CHAPTER 15
COMMUNITY PHARMACY
CHAPTER REVIEW
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Community Pharmacy
Regulations
Organization
Customer Service
Processing the Prescriptions
Preparing the Prescription
Customer Pick-up
Using a Cash Register
Other Duties
Review
COMMUNITY PHARMACY
• The practice of providing prescription services to the
public.
• Almost 2/3 of all prescriptions drugs in the US are
dispensed by community pharmacies.
• One of the key characteristics of community
pharmacy is the close interaction with patients.
TYPES OF COMMUNITY PHARMACIES
• Independent Pharmacies
– individually owned local pharmacies
• Food Store Pharmacies
– A&P, Giant Eagle, Kroger, Pathmark and others
• Chain Pharmacies
– CVS, Walgreens, Rite-Aid and others
• Mass Merchandiser Pharmacies
– Wal-Mart, Kmart, Costco, Target and others
RAPIDLY GROWING ASPECTS OF
COMMUNITY PHARMACY
• Disease State Management (DSM)
• Medication Therapy Management (MTM)
• Other Clinical services and Programs
DSM
• One-on-one pharmacist/patient consultation
sessions
– General medication advice and information
– Diabetes education and monitoring
– Asthma and Chronic Obstructive Pulmonary
Disease (COPD) education and monitoring
– Anticoagualtion education and monitoring
– Weight loss programs
– Smoking cessation programs
– Cholesterol reductions programs
MTM
• Tailored to provisions of Medicare Part D
– 5 Core elements
• Medication therapy review (MTR)
• Personal medication record (PMR)
• Medication-related action plan (MAP)
• Intervention and/or referral
• Documentation and follow-up
CLINICAL SERVICES AND PROGRAMS
• Walk in clinics staffed with nurse practitioners
– Treatment for a limited number of conditions such
as colds and minor injuries
• Pharmacist or nurse vaccination programs
– Influenza
– Herpes zoster
– Pnuemococcal
HOW TECHNICIANS HELP WITH
PHARMACY CLINICAL SERVICES &
PROGRAMS
• Coordinating billing
• Scheduling appointments
• Taking patient information
REGULATIONS: FEDERAL REGULATIONS
AFFECTING COMMUNITY PHARMACY
• Omnibus Budget and Reconciliation Act (OBRA)
• Health Insurance Portability and Accountability
Act (HIPPA)
• Medicare Prescription Drug Improvement and
Modernization Act (Medicare Part D)
• Combat Methamphetamine Epidemic Act (CMEA)
REGULATIONS: WHAT STATES REGULATE
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Counseling
Pharmacy technician certification
Pharmacist to pharmacy technician ratios
Scope of pharmacy technician practice
Record keeping
Required equipment in a pharmacy and work
area requirements
• Scope of medication compounding
ORGANIZATION
• Transaction windows for pick-up and drop-off of
prescriptions
• Pharmacist counselling area
• Drug Storage areas
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Tablets and capsules
Syrups and suspensions
Creams, ointments and other topicals
Eye ad ear drops
Rectal and vaginal preparations
Injectibles
Inhalers and nebulized medications
Locked storage for controlled substances
Refrigerated medications
ORGANIZATION CONT.
• Compounding area
– sink
• Prescription counter for preparing prescriptions
– Counting trays
– Vials
– Labels
• Prescription bins or shelves
– Completed prescriptions arranged by customer’s last
name
CUSTOMER SERVICE
• Presenting in a calm, courteous, professional
manner
– Listening carefully
– Making eye contact
– Repeating what the customer said
– Calling patients by name
• Knowing when to involve the pharmacist
• Dealing with customer complaints
– Positive responses vs. negative responses
PROCESSING PRESCRIPTIONS
• Prescription In-Take
– Patient drop off
– Faxed prescriptions
– E-prescriptions or electronically transferred
prescriptions
– Telephone prescription orders
ENTERING PATIENT PROFILE INFORMATION
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Patient name
Date of birth
Current address
Telephone numbers
Allergy information
Insurance information
ENTERING PRESCRIPTION INFORMATION
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Correct drug and strength
Drug quantity
Directions for use (the sig)
Number of refills
Dispense as Written (DAW) code
Physician name, address, phone, and DEA
number
PROCESSING REFILL PRESCRIPTIONS
• The prescription number
• Availability of refills
• Timeliness for refill
Filing Hard Copy Prescriptions
• By prescription number
• By class
– General prescriptions (non-controlled substances)
– Class III, IV, V controlled substances
– Class II controlled substances
PREPARING PRESCRIPTIONS FOR
DISPENSING
• Generating a label
• Retrieving the correct medication from stock
• Counting or measuring
– Using counting trays
– Automated filling and measuring devices
• Selecting a container
– Safety caps
– Easy open caps
• Affixing the prescription label and auxiliary labels
PHARMACIST FINAL CHECK
• The final step of the prescription filling
process before the prescription is bagged for
patient pick up
CUSTOMER PICK-UP
• Alphabetized prescription bins
• Signature logs
USING A CASH REGISTER
• Scanning a price
• Handling payments
– Cash
– Checks
– Credit cards
– Gift cards
– Coupons
ORDERING STOCK
• Transmitting drug orders to a drug wholesaler
• Receiving drug orders from a drug wholesaler
OTHER GENERAL DUTIES OF A PHARMACY
TECHNICIAN
• Assisting customers with where to find over-thecounter products
• Keeping the pharmacy clean, neat and in working
order
– Cleaning counting trays and countertops
– Keeping disposable supplies stocked
• Bags, vials and bottles, labels, paper, cash register receipts
– Facing stock bottles
– Pulling soon to expire stock from shelves
SEPARATION OF TRASH
• Regular trash
• Trash containing protected health information
– Shredding or sending out for shredding