laws impacting operations and patients.3

Key success factors for pharmacy technicians include exhibiting knowledge of procedures and standards for the labeling and dispensing prescription medications and excellent social skills to interact effectively with patients and staff. Attitudes of pharmacy technicians should reveal the traits of demonstrating interest in providing quality patient care, accepting responsibility and criticism, enthusiasm, willingness to learn, adaptability, and dependability. At the other end of the spectrum, pharmacists and supervisors of pharmacy technicians must adhere to workplace policies that require pharmacy technicians to be counseled on patient endangerment, unsafe pharmacy practice, or poor communication. During pharmacy technician training, serious examples impacting patient interactions may be explained, such as cases of patient abandonment. This occurs when someone brings an individual needing care to the facility, such as a patient with severe Alzheimer’s Disease, and never comes back.

Pharmacy teams create records and transmit patient health information. The Healthcare Insurance Portability and Accountability Act (HIPAA) includes securing the privacy of a patient’s medical information, securing electronic records, and providing health insurance portability. HIPAA violations can occur. Serious examples impacting patient interactions include when a violation of the HIPAA standards occurs or confidentiality violations, among other complicated scenarios. Corrective actions may require additional coaching. Missteps also require additional training, or verbal or written warnings, or performance improvement plans may be implemented.6

Regardless of the practice setting, pharmacy technicians need customer service expertise. Often, patients come to the pharmacy when they feel ill, sometimes with mental health concerns, or may be stressed due to family member afflictions. These patients may inadvertently communicate in an ungracious or even angry or threatening manner with the staff. Those situations require pharmacist leadership, intervention, and directing the pharmacy

technician away from the situation, and sometimes de-escalation strategies are needed. On rare occasions, pharmacists may contact management or police if a patient interaction is becoming dangerous to the staff.

Cultural Competencies

Many people think the United States has a uniform, cohesive culture because it is home to multiple cultures and people from diverse backgrounds and health practices.7 Americans can often act in a casual, friendly, and personal manner. Customers from a different culture may mistake this for impoliteness or flippancy.7 Pharmacy technicians should be empathetic and direct in communications and ensure that any patient-related misunderstandings are clarified promptly. A conscious or unconscious bias towards other people or other regions may be present. Bias should be realized and mitigated during conversations with patients.7 There are many articles, programs, and methods to increase awareness of cultural competencies. One resource from the Centers for Disease Control and Prevention can be located at this website: https://npin.cdc.gov/pages/cultural-competence.

Pharmacy technicians should remain aware that people from different ethnic groups may have different beliefs about their medical conditions and the medications used to treat them.7 Culture, religion, allergies, or personal preference may contribute to special considerations during patient interactions. There are many issues to inquire about or be aware of during patient interactions.

One scenario is that culture, religion, allergies, or personal preference may prohibit the intake of certain animal products or byproducts that are occasionally found in medications. Animal byproducts are defined as parts of animals that do not come from harvested meat, but they are still animal derived. Many other products, such as fluocinonide cream, contain no animal derived components. If a patient interaction raises this as a concern, the full prescribing information should be consulted and referral to the pharmacist should occur. Table 1 has

selected products that may contain ingredients sourced from animals. It is not a comprehensive list.

Table 1: Select Medications with Animal-Sourced Ingredients7-13

*Porcine (of pig origin)

Skills and Responsibilities of Pharmacy Technicians

Pharmacy technicians help deliver care in areas such as purchasing, receiving, auditing, sterile and non-sterile compounding, billing, informatics,

medication reconciliation, licensing, contracting, and marketing.14 The pharmacy technician enters medication orders from doctors' order sheets/prescriptions and fills them according to the label. The pharmacy technician ensures the correct product is dispensed and that the dosage form and quantities billed agree with the formulary and other insurer requirements; and enters correct billing data as required.14 The pharmacy technician completes and files paperwork to ensure payment for and delivery of pharmacy supplies. Another important function is to coordinate returns for credit when pharmaceuticals have expired and coordinate drug recalls.14 Depending on state laws, pharmacy board rules, and employer job descriptions, an advanced pharmacy technician may assist with simple compounding or perform IV admixtures using aseptic techniques and in compliance with accepted regulatory standards as required.14 There are many other functions beyond the scope of this program.

In face-to-face or telephone interactions, the pharmacy technicians help patients and answer questions that do not require professional judgment under the direct supervision of a pharmacist.14 A pharmacy technician delivers medication appropriately to patients and helps patients complete the purchase of their prescriptions.14

Patient needs have become more complex over the years. Patients may have multiple specialists for different conditions. The pharmacy technician's training and alertness to computer edits protect patients from adverse interactions.15 Good communication skills are indispensable to navigate care. Without these skills, the pharmacy technician may not know how to address issues with the patient or the pharmacist.15 During prescription processing, pharmacy technicians have processes to avoid errors. If a provider, pharmacist, or another technician makes an error, pharmacy technicians must be comfortable communicating concerns or addressing errors in a professional manner.15

Soft skills are attributes, behaviors, and attitudes that enable people to interact effectively. Soft skills can help build and maintain relationships and navigate complex situations. For example, if a patient complains loudly to a

pharmacy technician, sometimes replying in a soft voice may deescalate the situation. On-the-job training, or self-learning, including awareness of soft skills and personality distinctions, helps navigate interactions with teams or patients.16 This awareness can also improve empathy and professionalism, strengthen teams, and improve patient experiences.16 This occurs by learning about different perspectives of individuals and learning how to overcome communication challenges.

There are many resources that pharmacy technicians can utilize to enhance communication soft skills and understanding of personalities. Some of these may be free, offered by an employer, or reimbursable by an employer if the pharmacy technician, or pharmacist overseeing the pharmacy technician, explains the purpose of soft skills training. Table 2 provides select resources.

Table 2: Select Resources for Soft Skills and Personality Awareness

Patient Medication Safety

The involvement of pharmacy technicians in expanded roles, with pharmacist supervision, is being explored. One example of an expanded patient- facing role is medication reconciliation. Employers believe this may offer advantages of pharmacist-based interventions at a lower cost. Trained pharmacy technicians can gather medication histories with similar completeness and accuracy to other healthcare professionals.17

One study reported pharmacy technicians were trained by a postgraduate year 1 (PGY1) pharmacy practice resident on how to collect, verify, and accurately enter medication histories into the electronic medical record.18 Accuracy of pharmacy technician–collected medication histories was verified by a pharmacist through observation of their patient interviews, review of technician-completed medication history forms, and by contacting the patient’s outpatient pharmacy.18 The authors concluded that the pharmacy technician– completed medication histories resulted in an absolute risk reduction of errors of 50%.18 Pharmacy technicians were valuable to the medication history process. They enhance patient safety during care transitions and other situations.

A three-arm randomized controlled study found that when a pharmacist or pharmacy technician added a medication history to usual care processes, errors in the admission history were reduced by over 80%.19 There was no difference in the benefits provided by pharmacy technicians versus pharmacists. Most participants reported enjoying the new contact with patients; however, they also mentioned that it required them to learn new processes to interact with patients, such as using disinfectant before greeting the patient.19 They also learned how to handle difficult or unexpected situations, such as when patients were unwilling or unable to answer questions.19

Drug Interactions

Pharmacy technicians have a key role in additional aspects of the prescription process with patient-facing interactions and ramifications. A

pharmacy technician must consider drug interactions during the prescription process. They also must be vigilant if they see a possible OTC interaction. If a computer alert appears or the pharmacy technician notices a concern, the pharmacist should be notified, or the result can be detrimental to a patient’s health if not handled adequately. Some states allow pharmacy technicians to perform drug utilization reviews before a pharmacist performs verification. Pharmacy technician training includes awareness of some common drug interactions that are important to be aware of in all settings and require referral of the patient to the pharmacist. Figure 1 provides drug interaction examples.

Figure 1: Drug Interaction Examples20-22

Relationships with Patients

Pharmacy technicians need to develop and maintain good relationships with everyone involved in a patient’s care. Providers prefer to work with a trusted pharmacy to provide a positive patient experience.15 If a provider perceives a

pharmacy is making it difficult for a patient to receive care, they will recommend other locations.15

Retail pharmacy technicians use their customer service skills to answer common client questions regarding waiting times, number of refills, or how far apart refills can be filled. They may be responsible for managing drive-thru customers.1 Pharmacy technicians interact with patients to achieve positive health outcomes, reduce healthcare expenses, and provide a range of essential or niche services. Pharmacy technicians promote the appropriate use of generic drugs to lower costs, encourage taking medication as directed, and provide access to additional health services, such as immunizations.23

Self-Care

Sometimes, customers need simple information that is readily available on the OTC packaging. For example, a customer might ask what an analgesic is, what “enteric-coated” means, or which alternative brands are available.1 A pharmacy technician can safely answer these and other routine questions without referring the customer to the pharmacist. Pharmacy technicians identify what resonates best with each person and how to tailor a message. What to say and how to say it is important.15 One person may want facts from a pharmacy technician, such as what the label says about dosing interval. Another person may need more details, such as why a dosing interval is important or what happens if instructions are not followed.

Pharmacy technicians' skills development includes being bold and admit their lack of expertise.1 Customers appreciate when a pharmacy technician is concerned enough to make sure they receive accurate information about their self-care. When a question deals with the effects or administration of a medication or other questions beyond the normal scope of practice, ask the customer to wait for a moment while a referral to a pharmacist occurs.

Effective Communication is Vital

Good communication may be more important in healthcare than in any other field.15 Quality care and optimizing outcomes require effective patient communication. One study revealed 66% of medical errors were caused by ineffective communication.15

Drug Shortages

Unfortunately, drug shortages are a reality in pharmacy practice settings. This situation prevents patients from having access to the much-needed medication on time, typically resulting in delayed recovery or other undesired outcomes. Pharmacy technicians are champions for the efficient supply of drugs to all medical institutions. They must confer with pharmacists on how to address shortages to minimize the risk of patient harm and the optimal process to communicate drug shortages to patients.

Pricing and Insurance

Pharmacy technicians answer questions regarding insurance coverage and help patients understand copays.1 The consuming public wants health insurance and hassle-free medication coverage. With drug prices skyrocketing, patients often face large out-of-pocket expenses, even when paying for common generic medications. Pharmacy technicians are often the ones who give the patients news of high prices. Computer programs may provide on-screen alternatives, or occasionally pharmacy technicians share, with pharmacist supervision, alternatives or the on-screen formulary message, if an insurer denies coverage. Patients may not be able to afford certain treatments and patient interactions may include discussion of patient assistance programs, coupons, or other discussions as alternative solutions.

Patient Satisfaction

A 2012 survey found that customer service was an important factor for patients when choosing a pharmacy.15 Being friendly helps patients evaluate their satisfaction with their pharmacy experience. Pharmacy technicians must adapt to the communication style that is most comfortable for the patient.15 Nonverbal communication skills are important for the pharmacy technician to identify patient discomfort or satisfaction.15 As some employers and state laws permit pharmacy technicians to administer immunizations, the ability to observe body language projecting nervousness or identify needle phobia, fear, or uncertainty is critical to avoid conflict, avoid poor customer reviews online, and minimize patient frustration.

Practice Settings Beyond Community

Drug Studies

Some pharmacy technicians have rewarding positions in nontraditional locations undertaking drug studies with approved and unapproved agents, devices, or processes. These pharmacy technicians assist patients who come to the location for research transactions. Based on whether permitted by laws, regulations, or employers, the pharmacy technicians may have conversations with patients about supplies. They may interact with patients regarding returned clinical investigational drugs from patients in trials that have this requirement.25 Effective communication skills in these locations are critical for the execution of clinical trials or studies striving for the advancement of healthcare.

Specialty Settings

The specialty pharmacy technician supports pharmacy services in specialty practice areas (such as cancer, hepatitis c, immunology, neurology, or some other specialty practice area). These supportive functions are in various physical locations. Some articles describe specialty roles as providing a concierge service. Pharmacy technicians in specialty settings work with medications that are only

sometimes available in a retail setting due to high cost and may have laboratory testing requirements before dispensing the medication. Patient interactions may involve informing the patient that participation in monitoring or registries will occur, that special preparation and shipping requirements for a product are required, or that adjunctive nursing or home health is mandated, then directing the patient to other team members. These pharmacy technicians can provide integrated support to patients for total quality patient care.

There are other specialized practice settings, such as mail-order companies, prisons, hospice care units, compounding centers, and nuclear pharmacies. Pharmacy technicians have fewer customer service duties to manage in these settings; however, interactions about processes, costs, and delivery remain important for patient satisfaction. Training on gracious and professional behavior remains important in these settings.

Pharmacy Benefits Management

Pharmacy technicians routinely compare medication orders to the medications that a patient is taking. This role includes the use of technology for maintaining accurate records of patients and accurate orders and medication inventories. Pharmacy benefit management technician roles may involve written patient interactions by reviewing patient medications in reports. Pharmacy technicians may look for interactions in the reports or too many controlled substances filled by multiple prescribers. They may also be asked to look for patients with chronic conditions (such as diabetes, asthma, schizophrenia) with too few refills of medications that should be filled regularly. Letters, emails, or telephone calls to patients may follow the review to discuss the issue identified in the report. Verbal patient interactions, such as speaking with a member who has a question about a formulary status, a copay, or a prior authorization or quantity limits may be routine.

Transition of Care

Laws, training, or employment policies may permit pharmacy technicians to help pharmacists perform medication reconciliation within a transition of care roles.26 The transition of care may occur from inpatient status to outpatient status or from outpatient to inpatient, for example. They may include obtaining preadmission medication history, obtaining relevant patient information from outpatient pharmacies and health care providers, and documenting the compiled medication list. Pharmacy technicians can help resolve discrepancies in medication lists, therefore improving patient care. Furthermore, with proper training, pharmacy technicians may take on expanded roles designed to aid pharmacists with advanced patient care services to improve the transition of care.26

Summary

Some Americans do not follow their clinician’s advice. Many people have cost concerns or find instructions difficult to follow. Some individuals feel that treatment is contrary to their beliefs, and some do not understand what they should do with their medication. Pharmacy technicians have a diverse and vital role in patient interactions. As healthcare evolves, pharmacy technician interactions with patients will evolve. Pharmacy technicians should refer to a pharmacist for any questions involving patient assessment, proper administration technique, dosage, or effects of medication, and for questions that require professional opinion or judgment. Pharmacy technicians should use their best judgment to determine whether a customer’s question exceeds common pharmaceutical knowledge. At a legislative level, changes may be proposed to address innovative mechanisms that ensure quality and safety.

Course Test

Identify characteristics pharmacists can mentor pharmacy technicians on that lead to successful pharmacy technician-patient interactions.

Providing active and disengaged listening skills

Communicate clearly and ineffectively

Communicating well in writing, with suboptimal verbal skills

Demonstrate a respectful and professional attitude when interacting with diverse patient populations

Which statement is identified in the Pharmacy Technician Code of Ethics for a pharmacist to reinforce with the technician?

Use knowledge without skills to the best of one’s ability

Ensure the health and safety of the patient

Respect individuality and do not tolerate a patient’s temper

Disclose patient records to neighbors and family if asked

A possible implication of ineffective team-patient communication includes all of the following except

increased malpractice risk.

nonadherence to treatment.

improved patient and clinician satisfaction.

poor patient health outcomes.

Which statement is most accurate regarding cultural competency considerations that may impact patient interactions?

People from different ethnic groups may have different beliefs about their medical conditions

Culture and religion are the only factors contributing to special considerations

The USA has a uniform, cohesive culture so cultural competencies are less important than dispensing functions

Conscious bias but not unconscious bias towards other people or other regions may be present

A pharmacist's action after a misstep by a pharmacy technician may include all of the following corrective actions except

undertaking additional training.

verbal or written warnings.

performance improvement plans.

merit increases for the technician.

Pharmacists mentor pharmacy technicians on the importance of soft skills. Which of the following is not an important soft skill in pharmacy technician-patient interactions?

To improve empathy

To minimize professionalism

To strengthen teams

To improve patient experiences

Pharmacists provide distinct tasks to pharmacy technicians in different practice settings. Which statement below correctly describes pharmacy technician-patient interactions within various practice settings?

Pharmacy benefit management interactions mandate contact when a report shows no controlled substances

Specialty setting requires interaction if shipping is delayed by 7 days

Transition of care setting interactions may include obtaining preadmission medication history

Drug study settings inform patients to only return investigational drugs in trials to the Amazon pharmacy

If a patient reveals they cannot take animal products, which medication on the patient's electronic profile would not be impacted?

IV heparin

Desiccated thyroid

Conjugated estrogens

Fluocinonide cream

Pharmacists remind pharmacy technicians to remain alert for OTC- prescription interactions. Which is an example of a prescription drug interaction with an OTC that may be identified when a technician interacts with a patient at the pharmacy counter?

Warfarin and OTC aspirin

Lisinopril and OTC eardrops

Amiodarone and OTC topical hydrocortisone

Digoxin and OTC glucometer

Pharmacists’ leadership responsibilities include staff safety. A belligerent patient arrives at the pharmacy. The individual expresses anger and yells at the pharmacy technician. What is one early course of action to take?

Call the police before speaking to the patient at all

Ignore the patient until the individual stops yelling

The pharmacist intervenes, directing the technician away

Offer the patient candy to sweeten the individual’s disposition

References

Understanding Your Scope of Practice as a Pharmacy Technician. Careerstep.com/blog/news. July 8, 2019. https://www.careerstep.com/blog/news/understanding-your-scope-of- practice-as-a-pharmacy-technician/. Accessed August 17, 2023.

Statement on National Standards for pharmacy technician education. Joint Commission of Pharmacy Practitioners. March 15, 2019. https://jcpp.net/resourcecat/jcpp-news/. Accessed August 17, 2023.

ASHP/ACPE Accreditation Standards for Pharmacy Technician Education and Training Programs. Pharmacy Technician Accreditation Commission. July 10, 2018. https://www.ashp.org/-/media/assets/professional- development/technician-program-accreditation/docs/ashp-acpe- pharmacy-technician-accreditation-standard-2018.pdf. Accessed August 17, 2023.

Kim MG, Lee NE, Sohn HS. Gap between patient expectation and perception during pharmacist-patient communication at community pharmacy. Int J Clin Pharm. 2020;42(2):677-684. doi: 10.1007/s11096- 020-01014-3

Impact of communication in healthcare. Institute for Healthcare Communication. July 2011. https://healthcarecomm.org/about-us/impact- of-communication-in-healthcare/.Accessed August 17, 2023.

Pharmacy Technician Program Handbook 2023-2024. Arkansas State University-Beebe. May 24, 2023. https://www.asub.edu/images/uploads/20230612/2023-2024-pharmacy- technician-program-handbook-reviewed-by-legal-5-23-2023-74133.pdf. Accessed August 18, 2023.

Alsharif NZ, Khanfar NM, Brennan LF, et al. Cultural Sensitivity and Global Pharmacy Engagement in the United States. Am J Pharm Educ. 2019;83(4):7220. doi: 10.5688/ajpe7220

Babos MB, Perry JD, Reed SA,et al. Animal-derived medications: cultural considerations and available alternatives. J Osteopath Med. 2021;121(4):361-370. doi: 10.1515/jom-2020-0052

Heparin sodium for IV use. Prescribing information. Hospira, Inc. February 2023. https://labeling.pfizer.com/ShowLabeling.aspx?id=4313. Accessed

August 18, 2023.

Lovenox. Prescribing information. Sanofi-aventis US LLC. December 2021. April 2022. https://products.sanofi.us/lovenox/lovenox.pdf. Accessed August 18, 2023.

Zenpep. Prescribing information. Nestle HealthCare Nutrition, Inc. March 2020. https://www.zenpep.com/home- hcp/sites/g/files/lpfasj706/files/2021-03/Zenpep-March-2021-Full-

Prescribing-Information-and-Medication-Guide.pdf. Accessed August 18, 2023.

Vascepa. Prescribing information. Amarin Pharma. Inc. September 2021. https://amaringlobal.prod.acquia-sites.com/sites/default/files/2022- 12/Vascepa-PI.pdf. Accessed August 18, 2023.

Eriksson A, Burcharth J, Rosenberg J. Animal derived products may conflict with religious patients' beliefs. BMC Med Ethics. 2013;14:48. doi: 10.1186/1472-6939-14-48

Monteiro I. Job description for a pharmacy technician: primary duties. Indeed. March 9,2023. https://www.indeed.com/career-advice/finding-a- job/job-description-for-pharmacy-technician. Accessed March 3, 2023.

Communication: an essential skill for pharmacy technicians. National Healthcareer Association. August 2023. https://info.nhanow.com/learning- leading-blog/communication-an-essential-skill-for-pharmacy-technicians. Accessed August 18, 2023.

National Healthcareer Association Effective Communication is vital for pharmacy technicians. Pharmacy Times. May 7 2021 https://www.pharmacytimes.com/view/effective-communication-is-vital- for-pharmacy-technicians. Accessed August 17, 2023.

Irwin AN, Ham Y, Gerrity TM. Expanded Roles for Pharmacy Technicians in the Medication Reconciliation Process: A Qualitative Review. Hosp Pharm. 2017;52(1):44-53. doi: 10.1310/hpj5201-44

Rubin EC, Pisupati R, Nerenberg SF. Utilization of Pharmacy Technicians to Increase the Accuracy of Patient Medication Histories Obtained in the Emergency Department. Hosp Pharm. 2016;51(5):396-404. doi: 10.1310/hpj5105-396

Niederhauser A, Zimmermann C, Fishman L, Schwappach DLB. Implications of involving pharmacy technicians in obtaining a best possible medication history from the perspectives of pharmaceutical, medical and nursing staff: a qualitative study. BMJ Open. 2018;8(5):e020566. doi: 10.1136/bmjopen-2017-020566

Coumadin. Prescribing information. Bristol-Myers Squibb Company. October 2011. https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/009218s107 lbl.pdf. Accessed August 27, 2023.

Zestril. Prescribing information. AstraZeneca Pharmaceuticals LP. December 2014. https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/019777s064 lbl.pdf. Accessed August 27, 2023.

Cordarone. Prescribing information. Pfizer Wyeth Pharmaceuticals Inc. October 2014.

https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/018972s054 lbl.pdf. Accessed August 27, 2023.

Relationship with patients important for pharmacy techs. Ayers Career College. Dec 20, 2012. https://ayers.edu/blog/relationship-important-for-

pharmacy-techs/. Accessed August 17, 2023.

NPTA advocacy- key issues. National Pharmacy Technician Association. 2020. https://www.pharmacytechnician.org/npta/Key_Issues.asp.

Accessed August 17, 2023.

Job description technician, pharmacy (investigational drug service). University Health Network. American Society of Health-System Pharmacists. 2023. https://www.ashp.org/-/media/assets/pharmacy- practice/resource-centers/investigational-drug-services/articles-and- guidelines-example-pharmacy-technician-clinical-research-job.pdf. Accessed August 28, 2023.

Fabiilli NA, Powers MF. Roles for Pharmacy Technicians in Medication Reconciliation During Transitions of Care. J Pharm Technol. 2017 Feb;33(1):3–7. doi: 10.1177/8755122516680621

DISCLAIMER

The information provided in this course is general in nature, and it is solely designed to provide participants with continuing education credit(s). This course and materials are not meant to substitute for the independent, professional judgment of any participant regarding that participant’s professional practice, including but not limited to patient assessment, diagnosis, treatment, and/or health management. Medical and pharmacy practices, rules, and laws vary from state to state, and this course does not cover the laws of each state; therefore, participants must consult the laws of their state as they relate to their professional practice.

Healthcare professionals, including pharmacists and pharmacy technicians, must consult with their employer, healthcare facility, hospital, or other organization, for guidelines, protocols, and procedures they are to follow. The information provided in this course does not replace those guidelines, protocols, and procedures but is for academic purposes only, and this course’s limited purpose is for the completion of continuing education credits.

Participants are advised and acknowledge that information related to medications, their administration, dosing, contraindications, adverse reactions, interactions, warnings, precautions, or accepted uses are constantly changing, and any person taking this course understands that such person must make an independent review of medication information prior to any patient assessment, diagnosis, treatment and/or health management. Any discussion of off-label use of any medication, device, or procedure is informational only, and such uses are not endorsed hereby. Nothing contained in this course represents the opinions, views, judgments, or conclusions of RxCe.com LLC. RxCe.com LLC is not liable or responsible to any person for any inaccuracy, error, or omission with respect to this course, or course material.

© RxCe.com LLC 2023: All rights reserved. No reproduction of all or part of any content herein is allowed without the prior, written permission of RxCe.com LLC.