Study of Regulatory Restrictions in The Field of Pharmacies

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Technician Tutorial:
The Ins and Outs of Pharmacy Inventory
A patients most basic expectation for service at a pharmacy is that prescribed medications are in stock.
This is one reason its so important to ensure your pharmacy has the medications your patients need,
when they need them. Inventory is one of the most frequently performed tasks in a pharmacy, whether in
a community or hospital setting. In fact, after dispensing, managing and maintaining inventory is the
pharmacy technicians biggest role. This can offer great rewards for a job well done. On the other hand,
ignoring inventory poses great risks. Just a glance can reveal pharmacies that have well-managed
inventories and those that have neglected this vital job. This PL Technician Tutorial reviews the ins and
outs of pharmacy inventory.
Youre working on a refill: a 90-day supply of metoprolol extended-release 100 mg tabs for
Mary Bingham. Mrs. Bingham called in for this and said shell be in tomorrow afternoon to pick
it up. You are surprised when the computer alerts you there are only 80 tablets remaining in
stock. You check the shelf, and the computer is correct. Youre glad to have caught this issue,
because the pharmacy dispenses a lot of this medication. Fortunately, Mrs. Bingham isnt in the
pharmacy waiting for her prescription.
Besides having meds available, for what other reasons are managing and maintaining
pharmacy inventory important?
Pharmacy inventory itself is costly. While keeping adequate inventory in stock is a necessary
requirement to serve patients, keeping too much in stock can be financially detrimental. Both too little
inventory (below the pre-determined reorder point or par level) and too much inventory (reorder
quantities that cause you to exceed desired stock-on-hand) are directly related to poor inventory
practices.
In addition, there is an actual dollar cost associated with the space for storing inventory in the pharmacy.
Plus, space in a pharmacy is a valuable resource for other reasons. Good work takes place in an orderly
environment. A disorderly environment can lead to mistakes and a breakdown in efficiency. When vital
space such as countertops and shelving are used for long-term storage of inventory, workflow can be
impeded.
You wonder if there was somehow a mix-up with the reorder point for the metoprolol tabs, or the
reorder quantity needed to maintain the appropriate amount of stock-on-hand. Normally, you
keep up to 500 tabs of these tabs on the shelf, and reorder when you drop below 300 tabs. As
you are thinking about this short supply of metoprolol in your pharmacy, you notice there are
several unopened bottles of tranexamic acid tablets sitting on the counter. You know this med is
not frequently dispensed and its very expensive, so you make a mental note to mention this to the
pharmacist.
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How is a pharmacys inventory measured?

Most pharmacies count their inventory and its value annually, semiannually, or quarterly. Many
operations also have the ability to maintain a floating or perpetual inventory with automated inventory
systems. These systems account for inventory and its value as it is received and as it sells. This method
gives the pharmacy constant inventory information in real time. However, physical inventory
adjustments are still needed periodically. This physical measurement of inventory requires the actual
hands-on counting of bottles, tablets, etc.
Inventory measurement can be contracted or done in-house. There are several companies that specialize
in inventory measurement. Some pharmacies choose to use their own crew to do inventory. The method
and frequency of inventory measurement is not as important as having a policy that governs how it is
done. Following the policy gives the pharmacy a dependable method of knowing its inventory value.
Inventory levels and ratios such as the inventory value as a percentage of annual sales may be somewhat
similar in most pharmacies. However, differences in business approaches, work methods, and types of
patients will affect these numbers for your pharmacy specifically.
Where do pharmacies buy their inventory?

Most pharmacies purchase the majority of their inventory from a supplier such as a wholesaler.
Wholesalers are essentially a single source through which pharmacies can purchase drugs and supplies
from various manufacturers. A large number of pharmacies in the U.S. are supplied by a few national
wholesalers including McKesson, Amerisource/Bergen, and Cardinal. In Canada, major wholesalers
include McKesson and Kohl & Frisch. Pharmacies usually have multiple suppliers, at least a primary and
a back-up source. Big pharmacy chains may own their own wholesaler. Some pharmacies use a
combination of external wholesalers and their own warehouse. Drugs can also be purchased directly from
manufacturers. This is less convenient for pharmacies, but necessary for some drugs that have special
requirements such as limited distribution or special storage.
Business agreements govern discount rates, payment agreements, and return privileges between the
pharmacy and its supplier.
The wholesaler or warehouse offers an array of services other than supplying merchandise. The most
important of these is to take inventory back. The agreement between the supplier and the pharmacy
contains a set of rules governing all aspects of returning goods. Pharmacies need a way to sell goods back
to the wholesaler when too much stock is delivered, the wrong item is received, medications go out of
date, merchandise has stopped selling, etc. This inventory becomes unusable as it begins to expire in the
store. (Remember that if only a month and year are designated for the expiration date, the drug expires on
the last day of the month.)
The downside of too much inventory is not only financial. Issues with clutter or not moving stock
appropriately are also important considerations. The warehouse or wholesale operation can shift
merchandise from a location where it is not being used to one where it will be used, but only if the
pharmacy returns the product to the warehouse.
Some pharmacy companies choose to use a returned goods company in addition to their principal
wholesaler. These companies specialize in returns of out of date or close date merchandise that the
main wholesaler doesnt accept. The payment from these companies is lower than the usual wholesale
value, but they offer an easy way to dispose of product that is no longer saleable. These one box return
companies also handle Schedule II controlled substances including the required DEA 222 transfer forms
(in U.S.).
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What are some tools and strategies for ordering and maintaining inventory?
While community pharmacies will order medications based on what is purchased in the store, hospital
pharmacies will order what is needed from a list of drugs known as the hospitals formulary. The
formulary is usually determined by a group of health care professionals and administrators (the Pharmacy
and Therapeutics or P and T committee), balancing effectiveness of the medications with factors such
as cost and safety.
All staff should know their assignments and work to keep appropriate levels of useful inventory in stock.
Fortunately, pharmacies also have good tools to help with this, such as shelf labeling, automated
reordering, and automatic substitution.
Shelf labeling is a manual technique of inventory management. Labels are used to mark a shelf place for
each product. The label provides the name/strength/size of the medication, NDC (U.S.) or DIN (Canada),
reorder number, bar code, size, etc. These labels help when its time to reorder stock manually, such as
when a med drops below its predetermined par level or reorder point. Generating a reorder in a welllabeled pharmacy can be done easily using a portable data terminal device to scan labels and adjust order
quantities. By placing a label on the shelf for all products in the pharmacy, shortages can also be quickly
identified. Creating new labels can also be very helpful. If the store has to wait for the warehouse or
wholesaler to send labels, much of the impact of labeling is lost. Diligence and patience are required to
keep a store well-labeled, but the benefit to inventory levels, and ultimately to patients, is well worth the
effort.
Automatic reordering is a feature most pharmacies already have, though many may not use it. Most
computer systems allow reorder points and stock-on-hand values to be set for each medication, which is
referred to as a point of sale inventory system. Prior to generating an order, the system can list all
products that need to be replenished. A purchase order is then created and sent to the supplier. In more
advanced systems, the software determines inventory level through usage, then orders the merchandise
without any interaction from the pharmacy staff. Even with these automated systems, though, it is a good
idea to review each order to make sure the items and quantities are appropriate. If unusually high or low
amounts in the order catch your attention, take a look at your target inventory and actual inventory to see
if everything makes sense.
Most suppliers offer the option of automatic substitution to minimize out of stocks. This feature gives
the warehouse permission to send another size or brand if they are out of stock, or if a more economical
preparation becomes available. Chain pharmacies often have suppliers provide drugs from the same
manufacturer to all stores in the area. This way, patients will receive a familiar-looking medication
regardless of the location where they had it filled.
Here is a list of other tasks to help with maintaining and managing inventory:
Perform inventory tasks each day. Make sure you know the deadline by which an order must be placed
in order to be received in the pharmacy by the next delivery day.
Dont wait until products are out of stock to maintain your inventory. Pay extra attention to fast
movers, meds that are very commonly dispensed such as atorvastatin, furosemide, and metoprolol. It
can lead to patient dissatisfaction if these are out of stock, and also have significant financial impact for
the pharmacy.
In the community setting, avoid ordering new and expensive meds until a patient brings in a
prescription. Verify the cost with the patient beforehand, and dont open the container or label it until
the patient has paid. This way the drug can be returned to the supplier if necessary. In the hospital
setting, the need to stock new meds will be determined by the formulary. However, circumstances may
arise where a patient needs a new and expensive med that is not on formulary. If this is the case, a
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pharmacist or administrator will typically be able to advise about how much of the drug to order, and at
what point any excess should be returned.
Keep reasonable but not excessive amounts of non-income products such as bags, labels, and vials in
stock. Like excess inventory of drug products, these can tie up cash flow and space.
Mark products that are set to expire soon with a colored sticker or some other identifier so they can be
used first and removed from the shelves for return to the supplier at the appropriate time. In some
situations, such as for medication trays for code carts in the hospital setting, you will want to avoid
stocking medications that will expire soon (e.g., within the next three months). The reason is that the
carts will be stocked throughout the hospital, and monitoring and exchanging them within a short period
of time due to expired meds is not an efficient use of time. Make sure you are aware of these types of
rules in your pharmacy.
Fortunately, you are able to manually add metoprolol extended-release 100 mg tabs to your
order that will be delivered to your pharmacy tomorrow. The order is usually delivered early
and gets checked in right away.
What should be done when an order is received in the pharmacy?
When an order is received in the pharmacy, make sure the number of cartons received matches up with
the number of cartons shipped. Point out any noticeable damage to the shipment before the delivery
person leaves. Check the order in as soon as possible after it arrives to make sure all ordered items have
been received. Use the packing slip or invoice and mark off items as they are removed from the shipping
containers and placed on pharmacy shelves, etc. Contact the wholesaler or supplier immediately for any
damaged or shorted items. If the cause of a shorted item is a drug shortage, the pharmacist may need to
work with prescribers to find alternatives for patients.
Keep in mind that controlled substances may be delivered in a separate order from noncontrolled
substances. These may need to be checked in by the pharmacist and the paperwork must be filed
separately from other pharmacy invoices.
Make sure drug products are placed in the appropriate area for storage: shelves, locked cabinet,
refrigerator, or freezer. If you are unsure of proper storage, check with the pharmacist or look at the
package or product labeling, under the How Supplied or Storage and Stability section. Make sure
refrigerators and freezers are working properly to avoid wasting supplies of drugs that require
refrigeration or freezing, such as vaccines. When stocking new meds in the pharmacy, pay attention to
the potential for mix-ups to be caused by look-alike, sound-alike drug names. Use shelf tags, bins, etc to
separate these products to prevent dispensing errors.
Be sure to rotate stock when unpacking new orders so packages with shortest expiration get used up first.
Place new product behind, not in front of, whats already on the shelf. Also, mark open stock bottles to
avoid having multiple open bottles of the same product on the shelf.
What should be done with regard to returning inventory to the supplier?

Merchandise to be sent back to the warehouse should be kept in a designated area for returns. Usually
drugs that expire within one to three months will be removed from shelves and placed here. A recall is
another reason a drug may need to be removed from shelves and placed in a designated area.
The return process should take place at regular intervals. This will ensure there are not huge stacks of
unprocessed returns or multiple piles of return goods cluttering up the pharmacy. It is important to
process returns on a consistent basis. This ensures the most credit for returns while freeing up inventory
dollars to order the most needed items for your patients.
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You find out from the pharmacist that the bottles of unopened tranexamic acid tablets sitting on
the counter were pulled from the shelves for return to the wholesaler. You place these in the
designated area, knowing that returns will be processed within the next couple of days.
How is the inventory of controlled substances different from inventory for nonscheduled
drugs?
In the U.S., inventory of controlled substances has specific requirements mandated by the Drug
Enforcement Agency (DEA). The DEA requires that a controlled substance inventory (Schedule II-V) be
done when a pharmacy first opens, then once every two years. This record needs to be kept in an easily
accessible place for at least two years, in case of inspection. The record must contain the pharmacys
name, address, and DEA number and must be signed by the person who does the inventory. State boards
of pharmacy also have requirements for inventory of controlled substances. An example of this would be
perpetual inventory of Schedule II-V substances reported to the board of pharmacy twice a month. Both
state boards of pharmacy and pharmacy policy may dictate other procedures involving controlled
substances, such as the method for filing paperwork associated with the ordering of controlled substances,
storage of controlled substances, etc.
In the U.S., remember that the ordering of Schedule II controlled substances requires a special order form
(DEA form 222) that is available as either a paper triplicate or electronically. When C-IIs have passed
their expiration date, DEA Form 41 must be completed and destruction of the expired drugs must be
witnessed.
Rules regarding inventory of controlled substances are similar in Canada. For example, controlled
substances may need to be counted quarterly to make sure there are no major discrepancies.
Discrepancies may need to be reported to Health Canada, depending on the drug involved.
Can medications that patients dont use be returned to stock?

In most states and provinces, medications cannot be returned to stock once they have left a retail
pharmacy. Its impossible to know how the medication was stored or if its been altered in some way that
might make it dangerous. In the U.S., some states do allow the return of medications if they are in their
original container and unopened with the factory seal in place. If a medication is not picked up by a
patient and has not left the pharmacy, it may be returned to stock. The drug should not be added back to
the stock container unless its the same lot number. If not, just keep it in the prescription container and
remove patient-specific information. It can then be recounted into a new bottle and labeled for another
patient. These rules also apply to pharmacies that deliver medications to patients. If the medication is
never delivered and does not leave the possession of the driver, it may be returned to stock. Most states
and provinces have specific regulations on what may be returned and what cannot. In the U.S., check
with your state board of pharmacy for information on regulations specific to your state. In Canada, check
with your provincial or territorial pharmacy regulatory authorities.
In the hospital setting, unused unit doses can usually be returned to stock. However, storage conditions
on patient care units may determine whether or not injectables can be returned to stock. For example, if a
vaccine that requires refrigeration is found on a countertop in a med room or unused and in a med return
bin, you should check with the pharmacist about what to do with the dose. It may need to be discarded, or
if room temperature storage for a period of time is allowable per the manufacturer or other guidance, it
may be able to be redispensed to another patient. The same is true for IV piggybacks such as antibiotics
and for IV infusions or fluids such as heparin drips, insulin drips, and maintenance fluids (e.g., normal
saline 1000 mL with potassium chloride 20 mEq).

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One way to reduce unused medications in the hospital setting is to avoid delivering duplicate supplies.
For example, if a nurse reorders a medication, you can look into the reason for the reorder. Many
reorders are appropriate, such as when a medication ordered as a continuous infusion runs out (e.g.,
amiodarone, heparin, insulin) or when a bulk med is empty (e.g., inhalers, insulin vials, ointments).
However, if a reorder seems too soon, its a good idea to cover your bases and make sure the nurse is
looking in the correct location for the med, such as for meds that are refrigerated. Also, make sure the
patient wasnt transferred and his or her meds were delivered to the old location. If you do redispense a
med in response to a reorder and find that the patient already has an adequate supply on the patient care
unit, simply return the redispensed med to stock.
When Ms. Bingham comes in to pick up her metoprolol the next day, she brings with her an unused
Z-Pak that was prescribed for her husband about two weeks ago. She asks if it can be returned.
You tell her there is a chance, since it is in the original package and has not been used. However,
you ask the pharmacist to speak with her and confirm whether or not a return can be made.
Project Leader in preparation of this PL Technician Tutorial: Stacy A. Hester, R.Ph., BCPS, Assistant
Editor
Cite this document as follows: PL Technician Tutorial, The Ins and Outs of Pharmacy Inventory. Pharmacists
Letter/Pharmacy Technicians Letter. August 2015.

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(Page 1 of 4)
Technician Training Tutorial:

Optimizing Pharmacy Workflow
Optimizing workflow in the pharmacy is important for both efficiency and patient safety. Your pharmacy
should ideally function like a well-oiled machine or a Swiss watch, as they say. This involves both the
pharmacy environment itself and how the work is performed within the pharmacy environment. Think about
it like cooking a meal. Isnt it much more efficient to keep the dishes clean, remove garbage, and return
ingredients to their proper storage locations as you cook, as opposed to generating a bigger and bigger mess
as you work? Doesnt following recipes give you a better chance of producing a delicious dish instead of
something you never intended to create? Because work in the pharmacy involves more people and more
functions, this scenario is amplified when we apply it to dispensing meds efficiently and safely for patients.
Keep in mind that efficiency is not the same thing as rushing. Working efficiently means that effective work
is done in a minimum amount of time. In contrast, rushing or using shortcuts could lead to more problems,
such as errors, that will end up costing time in the long run. A good example of a shortcut that is quick but
does not improve efficiency is the use of unsafe medical abbreviations. They may be faster to write out than
the words they represent, but they are also known to cause very serious, even fatal, errors. This PL
Technician Training Tutorial covers practices you can use to improve pharmacy workflow.
Chuck Upton is a 57-year-old male who comes in to your pharmacy with a new prescription for
dexlansoprazole 30 mg capsules, take one by mouth once daily. He is a new patient, so you hand
him your standard form for new patients to fill out, which will include information about his
allergies, medical history, and insurance coverage.
Meanwhile, you notice three other people have come to the drop-off window, and things seem to be
getting busy. The next patient has a list of ten refills she needs, so you ask her if she will be waiting
to pick them up. She says, oh no, I know this will take some time, so Ill be back tomorrow
afternoon. You go ahead and put Mr. Uptons Rx before hers. Mr. Upton has taken a seat and
will be waiting for his Rx to be filled today. Hes okay with the 20 minute wait time.
What are some general practices I can use to improve the environment in my pharmacy?
As a rule, the pharmacy should always be kept both clean and organized. This may be easier said than
done, especially when the workload in the pharmacy is at its peak. Still, as they say, an ounce of prevention
is worth a pound of cure.
Always take the time to place medications and other pharmacy supplies in their proper storage
locations. This helps ensure that correct medications will be chosen from pharmacy shelves for filling
prescriptions. It also helps keep the dispensing process efficient, so you dont have to spend time searching
for the correct supplies (e.g., bags, labels, lids, vials) when you need them. In addition, placing meds and
supplies in their proper storage locations ensures that items stored in their proper places arent hidden by
other items that are inappropriately stacked or stored in places they dont belong.

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Be consistent about removing unnecessary items from the different locations in the pharmacy. For
example, cleaning out discontinued or unclaimed meds from the will-call area (or removing discontinued
meds from a patient care unit in the hospital) and returning them to stock on a regular basis will help keep
the will-call area organized, improving efficiency and patient safety. Errors that can be avoided by keeping
the will-call area neat and up-to-date include giving meds to the wrong patient. Another example is placing
meds that are soon to expire in a designated area to be returned. This can help prevent dispensing of meds
that are expired or too close to expiration to be dispensed.
Keep in mind regulatory agencies in the U.S., such as state boards of pharmacy, mandate standards of
cleanliness, such as keeping food and beverages out of refrigerators and freezers meant for medication
storage. Place your food and beverages only in areas designated for food and beverages. Also, be sure to
keep personal items such as purses and backpacks off of pharmacy floors and counters and in designated
areas such as cubbies, lockers, or break rooms.
How can the pharmacy be organized?

Just as a house has designated areas for certain activities such as eating, showering, and sleeping, a
pharmacy should have designated areas where certain activities are performed.
Define areas of activity and what functions should be performed in each area. Some of the areas of activity
might include prescription drop-off, computer order entry, compounding, and prescription pick-up.
Technicians can be assigned responsibility for the specific areas. Then technicians can be cross-trained to
work in different areas. Defining areas of activity in the pharmacy can reduce chaos, and allow technicians
to focus on one task from start to finish instead of bouncing from one task to another. Note that if you work
in a hospital setting, the different areas within the pharmacy may be far more different from each other than
those within a community pharmacy. Special competencies may be required for technicians to work in areas
of the hospital pharmacy such as the IV room.
Assigning technicians to different areas can also help prevent bottlenecking in the pharmacy. For example,
if only two technicians are working and both are at prescription drop-off, with no one assigned to the area
for filling prescriptions, the queue at the pick-up window will be out of control with patients waiting for
their filled prescriptions!
Monitor areas of activity to make sure work is not backing up anywhere and that problems are getting
handled in a timely manner. For example, if you see that a technician in an area other than yours is very
busy and you are having a lag in your work, you might ask if you can step in and cover for a few minutes so
that tech can troubleshoot on whatever is holding him or her up.
You start entering Mr. Uptons information into the computer. He has an allergy to sulfa drugs
(rash), and he has been taking acetaminophen for headaches and OTC omeprazole for upset
stomach. He doesnt list any other medical conditions or Rx meds that he has been using. You
look over his prescription to make sure all the necessary info is included: drug, dosage form,
strength, route, directions, number of refills, etc. The information is all there, so you are ready to
enter it in to the computer.
What practices can be used to optimize workflow?
There are a number of ways technicians can help optimize workflow in the pharmacy. Its best when all
pharmacy staff work toward this common goal.
Be on time for work. When folks come late to work, this can really throw a wrench in the workflow. No
one likes to start out the day being behind. Besides, tardiness is unprofessional, a poor example for
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coworkers, and a possible stimulus for disciplinary action. Make sure your breaks are scheduled at
appropriate times of day (those that arent the busiest), coordinated appropriately with your coworkers, and
that you return from your breaks on time.
Once your pharmacy is clean and organized and areas of activity are established, it is important that the
work patterns in each area are defined and followed. Work patterns mean that each technician is trained to
perform the same work similarly, so the work is both efficient and safety checks are incorporated
consistently.
Work patterns can be defined for functions such as gathering patient information, selecting medications from
pharmacy shelves, returning medications to stock, and so on. For example, the work pattern for choosing
meds from pharmacy shelves may involve a number of double checks as well as the use of shelf tags for
information about alternate storage locations for look-alike, sound-alike meds. Work patterns may also
incorporate customer service as a priority. Some examples include acknowledging patients as they approach
the pharmacy counter, promptly answering the telephone, and informing patients ASAP about any problems
regarding the filling of their prescriptions. Here is a very basic example of a work pattern for incoming
prescriptions:
Acknowledge the patient
Gather patient information including date-of-birth, medication history, diseases/conditions, allergies,

insurance coverage
Screen the patients prescription for omissions

Prioritize work, such as incoming prescriptions. Not all prescriptions much be filled ASAP, nor do all
prescriptions need to be filled at once. Try to find out when each prescription needs to be ready and make a
note on the prescription to inform other pharmacy staff. Then work on in-store prescriptions (or stat
orders in the hospital pharmacy) first. Fill in the gaps and lulls in your workload with prescriptions that
arent as pressing such as those that you know wont be picked up for a day or two (or in the hospital, those
that will go out on a scheduled delivery). Some work may be saved or scheduled for a time of day when you
know you will be less busy.
Have a system in place to handle problem prescriptions such as insurance rejects, out-of-stocks, refill
requests, etc. These can be separated from normal workflow with the use of a special system such as colorcoded baskets. A technician can be assigned to work on these problems and follow up on them as necessary,
rather than multiple technicians dealing with them individually and interrupting their assigned workflows.
This technician will also need to notify patients of any issues with their prescriptions, whether they are instore or planning to pick up the prescription at a later date.
Keep the lines of communication open. For example, communicate with your coworkers as soon as
possible about any problems that you anticipate will affect workflow. Some examples of these types of
problems include meds that are out of stock, special order meds, a large incoming order, a malfunctioning
automatic dispensing machine, and a third-party payor computer thats down. When you communicate
about these problems in a timely fashion, others may be able to help mitigate the problem, such as by
providing an extra set of hands, notifying patients of delays, etc. Remember that work is all business and all
about the patients. Dont let any kind of personal friction with coworkers impede professional
communication.
Also communicate with patients about any problems having to do with their prescriptions. This type of
customer service is very important and can help prevent unwanted outcomes such as frustration or
inconvenience for patients as well as delays or interruptions in their drug therapy. In the hospital setting,
nurses will appreciate being kept abreast of problems with their patients orders that might lead to delays.
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An example of this might be a med that is especially labor intensive to prepare or the need for an order to be
clarified by the pharmacist with a prescriber prior to dispensing.
Be sure to minimize distractions when you are on duty in the pharmacy. Avoid excessive chatter about
personal business, personal phone calls, text messaging, internet surfing, etc. Stay focused and on-task when
youre working to help reduce the chance of errors and disturbances to workflow. Use your break times to
attend to personal matters and socialize.
Mr. Uptons Rx is rejected by his insurance because it will require prior authorization. Mr. Upton
needs to try a generic form of this type of stomach medicine before his insurance will pay for
dexlansoprazole, which is not available as a generic and is more expensive. Mr. Uptons Rx goes
to another tech assigned to work on third-party rejections. You hear the technician tell Mr. Upton
that his Rx is going to take longer than expected because there are issues with his insurance.
Mr. Upton says he would be glad to come pick up his Rx first thing in the morning. Your coworker
thanks him for his patience and assures him that his med will be waiting for him when he arrives
tomorrow.
Cite this document as follows: PL Technician Training Tutorial, Optimizing Pharmacy Workflow. Pharmacists
Letter/Pharmacy Technicians Letter. October 2013.

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(Page 1 of 4)
Technician Training Tutorial:

Patient Profiles 101
An important part of being able to provide the best drug therapy possible for patients is having all the
necessary information about them and maintaining their patient profiles. Good patient profiles can help
the pharmacist identify which drugs should be avoided, which drugs will be appropriate, the appropriate
dose of a drug, and so on. In fact, about one in five serious, preventable adverse drug events happens
because health care providers DONT have enough information about patients. This Technician Training
Tutorial reviews the basics of gathering patient information.
Casey Sanchez is a 25-year-old female patient who comes into your pharmacy with an Rx for
doxycycline 100 mg PO BID x 21 days. She tells you she just moved into town and is a graduate
student in English literature at the local university. You suspect she has never had a prescription
filled at your place before. You double check this on the computer, and you do not find Casey
Sanchez.
What is my role, as a technician, in gathering patient information?
In the community pharmacy setting, technicians are likely to have the most face time with patients. This
opens up opportunities for asking patients questions and gathering info that is needed for making patient
profiles and keeping them current. Name, address, and date of birth are three pieces of information that
you likely gather for all patients, for identification. But beyond these basics, you can gather and maintain
patient information that will help prevent problems with drug therapies.
In the hospital setting, nursing staff will usually be responsible for entering most patient information into
the computer. However, pharmacy technicians may play a role, such as with entering medication lists
through medication reconciliation programs.
What information should I ask for and maintain on patient profiles?

Keep in mind that you need to gather information from new patients, but that you should also maintain
current information on existing patients. There are a number of things that can change. Some examples are
allergies, medical conditions, and weight. Making sure that a patients info is up-to-date when refilling
meds or dispensing a new Rx will help avoid any problems.
When communicating with patients, be clear in your questions and statements. Always use simple terms and
avoid the use of medical jargon. Request info from patients by using open-ended questions, as opposed to
questions that can be answered with a simple yes or no. This can help avoid mix-ups and
miscommunication. If your pharmacy has a policy on collecting patient info or a form you can use, make
sure and use it consistently.
Patient identifiers. Continue to ask for patient name, address, date of birth, and gender. This helps ensure
the right patient gets the right med. It seems very simple, but mix-ups with patients are not unusual. And
they can lead to significant harm.
Names can be tricky. Always verify spelling of names, both first and last. Think about names such as Ann
or Anne; Brian or Bryan; Erin or Aaron; Carrie, Cari, or Kerry; Smith or Smyth; Green or Greene; and so

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on. Plus, folks seem to be getting more and more creative with the spelling of names. They arent always
spelled like they sound.
Make sure you have the correct middle initial, as well as suffix such as Jr, Sr, II, III, or IV. This can help
prevent mix-ups between patients who have the exact same first and last names.
Keep phone numbers and insurance information up to date as well. Some computer systems allow you to
look patients up by phone number. And having current insurance info will prevent issues with billing.
You ask Casey Sanchez to verify the correct spelling of her name, as well as her address, phone
number, and date of birth. She spells her name with a K instead of a C (Kasey instead of
Casey). You enter the name correctly into the computer, and you make a note on the Rx of the
correct spelling. You also note in the computer that Kasey is a female.
Allergies. Medication should not be dispensed (except in very rare circumstances such as emergencies) until
a patients allergies are documented. Dont just ask for medication allergies. Other allergies that you should
document include vaccines, supplements, food, dyes, and other substances such as latex. In addition, ask for
the specific reaction the patient had to the substance to which he or she is allergic, as well as when the
reaction took place. This info can help the pharmacist make decisions (sometimes along with the prescriber)
about whether or not a drug therapy is appropriate.
Consider a situation where a patient who reports an allergy to the antibiotic penicillin is prescribed the
antibiotic cephalexin for an infection. In general, patients who are allergic to penicillin can also have
reactions with cephalosporin antibiotics such as cephalexin. If the patient reports a reaction such as
stomach ache with penicillin, the pharmacist is likely to go ahead and dispense the cephalexin. Stomach
ache is not generally a true allergic reaction. On the other hand, if the patient reports shortness of breath
with penicillin, which is a serious allergic reaction, the pharmacist is likely to take additional steps to decide
whether or not cephalexin will be safe for the patient.
Here are a few more examples of why good allergy info is important:
Patients with certain allergic reactions to eggs should in most cases only receive flu vaccine from allergy
specialists.
People with severe latex allergy might have trouble if medications in vials with natural rubber stoppers
are dispensed.
Patients with gluten sensitivity (celiac disease) can become very sick if they take medications that
contain gluten.
If a patient has had a serious allergic reaction to a vaccine in the past, he or she should not receive that
vaccine again.
You ask Kasey if she has any allergies. She responds that she is allergic to codeine, peanuts, and
strawberries. When you ask for specific reactions and when they happened, she tells you that she
has nausea with codeine, which happened about one year ago, and breathing problems and hives
with both strawberries and peanuts, which happened when she was a kid.
Medication lists. A comprehensive medication list is also important. This can help prevent any issues such
as duplicate therapy, incorrect dosing intervals or schedules, use of medications that are no longer needed,
and drug-drug interactions. A medication list should not be limited to Rx meds only. Meds such as overthe-counter products, and supplements such as vitamins and herbals should also be included. Also include
meds that are used on an as-needed basis and meds that are used topically such as creams, patches, eye
drops, and inhalers. These can be easy to forget.

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Vaccines that a patient has received should be included on a med list. This can help pharmacists recommend
appropriate vaccines for patients who have missed them or who are due for another dose.
You ask Kasey if she takes any medications. She says that she does not take any other Rx
medications, but that she does occasionally take acetaminophen, ibuprofen, and OTC omeprazole.
Medical conditions or disease states. Adding conditions or disease states to patient profiles can be key for
helping the pharmacist really fine tune drug therapy. For example, kidney disease or renal failure is a factor
for dosing many drugs. Doses will often need to be reduced because the body doesnt get rid of certain
drugs as quickly when the kidneys arent working well. An example of a drug thats cleared by the
kidneys is the antibiotic trimethoprim-sulfamethoxazole. Clearance by the liver is another way the body gets
rid of drugs. Doses of some drugs may need to be reduced for patients with liver disease or failure. This can
be true for products with acetaminophen, opioids, and a handful of others.
Pregnancy may not be thought of as a condition, per se, but its important to include on a patient profile.
Some drugs, such as ACE inhibitors (e.g., enalapril, lisinopril) should never be used in pregnancy. Some
antibiotics such as quinolones (e.g., ciprofloxacin, levofloxacin) and trimethoprim-sulfamethoxazole should
be avoided at certain times during pregnancy. Its also good for the pharmacist to know if a patient is
pregnant when helping with selection of an appropriate OTC product. Likewise, if a patient is breastfeeding,
this can be included in the patient profile. Drugs can pass to the baby through breast milk, so knowledge
that a patient is breastfeeding can affect drug selection.
You might be surprised to know that conditions such as glaucoma (high pressure in the eye) and myasthenia
gravis (chronic muscle weakness) can affect drug selection. Certain drugs can worsen these conditions, so
its important for the pharmacist to be aware of them. For example, the antibiotic telithromycin should not
be used by patients who have myasthenia gravis.
Other common disease states that should be included on patient profiles include diabetes (specify type 1 or
type 2), hypertension (high blood pressure), hypercholesterolemia (high cholesterol), asthma, heart failure,
any type of cancer, etc.
You ask Kasey if she currently has any medical conditions and she tells you that she has acid reflux
and tension headaches but she doesnt take any Rx meds for either condition, just the OTC meds
that she already mentioned.
Height and weight. Having a patients current weight is key, especially for children. Childrens bodies and
organs are still developing and dont yet function just like adults. Drug dosing for babies and kids is usually
based on weight, such as milligrams per kilogram per dose (mg/kg/dose) or milligrams per kilogram per day
(mg/kg/day). Since these patients weights change over time, be sure to always ask for the current weight.
Note that 1 kilogram (kg) is equal to 2.2 pounds (lbs). These units are easy to mix up. Here are some
example conversions:
Mrs. Simms baby son Carlisle weighs 14 lbs. How many kg does he weigh?
14 lbs 2.2 lbs/kg = 6.36 kg
Mr. Browns baby daughter Samantha weighs 6.7 kg. How many lbs does she weigh?
6.7 kg x 2.2 lbs/kg = 14.7 lbs

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How many kg do you weigh? How many lbs do you weigh? Keep this in mind if you need a quick
comparison to help you remember the conversion.
Always double check your calculations and computer entries. It doesnt hurt to glance at the patient either,
just to make sure the weight makes sense. For example, if you mistakenly enter the value of 10.5 into a
field with a unit of kg instead of lbs, the corresponding field with a unit of lbs might automatically populate
with 23.1. Just looking at the child might help you realize the mistake.
A patients height is necessary for calculating doses of some drugs such as some intravenous antibiotics and
chemotherapy. This is most applicable in the hospital setting. Keep in mind that 1 inch is equal to 2.54 cm.
Lifestyle. Having some information about a patients lifestyle is important for drug therapy and also for
helping the pharmacist encourage improvements and healthy behaviors. Lifestyle info that you can include
on a patient profile includes:
Consumption of certain foods and beverages. For example, alcohol can interact with meds that cause
sedation (such as some pain killers) or with metronidazole (which can increase side effects). Grapefruit
can interact with some meds and cause their blood levels to increase.
Cigarette smoking, which can affect how drugs are broken down by the body
Marijuana use, now legal in some states and in Canada, which may interact with some medications
Of all the patient information you collect, lifestyle information might be the most sensitive for patients. Stay
matter of fact and nonjudgmental in your tone. If youre uncomfortable, ask your pharmacist for guidance.
Kasey tells you she is 54 and weighs about 140 lbs. You enter these values into the correct fields
in the computer so that the units match up. Kasey is an occasional smoker and drinks alcohol
occasionally as well. You thank her for her patience and for the information she has provided, and
tell her it will be about 30 minutes before her Rx is ready. Kasey thanks you, and says she
appreciates you asking for her information. She has never had anyone collect this info from her
before in a pharmacy, and it helps her feel confident that she will be well taken care of now and
when she needs other medications in the future.
What else should I consider about gathering patient info and maintaining patient profiles?
Make sure you are familiar with your computer system so you know where to enter and how to access
patient information. Also, its important to know where to enter and how to access additional info such as
unusual allergies, notes regarding correspondence, and so on, that cannot be entered in any other field.
Remember that patient information of any kind must never be shared with individuals who are not involved
in a patients care and that patient information should never be accessed unless its necessary for the
patients care. Never share patient info with friends, family, or even coworkers unless its directly related to
pharmacy business.
Keep in mind that patients are likely to appreciate privacy and discretion when they are sharing very
personal information. You can help optimize this. Be conscious of the volume of your voice and use a more
private consultation area in the pharmacy when possible.
Cite this document as follows: PL Technician Training Tutorial, Patient Profiles 101.
Letter/Pharmacy Technicians Letter. March 2013.

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Pharmacists
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PL Technician Tutorial:
Certification and CE Requirements
Education, training, and certification help technicians demonstrate knowledge and skills, and their
ability to meet pharmacy practice standards. New state requirements are bringing up questions about
registration, certification, and licensure of pharmacy technicians. For example, the death of a toddler
in Ohio resulting from a hospital pharmacy technicians error not caught by the pharmacist led to the
passage of Emilys Law. Although the pharmacist was also held responsible, new requirements
were put in place for Ohio pharmacy technicians to maximize patient safety and ensure appropriate
pharmacy technician training.
This tutorial explains what technician certification means, how to become certified, and how to
maintain certification. It also reviews technician continuing education (CE) requirements and other
professional development opportunities for technicians. Each state will have different requirements
for its technicians. Use the Technicians CE & Training Organizer to find out requirements in your
state and keep track of your completion of required courses.
What are differences between registration, certification, and licensure for technicians?
States may require technicians to be registered, certified, or licensed. Some states dont require
anything of pharmacy technicians no registration, no licensure, and no certification. Other states use
different terms to describe technician requirements. For example, in Oklahoma, technicians are not
considered registered, but are given a permit. In Ohio, those who meet state requirements are
termed qualified technicians, not registered or licensed.
There is no standard definition of registration, certification, or licensure used by all states.
However, there are accepted, professionally recognized definitions of these terms. Registration is
defined simply as making a list. Registration is usually done to keep track of who is a technician,
where they work or live, and in some states, do background checks. Registration is the only
requirement in some states. In most states, registration does not address the educational and training
background of pharmacy technicians. Some states require technicians to complete additional
requirements to maintain their registration, such as completing a set number of CE hours.
Nearly one-half of states include certification in their regulations. Certification is defined as the
process by which a nongovernmental organization recognizes an individual who meets predetermined
qualifications specified by that organization. Technicians can become certified by taking a national
certification exam, or by meeting state certification requirements. National certification by exam
through the Pharmacy Technician Certification Board (PTCB) or the National HealthCareer
Association (NHA) recognizes technicians who have the education, knowledge, and training to
efficiently assist pharmacists in the safe and accurate preparation and dispensing of medications and
the provision of quality patient care and service. Some states require that technicians take one of the
national certification examinations to get state certification, registration, or licensure. However, other
states grant state certification by recognizing on-the-job training or a diploma, certificate, or
associates degree program from a community college or technical school. State certification may also
be granted through completion of training approved by the state pharmacy board or pharmacy
accreditor (e.g., the American Society of Health-System Pharmacists and Accreditation Council for
Pharmacy Education [ASHP-ACPE]) as an alternative to taking a national examination. The number
of states requiring either national or state certification is expected to increase due to patient safety
concerns. There is even a push for a federal law requiring certification in all states. Check the
Technicians CE & Training Organizer for certification requirements in your state.
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Licensure is required for technicians in some states, including Arizona, California, and Utah.
Licensure is defined as the process by which permission is granted to an individual to practice their
occupation after it is determined that the individual has the minimum level of competency to practice
safely. Licensure may require registration plus certification by exam and/or completion of education
and training. Keep in mind some states use the terms licensure and registration interchangeably.
Check the Technicians CE & Training Organizer to see if licensure is an option in your state.
Which national organizations offer a certification exam?

Certification exams are offered by the Pharmacy Technician Certification Board (Pharmacy
Technician Certification Exam [PTCE] at www.ptcb.org) and the National HealthCareer Association
(ExCPT exam at www.nhanow.com).
PTCB is a non-profit organization governed by five pharmacy organizations, including the American
Pharmacists Association (APhA), American Society of Health-System Pharmacists (ASHP), Illinois
Council of Health-System Pharmacists (ICHP), Michigan Pharmacists Association (MPA), and the
National Association of Boards of Pharmacy (NABP). The PTCB exam is vetted by NABP, which
performed a psychometric audit of the PTCB exam in 2001 and determined that the PTCE is
psychometrically sound, defensible, and valid. Since its inception in 1995, PTCB has certified over
555,000 pharmacy technicians through the examination.
The ExCPT exam is administered by NHA and is endorsed by the National Association of Chain Drug
Stores (NACDS) and the National Community Pharmacists Association (NCPA). The NHA is one of
the largest national health certification providers in the U.S. Established in 1989, the NHA provides
national credentials and an information support network to allied health care professionals, educators,
and the health care industry.
What is the NCCA? What does this mean for a certification exam?
The National Commission for Certifying Agencies (NCCA) reviews and accredits certification
programs that assess professional competency. Meeting NCCA criteria means, among other things,
that the certification program uses fair and valid tests, defines the professionals level of responsibility,
and requires continued proficiency. The PTCBs certification program and the NHA certification
process are accredited by NCCA.
Which exam does my state require?

The answer depends on your state. About a one-half of states currently include national certification
through a specific exam in their regulations. Several states plan to add a national certification
requirement in the near future. In some states, certification is voluntary, but a certain exam may be
recognized by boards of pharmacy if technicians wish to get certified. Other states do not specify
ANY certification requirements or recognize any specific exams for technicians.
If your state requires national certification, you will need to complete an exam recognized by your
states board of pharmacy. Currently, all states that require national certification recognize the PTCE
as board-approved; many of these states also recognize the ExCPT exam.
If certification is voluntary in your state and a specific exam IS recognized by the board of pharmacy,
its a good idea to pursue national certification through the board-recognized exam(s), even though
this certification is voluntary. For example, a state board may recognize the PTCE and/or ExCPT
exam as being board-approved for technicians to use in a voluntary national certification process.
If certification is voluntary in your state and a specific exam is NOT recognized by your state board of
pharmacy, you can still pursue this step in your professional development through the PTCE or
ExCPT exam. Some employers are also setting up internal certification standards that may apply in
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states with no board-approved national certification exam requirements. Alternatively, in some states,
there are other avenues for pursuing state certification, such as on-the-job training or completing an
educational program.
Before pursuing national certification in any state, check with your employer or pharmacist supervisor
about specific requirements or certifications that may be recognized within your organization. Use the
Technicians CE & Training Organizer to check your states requirements, see which exams are
board-recognized in your state, and watch for future changes in your state.
Where do I take the exam?

The PTCB exam is taken on a computer at one of over 220 Pearson VUE Professional Centers
throughout the U.S. Overseas military personnel can be tested at DANTES sites. See
www.pearsonvue.com/ptcb for testing locations.
The ExCPT exam is taken on a computer at a PSI Testing Center. There are over 600 test sites
nationwide. See www.psiexams.com or call 800-211-2754 for testing locations.
When and how do I sign up to take the exam?

The PTCB exam is offered continuously. You can apply online year-round at www.ptcb.org. After
submitting your application, youll receive a confirmation email within 24 hours and an Authorization
to Test (ATT) letter via email (if you provided an email address) or regular mail. Once you receive
the letter, you can schedule an appointment with Pearson VUE to take the exam. The Authorization to
Test letter gives you 90 days of eligibility to schedule an appointment to take the exam.
The ExCPT exam can be taken continuously. You can apply at www.nhanow.com. After submitting
your application, youll receive your confirmation to test. Youll have 24 hours to schedule your
exam. Call 800-211-2754 to register to take the exam at a PSI location of your choice. Or go to
www.psiexams.com to locate a nearby test center.
How much does it cost to take the exam?

It costs $129 to take the PTCB exam. The ExCPT exam costs $105.
What are the pre-requisites for taking a certification exam?

To take the PTCB exam, you must have a high school diploma or equivalent (e.g., GED), full
disclosure of all criminal and State Board of Pharmacy registration or licensure actions.
Coming soon in 2020, PTCB will require you to have completed an ASHP-ACPE accredited program
in order to sit for the exam.
To take the ExCPT, you must be within 30 days of obtaining a high school diploma or equivalent, and
have successfully completed a training program offered by an accredited or state-recognized
institution or an employer-based training program, or have a minimum of 1200 hours of supervised
pharmacy-related work experience within any one year in the last 3 years.
What do the tests cover?

The PTCE questions test knowledge and skills related to the activities performed by pharmacy
technicians. Most of the ninety multiple-choice questions relate to helping the pharmacist serve
patients. The exam is broken down into nine knowledge domains, with medication order entry and fill
process being the largest. The exam applies to both community and hospital settings. There are ten
additional pre-test questions that do not count towards your final score.
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The ExCPT consists of 120 questions, including 20 pre-test questions. A quarter of the exam covers
regulations and technician duties. About another quarter covers medications and drug therapy (e.g.,
drug classes, dosage forms, common side effects, interactions, and indications). The remaining
questions cover the dispensing process, including calculations and IV preparation.
How do I prepare for the exam?

Pharmacy technician training texts, academic study programs, and on-the-job experience can be
helpful in preparing for the exam. Completing an employer training program or technician training
program offered through a technical or vocational school or community college may be helpful.
Check with your pharmacist and other technicians who have successfully passed a certification exam
about help developing a study strategy.
Our Pharmacy Technicians University program is an online, interactive educational course designed to
prepare enrollees to pass any pharmacy technician certification exam. It also helps enrollees learn
what it takes to become a safe, efficient, and overall great pharmacy technician. The course allows
users to go through the content at their own pace. Plus, there are pacing questions, case studies,
educational games, and more to help cement the concepts to memory, as well as keep the experience
fresh and enjoyable. You can get additional information and enroll by going to the Pharmacy
Technicians University website.
Other resources may be available through the testing organizations:
The PTCB web site (www.ptcb.org) offers a sample exam to help in preparing for certification,
available at: http://ptcb.org/get-certified/prepare/practice-exam#.
The NHA web site (www.nhanow.com) also offers sample exams and study guides to help with
preparing for the ExCPT certification exam. These materials are available for purchase at:
http://www.nhanow.com/pharmacy-technician/prepare-for-exam.aspx.
What are my legal liabilities once I become nationally certified?

Whether you are certified or not, you can face criminal charges if you divert or steal medication,
intentionally give a patient more or less medication than prescribed, or put false medical information
in the patients profile for billing or insurance fraud. If you fill a prescription incorrectly and harm a
patient, you could face a lawsuit. This could happen if you enter incorrect information into the
computer, prepare an intravenous medication incorrectly, or put the wrong medication in a prescription
bottle and the pharmacist doesnt catch the mistake. Your employer may have a liability insurance
policy that covers you. Talk to your employer to see if you should carry additional liability insurance.
Make sure you understand what actions technicians are allowed to do in your state and the renewal
requirements in your state. If you perform an action that is considered outside the scope of practice for
technicians in your state, or fail to renew your registration, certification, or licensure as your state
requires, you could be fined or lose your ability to practice.
How long does national certification last?

Certification is good for two years for PTCB and NHA. Also keep in mind that your state might
require you to regularly (e.g., annually or every two years) renew your registration, certification, or
licensure with the board of pharmacy. Some states require CE in addition to maintaining national
certification.
Do I need to maintain my national certification?

Some states require certification for initial licensure or registration, but thereafter the technician does
not have to maintain certification. Other states require that you maintain your national certification.
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Even if it is not required by your state, it is a good idea to maintain your certification because you may
move to a state that requires it, or your state law may change. If your ExCPT or PTCB certification
lapses for more than 12 months, you will need to sit for the exam again to be certified. Check the
Technicians CE & Training Organizer for information on your state or certifying boards renewal
period and renewal requirements.
What are the CE requirements for nationally certified technicians?

To maintain certification, technicians certified by PTCB need to obtain 20 hours of pharmacy
technician-specific CE every two-year renewal period. Pharmacist-specific CE is not accepted. At
least one hour must be in pharmacy law and one hour must be in medication errors/patient safety. The
CE programs do not have to be accredited by the American Council for Pharmacy Education (ACPE).
Five of the hours can be completed by in-service projects assigned by your pharmacist, but by 2018
these hours wont be allowed due to inconsistencies in training. Examples include watching a training
video, reading a journal article, or computer-based training (CBT). Your pharmacist will record these
activities on a special form. A college life science (e.g., biology, chemistry) or math course, with
grade C or better, counts as 10 hours. However, only a max of 10 of your 20 hours of CE credit can be
earned from these college courses. Your transcript or grade report will serve as proof. (Contact PTCB
to make sure your life science or math course will qualify.) All of the proof of your completed CE
must be submitted to PTCB in time for your recertification (renewal). The online procedure for
recertification can be accessed here: http://ptcb.org/renew/recertify#.
Technicians certified by ExCPT need to obtain 20 hours of CE every two years. At least one hour
must be in pharmacy law. Similar to PTCB, the NHA also allows special projects and college courses
to count toward your certification hours. All of the proof of your completed CE must be submitted to
NHA in time for your recertification (renewal). The online form can be accessed here:
http://www.nhanow.com/pharmacy-technician/recertification.aspx.
Bear in mind states can have their own continuing education requirements that may be different from
those required to maintain certification. For example, a state may require a certain number of live
CE hours (e.g., CE delivered by live lecture or teleconference). They might also require that a certain
number of hours cover designated topics such as pharmacy law or medication errors. For example, in
South Carolina technicians need four hours of live CE annually. See our Technicians CE & Training
Organizer for answers about exactly what, if any, CE is required in your state. You can also find
the appropriate Pharmacy Technicians Letter CE course to meet any state requirement, including live
CE requirements.
In some states, the CE must be approved by the board or by ACPE. Consider doing only ACPEapproved CE programs to ensure the programs are acceptable in your state(s). For example, Louisiana
specifies that ten hours must be ACPE approved.
Your state might require tech-specific CE. Some CE is specifically designed for technicians. These
programs have an ACPE code number with the letter T (as opposed to P for pharmacists) at the
end of the code. Regardless of your states requirements, try to choose tech-specific programs because
their breadth, scope, and subject matter are geared specifically to technicians. Technicians can rest
assured that Pharmacy Technicians Letter CE meets ACPE requirements, is specifically designed for
technicians, and will meet PTCB, NHA, and state CE requirements.
How does the board or certifying organization keep track of my CEs?

You may not need to send in your CE certificates unless the state board or certifying organization
audits them. Therefore, you will need to keep proof that you have completed and passed the required
number and types of CEs for a period of time designated by your board and/or certifying organization
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in the event of an audit. For example, for purposes of recertification, PTCB recommends keeping
documentation of CE credits for at least one year past your certification expiration date. NHA requires
that you upload credits online, or mail/fax copies of your completed CE for recertification. Some
states require that documentation be kept up to five years. Technicians should print and keep their
Pharmacy Technicians Letter CE statements of credit as proof of completed CEs.
You also need to report CE credits through a national system, called CPE Monitor, if you want to earn
any of your CE from an ACPE-accredited provider. CPE Monitor is a national, collaborative effort by
National Association of Boards of Pharmacy (NABP) and the Accreditation Council for Pharmacy
Education (ACPE) to provide an electronic system for pharmacists and pharmacy technicians to track
their completed continuing pharmacy education (CPE) credits. To enroll, go to your Technicians CE
& Training Organizer.
I have been a technician for some time. Am I exempt from certification?

Depending on your state and when you started working, you may be exempt from taking a national
certification exam. You might have the option of working as a technician trainee for one or two years
pending state certification, again depending on your state. Check with your state board for more
information.
What additional career development opportunities are possible if I become certified?

Many options exist for technicians wishing to pursue career development or training once national or
state certification is achieved. Talk to your pharmacist or employer about growth or specialization
opportunities within your organization. Many technicians have advanced within their organization to
be a Lead Technician, with resulting supervisory, scheduling, or other responsibilities. A
Pharmacy Technician Trainer may have responsibilities for educating other techs on new
technology, insurance billing, or other professional service initiatives. Some pharmacies may also
offer opportunities for technicians to take on new roles to assist the pharmacist with patient care,
disease state management, or medication therapy management programs. For example, some chain
pharmacies allow technicians to complete a Certified Technician Screener or other training to
participate in pharmacy glucose, cholesterol, and other screenings; immunizations; or disease state
management programs as allowed in their state.
Obtaining additional training may be helpful in expanding your responsibilities. For example, the
National Pharmacy Technician Association offers certificate programs in Sterile Products or
Compounding that combine home study and experience-based learning to help technicians further
specialize. See www.pharmacytechnician.org for more information on these certificate programs.
Who do I contact if I have additional questions?

The Technicians CE & Training Organizer gives all the information on state CE and national
certification requirements and renewal, state-recognized certification processes, and requirements and
renewal periods for state registration, licensure, and permits. If you have national certification, use the
Technicians CE & Training Organizer for information on recertification periods, renewal
requirements, and what types of CE you need. Call Pharmacy Technicians Letter at 209-472-2240 or
email us at ce@pletter.com if you need additional information on your requirements. You can also
contact the national certification organizations or your state board of pharmacy if you have additional
questions about certification or state requirements. Ask your employer or pharmacist supervisor
questions about technician requirements in your organization.

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Contact and Website Information

Pharmacy Technicians Letter / Pharmacy Technicians University
Address:
3120 W. March Lane
Stockton, CA 95219
Phone: 800-995-8712
Email: ce@pletter.com
www.TherapeuticResearch.com
Pharmacy Technician Certification Board
Address:
2200 C Street, NW Suite 101
Washington, DC 20037
Send Recertification Applications to:
Pharmacy Technician Certification Board
P.O. Box 75430
Baltimore, MD 21275
Recertification Application can be accessed here: http://ptcb.org/renew/recertify#.
Phone: 800-363-8012
Fax: 202-429-7596
Email: contact@ptcb.org
http://www.ptcb.org
National Healthcareer Association
7500 West 160th St
Stillwell, KS 66085
Phone: 800-499-9092
Fax: 913-661-6291
Email: info@nhanow.com
http://www.nhanow.com
State Board of Pharmacy
See www.nabp.net/boards-of-pharmacy for contact information for each state board
Cite this document as follows: PL Technician Tutorial, Certification and CE Requirements. Pharmacists
Letter/Pharmacy Technicians Letter. March 2016.

Phone: 209-472-2240 ~ Fax: 209-472-2249
PL Detail-Document #300801
This PL Detail-Document gives subscribers
additional insight related to the Recommendations published in
PHARMACISTS LETTER / PRESCRIBERS LETTER

August 2014
Medication Therapy Management

Hundreds of billions of dollars are wasted every year because of the misuse of medications. Pharmacistprovided medication therapy management (MTM) improves patient outcomes and reduces overall health
care costs. MTM can describe a broad range of patient-centered services that optimize therapeutic
outcomes for patients such as medication therapy reviews, anticoagulation management, and
immunizations. The Medicare Modernization Act of 2003 created more opportunities for pharmacists to
provide MTM by requiring all Medicare Part D prescription drug plans to offer an MTM program. A
comprehensive medication review (CMR) with standardized written summaries must be offered annually
to all Medicare Part D beneficiaries enrolled in an MTM program. This includes enrollees in long-term
care settings. A targeted medication review (TMR) is also required at least quarterly for these patients to
evaluate and manage specific or possible drug-related problems. For 2014 and 2015, there is a display
(i.e., test) measure for Part D plans that looks at the percentage of MTM-eligible Part D patients who
have received a CMR. This display measure is expected to be counted as a quality measure for Part D
Star Ratings in 2016 (based on 2014 data), so the number of CMRs provided today is important. But only
about 10% of Part D patients eligible for a CMR get one. There are plenty of inspiring success stories of
how pharmacists have expanded their services to include MTM, but there are also many considerations
for pharmacists when getting started with MTM, which may vary depending on practice setting. Here is a
toolbox to help you get started or enhance your MTM services, with helpful tips and links to some great
resources from Pharmacists Letter.
Topic
Tips and Resources
Program
Development
Consider Your Resources and Strengths

Network with other pharmacists who provide MTM and look for best practices.
Recognize what you already do such as calling prescribers about drug-drug
interactions, suggesting less expensive alternatives, or finding ways to improve
adherence. Consider how to expand your patient care services from there.
Start with disease states you know best. Consider low hanging fruit where
you can have a lot of impact, such as cardiovascular conditions, diabetes, COPD,
etc.
Consider opportunities to engage patients about the use of devices such as
inhalers, nebulizers, peak flow meters, insulin pens, needles, syringes, blood
glucose meters, testing supplies, etc.
Perform a SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis for
your practice. Use this to identify where changes need to be made to address
internal deficiencies and be prepared to handle external challenges.
Build Your Clientele
Identify patients most likely to benefit from MTM (e.g., those who struggle to
afford meds, those who get early or late refills, those who get multiple meds or
who have multiple conditions or prescribers, those who need immunizations,
those recently discharged from the hospital). Consider using computer-generated
reports; recommendations from technicians, pharmacy students, or cashiers; and
referrals from other health care providers. Also consider unique opportunities,
such as in long-term care settings, when looking to expand services.
More. . .

3120 W. March Lane, Stockton, CA 95219 ~ Phone: 209-472-2240 ~ Fax: 209-472-2249
www.PharmacistsLetter.com ~ www.PrescribersLetter.com ~ www.PharmacyTechniciansLetter.com
(PL Detail-Document #300801: Page 2 of 9)
Topic
Program
Development
continued
Tips and Resources
Consider contracting with online MTM platforms, third party plans, or

employers to identify patients who are eligible for reimbursable MTM services.
Flag eligible patients in your pharmacy system and watch for computer
eligibility alerts. Take action on suggested interventions and schedule CMRs for
eligible patients.
Look at the Logistics

Determine the amount of time required for individual MTM appointments (e.g.,
usually at least 20 to 30 minutes for a CMR) and staffing required to schedule
appointments.
Identify a private or semiprivate area from which to conduct MTM sessions.
Consider use of a privacy screen if necessary.
Assess what equipment you will need, such as a computer and printer, secure
filing area for paper records, sphygmomanometer and stethoscope, clipboard, etc.
Get Buy-In from Staff, Providers, and Patients
Educate staff about the importance of MTM (e.g., improved quality of patient
care, improved outcomes, avoided adverse effects, reduced overall health care
costs, enhanced patient satisfaction).
Build relationships with key local providers and market your service to them.
Consider setting up face-to-face appointments with providers to introduce
yourself and explain your service, or notifying prescribers about scheduled CMRs.
Consider marketing tools, such as a mass mailing to educate patients about the
opportunity to make appointments for MTM, professional flyers stuffed in
prescription bags, or posters that promote the service.
Find out what patients or caregivers expect or desire from MTM. Engage
patients and explain the individualized benefit that they will receive from a CMR,
so they understand the value. For example, getting all health care providers on the
same page, answering all medication-related questions, being able to stay
healthier and save money, etc. Explain how MTM will help address the patients
top concerns.
Develop a 30-second pitch for your entire pharmacy team to quickly and
clearly explain the benefits of MTM and what the patient can expect. Here is an
example script: Did you know your pharmacist can provide a medication
check-up to look at all the medicines you take, including prescriptions, over-thecounter products, vitamins, herbal products, and supplements? Well work as a
partner with you and your prescriber to make sure youre getting the most benefit
from your medicines. Well also look at whether there are any less expensive
alternatives that might help save you money, make sure youre taking the right
meds in the right way and at the right doses, and answer any questions you may
have about your medicines. Youll get a complete medication list after the visit.
Would you like to schedule an appointment?
Dont become discouraged by small setbacks such as recommendations that are
not accepted by a prescriber.
Roles
for
Pharmacy Staff
Find ways techs can help prompt pharmacists to speak to patients about
MTM throughout the dispensing process, such as identifying eligible patients at
drop-off or flagging completed prescriptions.
Encourage techs and other pharmacy staff to use the 30-second pitch and other
More. . .

www.PharmacistsLetter.com ~ www.PrescribersLetter.com ~
www.PharmacyTechniciansLetter.com
Topic
Roles
for
Pharmacy Staff
continued
Tips and Resources
Billing
and
Reimbursement
MTM
Workflow
marketing tools to recruit patients.

Train techs to perform tasks such as getting intake forms from patients, filling
out medication history forms, obtaining vital signs (if appropriate), etc.
Delegate administrative tasks to pharmacy staff, such as scheduling
appointments, prepping paperwork, making reminder calls, faxing info to
providers, billing, and documenting, as appropriate.
Incorporate pharmacy students into the process where possible.
Share success stories with pharmacy staff to ensure they see the value of MTM
and to keep them engaged and motivated.
Apply for a National Provider Identifier (NPI) number in order to bill for
MTM services covered under Medicare Part D
(https://nppes.cms.hhs.gov/NPPES/StaticForward.do?forward=static.npistart)
Determine your fees. These may be negotiable with some payers and you will
need to establish pricing for self-paying patients.
Check with third party payers about how to bill for pharmacists services, such
as what services are covered, what billing codes must be used (e.g., CPT, ICD),
and where to submit the claims.
If you are contracted with an online MTM platform, make sure all staff complete
any necessary training and understand all documentation and billing
requirements.
Delegate billing to pharmacy staff when possible.
Setting It Up
Develop a systematic process for providing MTM. For targeted interventions,
build steps into your existing workflow if possible (i.e., identification of a
problem, discussion with the patient, contacting the prescriber if necessary for
interventions and/or to let him/her know that a medication review has been
completed, and following up with the patient). Map it out with a flow chart.
Consider having a point person who can lead the implementation of patient
care services.
Find out the capabilities of your available technology such as collecting data,
identifying eligible patients, guiding the pharmacist through the MTM interaction,
and generating patient education materials.
Schedule appointments for CMRs during pharmacist overlap or off-peak times
if possible. Consider whether telephone-based services are an option.
Create a system for timely follow-up with patients and/or providers, such as with
computer reminders or a binder divided by day of the month. Involve your entire
pharmacy staff in follow-up to ensure that patient and provider recommendations
are accepted and effective, to evaluate med changes and ensure problems are
resolved, and identify new concerns.
For Each CMR Appointment
When scheduling the appointment and making reminder calls, ask patients to
bring the meds they take (e.g., inhalers, samples, OTC products, vitamins, herbals,
supplements, etc), an updated med list, any recent lab results, and a list of
questions or concerns. Encourage the patient to bring a friend or family member
if that person helps with the patients care or with managing his or her meds.
Have techs gather needed paperwork, equipment, and lab results (e.g., A1C,
More. . .
Topic
MTM
Workflow
continued
Tips and Resources
lipids, serum creatinine) in advance of patient appointments.

Once the patient arrives, have a tech get the patient started with paperwork;
gather all medications; document allergies, vaccines, medical and social history,
labs and vital signs if available; help create the personal medication list; etc.
Review available patient information from the patient profile or claims data
provided by third parties. Rely on the patient to give you additional details.
Find out how the patient uses his or her meds. Ask open-ended questions about
why, how, and when the patient takes each med to find problems as you create the
personal medication list in patient-friendly language. Use probing questions to
get more info if needed.
Ask about the patients beliefs regarding their medications, including cultural or
religious beliefs, whether they believe the medications are helpful, etc.
Consider the patients health literacy and address potential barriers.
Evaluate the patients medication-related concerns. Prioritize and focus on
those that impact the patient most (e.g., high costs, complicated regimen, etc), and
use this information to help guide the medication action plan.
Find and prioritize medication-related problems. For example, match up
medications with conditions to find unneeded meds or undertreated conditions.
Consider whether other medications may be more effective, safer, or less
expensive, or if the patients regimen can be simplified.
Use our helpful tool, Worksheet for Med Review, to get started with the above
steps.
Develop a plan based on the high-priority problems. Ensure patients understand
your recommendations, and what information youll be sharing with prescribers.
Collaborate with the patients health care provider(s) and communicate visit
findings and documentation (including medication action plan and personal
medication list), even if medication changes are not being recommended.
Use a standardized format, such as a SOAP note, for documentation. Keep
notes clear and concise. (See Resources from the Web section for more
information.)
Use templates for med lists, action plans, and communication with providers.
(Note that beginning on January 1, 2013, Medicare Part D requires use of the
CMS Standardized Format, which includes a cover letter, Medication Action Plan
[MAP], and Personal Medication List for the Comprehensive Medication Review
[CMR]. These documents must be provided to the patient within 14 calendar days
of the visit.)
o The above templates can be downloaded at
http://www.cms.gov/Medicare/Prescription-DrugCoverage/PrescriptionDrugCovContra/MTM.html.
o Other sources for med list templates include:
Making a Medicine List Makes You Medicine Smart
(www.talkaboutrx.org/assocdocs/TASK/754/Making_Medicine_
List.pdf)
My Medication Record
(www.wapatientsafety.org/downloads/My-Medicationrecord.pdf)
How to Create a Pill Card (http://www.ahrq.gov/patientsconsumers/diagnosistreatment/treatments/pillcard/pillcard.html#Template)
More. . .

Topic
Tips and Resources
MTM
Workflow
continued
Liability
Credentialing
and
Education
Resources
from
Pharmacists
Letter
My Medicine List
(www.safemedication.com/safemed/MyMedicineList.aspx)
My Medicine Record
(www.fda.gov/Drugs/ResourcesForYou/ucm079489.htm)
Empower patients with information about self-care, medical conditions, and
medications. Use patient handouts to help educate patients.
Remember that documentation serves as a risk prevention tool. Document
information thats correct and necessary and be consistent in your documentation.
Be aware of local, state, and federal regulations that may apply with MTM
services, such as HIPAA, CLIA, and OSHA certifications if they apply.
Maintain records as required by payers and your employer.
Determine if third party payers require special training or credentialing for
pharmacists who provide MTM
Consider training such as the certificate course for MTM that is available through
the American Pharmacists Association (APhA).
Stay up-to-date with evidence-based recommendations and guidelines
Consider mechanisms for quality assurance like staff training, peer-review of
clinical notes, etc.
Communication, Development, and Education

PL Patient Education Handouts
Precepting in the Community Pharmacy Part 3: Incorporating Students into the
Development and Implementation of Pharmacy Services (focuses on involving
students in the establishment of an MTM program)
Enhancing Patient Counseling with Effective Communication Skills
Using Motivational Interviewing to Create Change
Guide for Helping Patients Afford Their Medications
Medication Adherence Toolbox
Collaborative Drug Therapy Management (CDTM)
Technician Training Tutorial: Helping Patients with Medication Lists (includes a
medication list template)
PL Colleagues Interact (to network with others who provide MTM)
Quality Measures for Pharmacists
Quality Measures: What Pharmacy Teams Need to Know
Drug Therapy
Formulary/Drug Comparison (includes dosage comparison charts, drug class
comparison charts, device comparison charts, and a template letter for sending
to prescribers to request drug switches)
Potentially Harmful Drugs in the Elderly: Beers List
STARTing and STOPPing Medications in the Elderly
Clinical Guidelines: Selection, Use, and Implications for Healthcare
Lab Monitoring for Common Medications
Liver Function Test Scheduling
Improving Patient Safety: Medication Reconciliation Basics
Appropriate Use of Oral Anticoagulants
More. . .
Topic
Resources
from
Pharmacists
Letter
continued
Resources
from the
Web
Tips and Resources

Disease States
Improving Outcomes After Myocardial Infarction
Improving Diabetes Outcomes
Improving COPD Care
Preventing and Treating Community-Acquired Pneumonia
Improving Heart Failure Care
The Current Cholesterol Controversy
Treatment of Hypertension: JNC 8 and More
Medication Therapy Management: Utilizing the Pharmacists to Control Our

Health Care Costs, a short video, is available at
http://www.youtube.com/watch?v=QnCGD05u58k
Information about APhAs MTM certificate program is available at
http://www.pharmacist.com/apha-certificate-training-programs
Some currently available systems that can help with documentation and/or
billing for MTM services:
o Mirixa, founded by the National Community Pharmacists Association
(www.mirixa.com)
o OutcomesMTM (www.outcomesmtm.com)
o PharmMD (www.pharmmd.com)
o ConXus MTM, from Protocol Driven Healthcare, Inc.
(www.pdhi.com)
o Medication Management Systems/Assurance Pharmaceutical Care
Documentation Software, from the University of Minnesota Peters
Institute of Pharmaceutical Care (www.medsmanagement.com)
o Medication Pathfinder, from Clinical Support Software
(www.medicationpathfinder.com)
More information on billing in non-hospital based settings at
http://www.ashp.org/DocLibrary/Policy/Ambulatory-Care/Pharmacist-Billing-inPhysician-Based-Clinic-FAQ.pdf
APhA MTM Central, with comprehensive info on MTM and resources for
everything from clinical to business, is available at
http://www.pharmacist.com/mtm
Integrating Comprehensive Medication Management to Optimize Patient
Outcomes Resource Guide (from the Patient-Centered Primary Care
Collaborative)
http://www.accp.com/docs/positions/misc/CMM%20Resource%20Guide.pdf
Medicare Part D MTM info, including required forms, is available at
http://www.cms.gov/Medicare/Prescription-DrugCoverage/PrescriptionDrugCovContra/MTM.html
MTM toolkit from Agency for Healthcare Research and Quality (AHRQ) is
available at
http://effectivehealthcare.ahrq.gov/ehc/products/33/1186/DEcIDE38_Toolkit_201
20711.pdf
Information about writing SOAP notes is available at
http://www.ashp.org/DocLibrary/MemberCenter/SHACCP/Anticoag_Clinical_do
cumentation.pdf
More. . .
Topic
Resources
from the
Web
continued
Tips and Resources

Patient Assessment Tools
Mini-Mental State Exam (MMSE) is available at
http://www.framinghamheartstudy.org/share/protocols/mm1_8s_protocol.pdf
Pain scales including Wong-Baker FACES and multiple language scales are
available at http://www.partnersagainstpain.com/measuring-pain/assessmenttool.aspx
Patient Health Questionnaire (PHQ-9) for depression is available at
http://www.cqaimh.org/pdf/tool_phq9.pdf
Definitions
Comprehensive medication review (CMR): According to the Centers for Medicare and Medicaid
Services (CMS), MTM includes an interactive person-to-person or telehealth consultation performed by a
pharmacist or other qualified provider and an individualized, written summary in CMS standardized
format. The summary includes a personalized medication action plan and medication list. CMR involves
the systematic process of collecting patient-specific information, assessing medication therapies to
identify medication-related problems, developing a prioritized list of medication-related problems, and
creating a plan to resolve them with the patient, caregiver, and/or prescriber. Some examples of
recommendations that might result from CMR include a need for additional drug therapy, identification of
an unnecessary drug therapy, identification of a drug dose that is too high or too low, availability of a
more effective drug, identification of an adverse drug reaction, and identification of medication adherence
issues. Also referred to as a comprehensive medication therapy review (MTR). The American
Pharmacists Association (APhA) defines comprehensive MTR as a process where the pharmacist collects
patient-specific information including all current medications including prescription and nonprescription
products, herbals, and other dietary supplements. The pharmacist assesses the regimen to identify any
medication-related problems, prioritizes problems, and then works with the patient and/or prescriber to
create a plan to resolve any problems.
Medication action plan (MAP): This is a document the patient receives at the end of an MTM visit. It
should be a simple guide, written in patient-friendly language, for patients to keep track of their meds and
health concerns, what they need to do to address those concerns, and associated actions that already have
been taken.
Medication therapy management (MTM): In addition to being described as a broad range of patientcentered services provided by pharmacists, MTM is also described more specifically by a framework
consisting of five core elements: a medication therapy review (MTR), a personal medication record
(PMR), a medication-related action plan (MAP), intervention and/or referral, and documentation and
follow-up. This model is based on a set of standards adopted by APhA/NACDS (National Association of
Chain Drug Stores), which can be found at
http://www.pharmacist.com/sites/default/files/files/core_elements_of_an_mtm_practice.pdf.
Personal medication record or list (PMR or PML): Another document the patient receives at the end
of an MTM visit. The PMR includes patient information (e.g., allergies, medication-related problems,
demographic information) and a comprehensive list of all meds (Rx, OTC, herbals, dietary supplements)
along with doses, reason for use, instructions for use, start/stop date, and prescriber, in patient-friendly
language. Patients should be encouraged to keep this list updated and share it with all other health care
providers, and pharmacists may do so as well, to promote continuity of care.
continued on next page
More. . .
Targeted medication review (TMR): A follow-up intervention to address specific or potential

medication-related problems, assess medication use, monitor whether unresolved issues need attention,
determine if new drug therapy problems have arisen, and assess if the patient has experienced a transition
in care. These are also referred to as targeted MTRs.
Users of this PL Detail-Document are cautioned to use their own professional judgment and consult any other
necessary or appropriate sources prior to making clinical judgments based on the content of this document. Our
editors have researched the information with input from experts, government agencies, and national organizations.
Information and internet links in this article were current as of the date of publication.
More. . .
Project Leader in preparation of this PL DetailDocument:

Stacy A. Hester, R.Ph., BCPS,
Assistant Editor
Cite this document as follows: PL Detail-Document, Medication Therapy Management.
Letter/Prescribers Letter. August 2014.
Pharmacists
Evidence and Recommendations You Can Trust

3120 West March Lane, Stockton, CA 95219 ~ TEL (209) 472-2240 ~ FAX (209) 472-2249
Subscribers to the Letter can get PL Detail-Documents, like this one,

on any topic covered in any issue by going to www.PharmacistsLetter.com,
www.PrescribersLetter.com, or www.PharmacyTechniciansLetter.com

Study of Regulatory Restrictions in The Field of Pharmacies

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(Page 1 of 6)

Copyright 2015 by Therapeutic Research Center

How is a pharmacys inventory measured?

Where do pharmacies buy their inventory?

What should be done with regard to returning inventory to the supplier?

Can medications that patients dont use be returned to stock?

Copyright 2015 by Therapeutic Research Center

Copyright 2015 by Therapeutic Research Center

Technician Training Tutorial:

Copyright 2013 by Therapeutic Research Center

How can the pharmacy be organized?

Acknowledge the patient

Gather patient information including date-of-birth, medication history, diseases/conditions, allergies,

Screen the patients prescription for omissions

Copyright 2013 by Therapeutic Research Center

Technician Training Tutorial:

What information should I ask for and maintain on patient profiles?

Copyright 2013 by Therapeutic Research Center

Copyright 2013 by Therapeutic Research Center

Copyright 2013 by Therapeutic Research Center

Copyright 2013 by Therapeutic Research Center

Which national organizations offer a certification exam?

Which exam does my state require?

Where do I take the exam?

When and how do I sign up to take the exam?

How much does it cost to take the exam?

What are the pre-requisites for taking a certification exam?

What do the tests cover?

How do I prepare for the exam?

What are my legal liabilities once I become nationally certified?

How long does national certification last?

Do I need to maintain my national certification?

What are the CE requirements for nationally certified technicians?

How does the board or certifying organization keep track of my CEs?

I have been a technician for some time. Am I exempt from certification?

What additional career development opportunities are possible if I become certified?

Who do I contact if I have additional questions?

Copyright 2016 by Therapeutic Research Center

Contact and Website Information

Copyright 2016 by Therapeutic Research Center

PHARMACISTS LETTER / PRESCRIBERS LETTER

Medication Therapy Management

Tips and Resources

Consider Your Resources and Strengths

Copyright 2014 by Therapeutic Research Center

(PL Detail-Document #300801: Page 2 of 9)

Tips and Resources

Consider contracting with online MTM platforms, third party plans, or

Look at the Logistics

Copyright 2014 by Therapeutic Research Center

(PL Detail-Document #300801: Page 3 of 9)

Tips and Resources

marketing tools to recruit patients.

(PL Detail-Document #300801: Page 4 of 9)

Tips and Resources

lipids, serum creatinine) in advance of patient appointments.

Copyright 2014 by Therapeutic Research Center

(PL Detail-Document #300801: Page 5 of 9)

Tips and Resources

Communication, Development, and Education

(PL Detail-Document #300801: Page 6 of 9)

Tips and Resources

Medication Therapy Management: Utilizing the Pharmacists to Control Our