Andreski Michael, Myers Megan, Gainer Kate, Pudlo Anthony
J Am Pharm Assoc (2003). 2018 May-Jun;58(3):268-274.e1. doi: 10.1016/j.japh.2018.02.005. Epub 2018 Mar 30.
Determine the effects of an 18-month pilot project using tech-check-tech in 7 community pharmacies on 1) rate of dispensing errors not identified during refill prescription final product verification; 2) pharmacist workday task composition; and 3) amount of patient care services provided and the reimbursement status of those services.
Pretest-posttest quasi-experimental study where baseline and study periods were compared.
Pharmacists and pharmacy technicians in 7 community pharmacies in Iowa.
The outcome measures were 1) percentage of technician verified refill prescriptions where dispensing errors were not identified on final product verification; 2) percentage of time spent by pharmacists in dispensing, management, patient care, practice development, and other activities; 3) the number of pharmacist patient care services provided per pharmacist hours worked; and 4) percentage of time that technician product verification was used.
There was no significant difference in overall errors (0.2729% vs. 0.5124%, P = 0.513), patient safety errors (0.0525% vs. 0.0651%, P = 0.837), or administrative errors (0.2204% vs. 0.4784%, P = 0.411). Pharmacist's time in dispensing significantly decreased (67.3% vs. 49.06%, P = 0.005), and time in direct patient care (19.96% vs. 34.72%, P = 0.003), increased significantly. Time in other activities did not significantly change. Reimbursable services per pharmacist hour (0.11 vs. 0.30, P = 0.129), did not significantly change. Non-reimbursable services increased significantly (2.77 vs. 4.80, P = 0.042). Total services significantly increased (2.88 vs. 5.16, P = 0.044).
Pharmacy technician product verification of refill prescriptions preserved dispensing safety while significantly increasing the time spent in delivery of pharmacist provided patient care services. The total number of pharmacist services provided per hour also increased significantly, driven primarily by a significant increase in the number of non-reimbursed services. This was mostly likely due to the increased time available to provide patient care. Reimbursed services per hour did not increase significantly mostly likely due to lack of payers.
确定一项在7家社区药房开展的为期18个月的使用技术检查技术的试点项目对以下方面的影响：1）再填充处方最终产品核查过程中未发现的配药错误率；2）药剂师工作日任务构成；3）提供的患者护理服务数量以及这些服务的报销状态。
前后测准实验研究，比较基线期和研究期。
爱荷华州7家社区药房的药剂师和药房技术员。
结局指标为：1）技术人员核查的再填充处方中，最终产品核查时未发现配药错误的百分比；2）药剂师在配药、管理、患者护理、业务发展及其他活动中花费时间的百分比；3）每位药剂师工作小时数内提供的患者护理服务数量；4）使用技术人员产品核查的时间百分比。
总体错误（0.2729%对0.5124%，P = 0.513）、患者安全错误（0.0525%对0.0651%，P = 0.837）或管理错误（0.2204%对0.4784%，P = 0.411）均无显著差异。药剂师配药时间显著减少（67.3%对49.06%，P = 0.005），直接患者护理时间显著增加（19.96%对34.72%，P = 0.003）。其他活动时间无显著变化。每位药剂师工作小时数内可报销服务（0.11对0.30，P = 0.129）无显著变化。不可报销服务显著增加（2.77对4.80，P = 0.042）。总服务显著增加（2.88对5.16，P = 0.044）。
药房技术人员对再填充处方进行产品核查可保持配药安全，同时显著增加药剂师提供患者护理服务的时间。每小时提供的药剂师服务总数也显著增加，主要是由于不可报销服务数量显著增加。这很可能是因为提供患者护理的可用时间增加。每小时可报销服务未显著增加，很可能是由于缺乏支付方。
