Is Pharmacy Volume An Issue?

Here is a recent headline from USA Today that is guaranteed to capture your attention. Is it sensationalism? The Angry Pharmacist certainly thinks so although I think he/she is being a little harse when they say things like:

If you read the article, it plays on the emotion of the poor kid who got the wrong medication, and the poor baby who got 5x the amount of amoxicillin and would ‘writhe in pain’ (give me a f**king break, a 16 day old baby isn’t even developed enough to know it even exists, let alone what pain is). Wah wah wah. The kid probably was colic or had some gas and was fussy.

Those of us with kids certainly would care and believe that our kids feel pain. I don’t think I would trivialize someone’s individual experience like that.

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The USA Today article says that retail pharmacy error rates run less than 1% which seems lower than some numbers I have seen depending on what you count as an error. Is it errors reported to the state board? Is it errors that cause harm? Is it errors that are made by humans but caught by the computer system?

An Auburn University pharmacy study in 2003 projected the odds of getting a prescription with a serious, health-threatening error at about 1 in 1,000. That could amount to 3.7 million such errors a year, based on 2006 national prescription volume.

Obviously pharmacists are over-worked. I know the head pharmacist at my pharmacy works almost 80 hours a week year round. At some point, fatigue will influence a manual job. Additionally, I was shocked when I first realized that in many states all that is required to be a pharmacy technician is a high school diploma. They aren’t highly trained individuals although many with years of experience know a ton and are key pieces of the process. There are some efforts to require certification of technicians across states such as the Institute For The Certification Of Pharmacy Technicians.

Job stress for pharmacists has been documented numerous times and given their salaries, many pharmacies push them to drive down the cost to fill (i.e., the more scripts filled divided by the salary = less cost per Rx).

Daniel Hussar, a pharmacy professor at the University of the Sciences in Philadelphia, offers a more critical view. He says staffing policies have made pharmacy chains stressful workplaces. “The emphasis on speed is counterproductive. It’s an invitation for error,” says Hussar, editor of The Pharmacist Activist, an online newsletter.

The time expectations for the pharmacist are very tight as USA Today reports.

Walgreens’ budget guidelines for work hours, never previously publicized, say a pharmacist at a typical store might have as little as two minutes to verify the accuracy of a drug, its dosage and directions.  [And include counseling?]

With a huge shortage of pharmacists and utilization of drugs going up rapidly, this issue isn’t going away.

One Response to “Is Pharmacy Volume An Issue?”

  1. A recent survey of US consumers showed that 58% thought only licensed pharmacists were involved in the filling of prescriptions. Of those that understand technicians assist the pharmacist, few understand the regulations – or lack of regulations – for technicians.

    Today, 39 states require pharmacy techs to register with the state board of pharmacy. Thirty-four require some form of training and 28 recognize certification (or require it under certain circumstances). Very few states (15) require any kind of continung education. This is changing. States such as Iowa and Illinois have adopted new requirements and more states are in the midst of, or, beginning discussions.

    Training and certifying all technicians will not eliminate all errors but it is a good step to establishing a standard for pharmacy technician practice. Errors result also from system issues which all in the profession have an obligation to help eliminate and improve patient care.

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