Scope of Contemporary Pharmacy Practice: Roles, Responsibilities ...

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■■  Scope of Contemporary Pharmacy Practice: Roles, Responsibilities, and Functions of Pharmacists and Pharmacy Technicians The Council on Credentialing in Pharmacy (CCP) has developed a resource paper that provides an overview of current pharmacy practice, its range of services, and the role of pharmacy technicians. The Academy of Managed Care Pharmacy (AMCP) is a member of CCP, and AMCP staff played a role in the development of the resource paper, Scope of Contemporary Pharmacy Practice: Roles, Responsibilities, and Functions of Pharmacists and Pharmacy Technicians.1 This resource paper describes the current roles of pharmacists and pharmacy technicians. As known to health professionals in managed care pharmacy, the pharmacist’s role is evolving from supervising medication distribution to providing medication therapy management and disease prevention and management services. The settings in which pharmacists practice include community pharmacies, ambulatory care clinics, hospitals, long-term care facilities, home care agencies, and managed care organizations (MCOs). Other settings include the pharmaceutical industry, research, government, academia, professional associations, and poison information centers. This resource paper serves as a snapshot (or photo album of snapshots) as to where the profession is today, and is intended to be used by the pharmacy profession to communicate to those both outside and within the profession the many aspects of pharmacy services. “This scope of practice and the complexity of the medications managed within each practice require a pharmacist and pharmacy technician workforce that is diverse in knowledge, competently trained, and appropriately credentialed and that demonstrates professional judgment, values, and attitudes.”2 Some of the information contained in the resource report includes: • Medication therapy management promotes the appropriate use of medications through a partnership of the pharmacist, the patient or caregiver, and other health professionals. • Pharmacists’ education revolves around 3 broad competency areas: patient care, systems management, and public health. These 3 main competency areas align with the 5 core competencies identified by the Institute of Medicine: (1) delivering patient-centered care, (2) working as a part of interprofessional teams, (3) practicing evidence-based medicine, (4) focusing on quality improvement, and (5) using information technology.3 • Doctor of Pharmacy (PharmD) students are required to complete 6 years of postsecondary education. This 6 years of pharmacy education and training ensures that pharmacists are appropriately prepared to collaborate with other health care professionals. • Pharmacists’ postlicensure training programs and credentials are “(a) competency-based, (b) developed on the basis

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of comprehensive task analysis in the relevant areas, and (c) accredited by organizations to assure quality, validity, and integrity.” Postgraduate year 1 (PGY1) residencies focus on managing medication use for a broad range of disease states and patients. Postgraduate year 2 (PGY2) residencies focus on specialized practice and more in-depth training for a narrow range of diseases or patients. Specialty board certification from the Board of Pharmacy Specialties (BPS) can be obtained in 5 areas currently: nuclear pharmacy, nutrition support pharmacy, oncology pharmacy, pharmacotherapy, and psychiatric pharmacy. Other credentials offered to pharmacists include Certified Geriatric Pharmacist (CGP), Certified Diabetes Educator (CDE), and Certified Anticoagulation Care Provider (CACP). Today most pharmacists work in patient care settings. The resource paper describes the services provided by pharmacists in patient care settings as being differentiated by the scope and complexity of care provided. The majority of pharmacists in patient care roles can be described as “generalist practitioners,” serving a variety of patients with diverse medical needs, varying in complexity.4,5,6 Other pharmacists focus their practice on specific therapeutic areas, patient populations, or specialized practices. Pharmacists with advanced training assess medically complex patients, develop individualized medication regimens, and monitor patient responses to medications. For example, pharmacists with the classification “board-certified pharmacotherapy specialist (BCPS)” may be “responsible for providing direct patient care at an advanced level, often in a multidisciplinary team.”2 Pharmacists also practice in many nontraditional settings, including MCOs, patient call centers, hospice, drug and poison information services, academia, regulatory agencies, pharmacy organizations, and the pharmaceutical industry. States have expanded the scope of practice of pharmacy technicians and many states now require technicians to have more extensive training. Pharmacy technicians are employed in community pharmacy, hospital pharmacy, the military, home health care, long-term care facilities, mailorder pharmacies, and MCOs.

“The evolution in pharmacy practice has presented opportunities for pharmacists to perform both traditional and nontraditional services. New postlicensure training and credentials support, enhance, and demonstrate the competence of pharmacists. New responsibilities for pharmacy technicians allow them to better support pharmacists.”2 CCP has developed The Scope of Contemporary Pharmacy Practice “to describe where pharmacy is today and what pharmacy practice will look like in the future.”2 The Scope of Contemporary Pharmacy Practice document also serves as a reminder and an update to managed care pharmacists of the wide range of pharmacist

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responsibilities and activities and can be used to illustrate those roles to decision-makers who may not be familiar with the contemporary roles, education, training, and competencies of pharmacists. As managed care pharmacists develop medication therapy management (MTM) programs, this resource illustrates what services are being offered and what credentials are held by pharmacists. Marissa Schlaifer, MS, RPh Director of Pharmacy Affairs, Academy of Managed Care Pharmacy Secretary/Treasurer, Council on Credentialing in Pharmacy [email protected] Michael J. Rouse, BPharm (Hons), MPS President, Council on Credentialing in Pharmacy Assistant Executive Director, International and Professional Affairs Accreditation Council for Pharmacy Education [email protected]

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REFERENCES 1. Council on Credentialing in Pharmacy. Scope of contemporary pharmacy practice: roles, responsibilities, and functions of pharmacists and pharmacy technicians. 2009. Available at: www.pharmacycredentialing.org/ccp/ Contemporary_Pharmacy_Practice.pdf. Accessed July 9, 2010. 2. Paolini N, Rouse MJ. Scope of contemporary pharmacy practice: roles responsibilities, and functions of pharmacists and pharmacy technicians executive summary. Am J Health Syst Pharm. 2010;67(12):1030-31. 3. Greiner AC, Knebel E, eds. Health Professions Education: A Bridge to Quality. Washington, DC: National Academies Press. 2003:45-74. http:// www.nap.edu/openbook.php?isbn=0309087236. Accessed July 11, 2010. 4. Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47(3):533-43. Abstract available at: http:// www.ajhp.org/cgi/content/abstract/47/3/533. Accessed July 11, 2010. 5. Hawksworth GM, Chrystyn H. Clinical pharmacy in primary care. Br J Clin Pharmacol. 1998;46(5):415-20. Available at: http://www.ncbi.nlm.nih. gov/pmc/articles/PMC1873703/pdf/bcp0046-0415.pdf. Accessed July 9, 2010. 6. Manasse, Jr. HR, Speedie MK. Pharmacists, pharmaceuticals, and policy issues shaping the workforce in pharmacy. Am J Pharm Educ. 2007;71(5):82. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2064880/pdf/ ajpe82.pdf. Accessed July 9, 2010.

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