Poll: ‘devolving’ dispensing

Are pharmacists handing too much of their dispensing role to pharmacy technicians or assistants?

Last week, pharmacy stakeholders expressed concern that pharmacy was “devolving” too much of its primary dispensing role to non-pharmacists.

In his editorial in the Journal of Pharmacy Practice and Research, Professor Chris Alderman said “it seems that enthusiasm for participation in the work of dispensing prescriptions is waning among contemporary practitioners”.

But once out of the hands of pharmacists, the “traditional pharmacy-specific skill set” might appear not to be essential to deliver these job functions, he warned.

And in a related article, Danielle Stowasser, program director, Electronic Medication Management Program, Metro North Hospital and Health Service, Brisbane, wrote that handing medication supply services to pharmacy technicians or nursing staff could ultimately lead to a situation where there is no pharmacist oversight of these processes.

The articles sparked a lively yet thoughtful discussion among AJP readers, with several readers discussing the nature of the dispensing process itself and how it interlocks with counselling and professional services such as HMRs: is dispensing itself simply the “pick and stick” process, or just one facet of a wider clinical service?

Several readers suggested that moving the technical side of the dispensing process away from pharmacists diminishes this wider role; another hinted that large script volumes may already diminish the role in some pharmacies.

Has the pharmacy profession distanced itself too much from the technical side of dispensing? We’d like to know what you think. Tell us in our poll below, and please feel free to continue the discussion in comments.

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  1. robert broadbent

    Read with interest somewhere or other that an American research doctor had devolved preparation of his particular requirements to the local pharmacist cos he was sure the required serial dilutions would then be correct. I am an ‘old school’ advocate in case you hadn’t guessed.

  2. Cat

    Personally find the problem to be finding staff with enough knowledge to understand there is a vast difference between preparing medications and dispensing (using clinical skills to ensure right medication for right patient at the right dose). Added to some unfortunantly lazy colleagues that prefer to let over zealous techs/assistants be the face to the clients.

    • Big Pharma

      Agree. This is because the entrance to pharmacy school has devolved, the course standards have devolved and registration exams have devolved……who would have thought clinical skills and application would also devolve?

      Even advanced clinical pharmacist input into healthcare teams has devolved (inappropriate HMR caps). A recommendation made within the profession itself…Now that’s backwards!!

  3. PeterC

    This is another oversimplification – or perhaps deliberate journalistic obfuscation – of what is really a quite subtle question. No pharmacist in their right mind believes the clinical – that is the ‘direct patient care’ – aspects of dispensing can ever be devolved to a non-pharmacist and if you ask the question that way then everyone except the genuine idiots and beyond-redemption-cowboys will answer the same.

    When you start bandying about less precise terms like ‘technical’ however, the water gets muddier. Depending on how your practice and workflow is designed and automated, it may or may not be possible/ feasible/ acceptable/ desirable to devolve certain defined non-clinical aspects of prescription processing to an adequately trained non-pharmacist, especially if it is to ensure that pharmacists devote an overwhelming majority of their (valuable) time to clinical dispensing (and non-dispensing) activities. In other words, the answer you give is likely to depend on other (unasked) questions.

    In other words, this poll is basically worthless. In my opinion.

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