#pam2017

The pharmacy technician accepts your prescription and gives you a wait time of 20 minutes. You sigh and accept it as you head to sit down in the waiting area.

The technician quickly checks to see if the prescription is valid and enters it into the computer system. They also quickly check that the drug, dose, directions and quantity to dispense is correct. Once it’s entered, it moves on to be filled. Uh oh. Severe interaction. 

The interaction is between ramipril and Septra.

You’re taking ramipril for high blood pressure. However, when Septra is taken at the same time as ramipril it can produce a potentially life threatening increase in potassium. This could lead to muscle weakness, an abnormal heart rate, palpitations, and even death. 

Your pharmacist doesn’t want you to have to experience this. She picks up the phone and calls your doctor. The receptionist puts her on hold. While on hold she moves on to check other prescriptions so that she doesn’t fall behind. 

Oh look, an interaction with another patient’s prescription. 

Your doctor picks up the phone and your pharmacist explains the nature of the interaction and what could possibly result. She asks if the doctor would still like to continue with this antibiotic, as sometimes it is the only choice. He doesn’t and asks her what would be a suitable alternative. She suggests MacroBID for 5 days. The doctor accepts and she takes a verbal for the order. It goes back to entering and filling by the technicians. No interactions this time!

You arrive back at the counter at exactly 20 minutes. The cashier explains that the pharmacist is just checking the prescription and bagging it, and that she will be right with you.

As a student pharmacist, I’ve heard people say so many things when you tell them that their prescription is going to take 15+ minutes to get ready. For example:

“It’s only a couple of pills in a box - can’t you just stick a label on it?”

“I’m not feeling very well, can you give me one of the pills now and I’ll pick up the rest tomorrow?”

Imagine the implications in this scenario if your pharmacist just stuck a label on the prescription you just handed in. Or even if she just gave you one pill to get you by.

A lot of doctors don’t think about drug interactions when they’re prescribing. Their job is to diagnose. A pharmacist on the other hand deals with these drugs on a day to day basis. They have the knowledge to understand drug interactions and act on them appropriately.

Your pharmacist’s main job is to ensure that your prescription is right for you. This means that they check to make sure your new medication’s dose is appropriate, that it doesn’t interact with medications you are currently taking, with an allergies you may have, or with your medical conditions. 

Your pharmacist understands that you’re in a hurry, that you’re not feeling well. And most of the time, most pharmacists will speed along the process as much as they can. But when a pharmacist reaches a roadblock where things need to be changed, we need more time. In this story, the pharmacist was able to get the doctor within the timeframe the technician gave luckily. But often times, the doctors are with other patients and cannot take the call. At our pharmacy, the pharmacists writes a note and faxes the doctor about the issue because if the pharmacist waited on the phone all day, no one would get their prescriptions.

How much collaboration actually happens in the pharmacy? 

After all it’s mainly just occurs between the people that work at the pharmacy and between the “patient” and them right?

Well, that is partially correct, assuming that there are no issues with the prescription. But, if there is a problem with the prescription, you can ask any pharmacy team member and you will often find that there is a LOT of collaboration happening behind the scenes.

The collaboration can happen with other pharmacists and pharmacy technicians (at other pharmacies), physicians, nurses, and even with the patient’s agents (think caregivers or even other family members). With the expanding scope of every health care related practice, pharmacy staff can even collaborate with dentists, dietitians, dental hygienists, podiatrists and pretty much anyone that might be involved with the medication of the patient.

If it is a problem with your insurance coverage, the pharmacy may even contact your insurance company on your behalf to get prior authorization or even find out if the medication is covered.

In any health care field you will find interdisciplinary (aka multiple areas of health care) collaboration to ensure that the patient has the best therapeutic outcome possible! Pharmacy would not be different!

In fact, in honour of collaboration, tomorrow you will find a post from the @phocusedonpharm who kindly accepted my request to write a post for my mini series of posts for pharmacy awareness month!

In the past few posts, you may have noticed that I used the term “accredited program” for pharmacy technician schools.

Every accredited pharmacy technician program in Canada has to go through a process that ensures that the curriculum meets specific standards. 

Who creates these standards? Well they are determined by the Canadian Council for Accreditation of Pharmacy Programs (CCAPP). 

CCAPP is an organization that determines an educational standard and evaluates whether or not a pharmacy technician (and also pharmacist) program has met the criteria. They have the power to allow a program to be accredited for a specific amount of years or even revoke the accreditation status of a program if it does not meet standard. Furthermore, this helps to ensure that the education requirements throughout Canada are standardized to a certain degree!

If you are interested in reading a bit more about CCAPP, you can visit their website here or read about from my old posts here and here.

Well for those of us working in a pharmacy it is more than that!

In addition to providing medications (once we have a legal prescription of course) pharmacies offer other services that include medication management, administer injections, medical device teaching and more!

For us health care professionals (aka pharmacists and pharmacy technicians), it is also a work place that is engaging, rewarding and of course has its lows and ‘headaches’. 

As a ‘new’ to practice regulated pharm tech in a ‘specialized’ pharmacy environment, I have the privilege to see the impact of my work cascade to the patient and the other levels of the health care world. (Note: I work in what is considered to be hospital pharmacy.) If the main sterile room is late in making the IV preps, it directly impacts the patient as well as the nursing staff that day. For outpatients needing some oral medications, delays in the pharmacy may result in delayed start times for the patient. When a pharmacy staff member (aka pharmacist or pharmacy technician) notices a medication order that is different than normal, it may go back to the doctor for clarifications. The result would also have a direct impact on whether or not the treatment may work for the patient!