Giving pharmacy technicians more responsibility has been a growing trend for some time. As pharmacists provide more clinical care, technicians are stepping in to fill some of the tasks that might not necessarily require a pharmacist’s skills.

“Provider status for pharmacists is on the verge of becoming a reality, and pharmacists will increasingly turn over certain tasks to technicians as they become more committed to direct patient care,” said Pharmacy Technician Certification Board CEO Everett B. McAllister, BSPharm, MPA. McAllister, a retired U.S. Air Force colonel, was the 2011 recipient of APhA’s Distinguished Federal Pharmacist Award.

This trend has been on the rise in federal pharmacy. In the U.S. Departments of Defense and Veterans Affairs (VA), technicians have even begun expanding into clinical roles.

“As clinical pharmacist responsibilities increase, an experienced clinical pharmacy technician becomes essential to assist in managing workload,” Salman Tranam, CPhT, a clinical pharmacy technician at Kimbrough Ambulatory Care Center on the Fort Meade Army Base in Maryland, told Pharmacy Today.

Spotlight on Fort Meade

In the U.S. Army, the clinical pharmacy technician position was designed to offer direct support to clinical pharmacists. The Fort Meade Army Base has three clinical pharmacists on staff for its two outpatient pharmacies and one ambulatory care center on the base.

“We do a lot,” Ellen Varner, PharmD, a clinical pharmacist at Fort Meade, told Today. “We run an anticoagulation clinic for Fort Meade patients and those in outlying clinics, as well as smoking cessation and lipid clinics.”

They also counsel patients with asthma and diabetes, take referrals, and are fully integrated into the patient-centered medical home (PCMH) model, where pharmacists are key members on a patient’s care team.

“Technicians are very skilled,” Jennifer Evans, PharmD, a clinical pharmacist at Fort Meade, told Today. “They know a lot about medications and can offer a lot to the PCMH team.”

Tranam said working with a clinical pharmacy technician allows more efficient patient care by having the technician do things like conduct patient screenings and schedule appointments.

Polypharmacy guidelines released in 2010 by the Office of the Surgeon General have also spurred the growth of the clinical pharmacist’s role, according to Evans. The guidelines are aimed at reducing the risk of suicide and other adverse effects associated with taking multiple medications with or without recreational drugs or alcohol.

“It [the guidelines] told pharmacists they need to meet with all patients on high-risk medications,” said Evans. “That push opened the door for clinical pharmacy, and with it came the need for support and the technician opportunity in federal pharmacy.”

The model of using clinical pharmacy technicians has been evolving for a little more than a year at Fort Meade. Evans said they are working on integrating technicians at other bases as well.

But the scenario and resources are different within each Army location and throughout federal pharmacy, according to Varner.

“The idea in Army clinical pharmacy is to have a technician right there with a pharmacist, just like in traditional dispensing,” she said.

COL John Spain, PharmD, BCPS, U.S. Army Pharmacy Consultant, said there’s always going to be the question of oversight when technicians take on more responsibility, but the close relationship between technician and pharmacist makes a difference.

More models

In the late 1990s, the Phoenix VA Health Care System pioneered one of the first clinical pharmacy technician programs, where technicians were part of primary, specialty, and inpatient care services.

“Some clinical technicians have ultimately shifted to leadership positions within pharmacy and even different service lines,” Eric Weber, PharmD, BCPS, FASHP, a clinical pharmacy specialist at the Phoenix VA, told Today. “While these promotions may be a loss to clinical pharmacy services, they serve as a testament to the talent and development of these technicians.”

The Phoenix VA still has two longstanding clinical pharmacy technicians working in its centralized anticoagulation clinic.

Weber said they may have been one of the first to use clinical pharmacy technicians, but he’s sure other VA facilities have also run with the concept and expanded into other areas.

The U.S. Coast Guard (USCG) has a different model entirely that’s been in place for many years, where pharmacy technicians all stand duty. They are also EMT trained.

“Our pharmacy technicians are highly experienced individuals with years of medical experience both ashore and under way,” said LCDR Christopher Janik, PharmD, MSEDM, BCNP, USPHS/USCG, who is Regional Pharmacy Executive at the USCG Academy Regional Clinic in New London, CT.

Although the arrangement is informal, he said, the pharmacists have the ability to use a pharmacy technician’s potential to a large degree to assist with clinical pharmacy functions.

All around, Janik said, if they had more technicians, pharmacists could do even more.