The PharmacyTechnician 4E Chapter 17Other Environments
Course Outline1. Mail Order Pharmacy2. Long-Term Care3. Home Infusion
Mail Order Pharmacy Chronic condition Continuing condition that requires ongoing treatment for a prolonged period. Maintenance medication Medication that is required on a continuing basis for the treatment of a chronic condition. Acute condition Sudden condition requiring immediate treatment.
Mail Order Pharmacy Type of pharmacy that mails or delivers medications. Requires a delivery time of at least 24–48 hours. Used for maintenance medication. Serves broad geographic areas. Process a high volume prescription which allows deep discounts. Dispense a 3 month supply at time.. Most third party insurers force their clients to use mail order pharmacy for maintenance medications.
Online Drugstores Online drugstores are a type of mail order pharmacy that use the Internet to advertise and take orders for drugs which are then mailed to the customer. Drugs cost less in Canada and U.S. Cross-border regulations allow Canadian pharmacies to fill individual prescriptions from U.S. consumers for small amounts of drugs. Canadian online drugstore industry has grown rapidly, and has been the subject of much consumer and political debate.
Long-term Care Facility Long-term Care Facility An institution that provides care for geriatric and disabled patients. Includes adults who suffer from chronic (long-lasting) or debilitating illnesses as stroke or Alzheimer’s disease.Nursing Homes Most long-term care facilities are nursing homes that provide daily nursing care. Patients in this setting are generally referred to as residents.
Institutional Pharmacy Skilled-care facilities (SCF) Limited to patients requiring more round-the-clock nursing care (such as IV infusions) or recovery after a recent hospitalization. Most patients are discharged from SCF to home when they have adequately recovered. Other long-term care facilities Include patients with acute or chronic psychiatric disorders or rehabilitation facilities for those with serious traumatic brain or spinal cord injuries.
Long-Term Care Pharmacists Distributive pharmacist Ensures long-term care patients receive the correct medications ordered. Consultant pharmacist Develops and maintains an individual pharmaceutical plan for each long-term care patient.
Licensed pharmacists’ Role Some long-term care facilities have an “in-house” pharmacy while others contract with a community pharmacy or allow each resident to choose his or her pharmacy. Licensed pharmacists’ Role Establish record-keeping systems related to controlled substances. Review drug regimens. Monitor repackaging and storage of pharmaceuticals. Ensure that medications are uncontaminated and have not expired. Note medication errors and adverse reactions or interactions. Educate residents on drug therapies and self-medication. Provide medications to outpatients or residents on weekend leave.
A Pharmacy Technician’s Role Log prescriptions and refill orders via computer. Prepare billings. Maintain drug boxes or trays for emergencies. Package and label medications. Deliver medications to the nursing home. Maintain records, retrieve and organize patient charts. Conduct inspections of drugs in the inventory and in the nursing stations. Repackage drugs in unit doses labeled for each patient.
Long-Term Care Pharmacy In-house pharmacies may provide a 7-day supply of medication in “blister packs.” Community pharmacies fill medication carts or trays with a 30-day supply of medication. Medication orders rarely change in this environment.
Home Infusion Pharmacy A pharmacy that dispenses, prepares, and deliversdrugs and medical supplies directly to the home of thepatient. Spiraling hospitalization costs, regulatory changes,and advances in parenteral therapies have created anexplosion in this field. The home healthcare market continues to growbecause of our aging society and as an alternative to thehigher cost of hospitalizations. Many hospitalized patients are discharged as soon as possible to continue their recovery at home with IV solutions.
Home Infusion Pharmacy Pharmacists and pharmacy technicians working in home healthcare. Provide educational materials. Carry out traditional compounding and delivery functions. Prepare and provide infusions and infusion equipment. Might be available for emergencies on a 24- hour basis.
Primary Home Infusion Cont.The primary therapies provided by home infusionservice include: Antibiotic Therapy Common home infusion service used in treating AIDS related and other infections. Parenteral Nutrition Required for patients with various intestinal disorders. Pain Management Applies to the infusion of narcotics for patients with painful terminal illnesses or other types of severe chronic pain. Chemotherapy Provided in the home, generally in conjunction with an oncology program at a hospital or clinic.
Home Care TeamThe team that provides home health care includes thefollowing: Physician Orders the infusion therapy. Registered Nurse Responsible for coordinating and monitoring the care plan and the home care team, and for educating the patient. Pharmacist Works with the supervising nurse to develop a pharmaceutical care plan which includes selection of the infusion device, identification of potential adverse reactions and interventions, and monitoring practices. Pharmacy Technician The technician works under the pharmacists supervision and may be involved with compounding, labeling, delivery, and other non-consulting activities. Home Care Aide Aides are non-professional staff employed by the home care agency who work under the supervision of the registered nurse. They assist in various aspects of a patients care, but generally not in medication therapy.
Home Care Team Cont. Pharmacy Technician Works under the pharmacists supervision. May be involved with compounding, labeling, delivery, and other non-consulting activities. Home Care Aide Non-professional staff employed by the home care agency. Work under the supervision of the registered nurse. Assist in various aspects of a patients care, but generally not in medication therapy.
Managed Care•A type of health insurance system that emphasizeskeeping the patient healthy of diseases controlled toreduce healthcare costs.•A relatively new form of healthcare that has growndramatically over the past 35 years. • One of the first managed-care organizations was Kaiser Permanente.
Managed Care Cont.• Health maintenance organization (HMO) is another name for managed care. Most HMOs are centralized primary-care clinics. Serve patients with pharmacy, x-ray, and laboratory departments. Similar to a hospital, HMO’s usually have an approved drug list or formulary that has been recommended by a drug information pharmacist and approved by the medical staff.
Managed Care Cont. After the patient sees the physician, the patient may go to the HMO pharmacy to fill a prescription. Patients needing refills may call an automated telephone number to expedite processing and reduce waiting times. This “time savings” also allows the pharmacist to spend more time reviewing the computerized medication profile and counseling the patient.
Managed Care Cont. The pharmacy technician in managed care performs similar functions to those in the community pharmacy. Insurance billing and cashiering are minimal. Clinical pharmacists may work closely with the primary- care physicians to better control chronic disease. Educating Monitoring Adjusting doses of medications per physician- approved protocols.
Terms to Remember1. Acute condition2. Antibiotic therapy3. Automated dispensing system4. Chronic condition5. Consultant pharmacist6. Distributive pharmacist7. Home care agencies8. Maintenance medication