Proportion of work appropriate for pharmacy technicians in anticoagulation clinics

Purpose. Results of a two-part study to determine the proportion of anticoagulation clinic (AC) work that could potentially be shifted from a pharmacist to a clinical pharmacy technician (CPT) are presented. Methods. In part 1 of the study, a group of eight clinical pharmacists and four CPTs from Veterans Affairs (VA) ACs used a modified Delphi process to categorize AC tasks as appropriate or inappropriate for a fully trained, licensed CPT. In part 2, a three-day time study was conducted at an AC staffed by one clinical pharmacist to determine the amounts of pharmacist time spent performing the tasks delineated through the Delphi process. Based on the time study data and task appropriateness categorizations, the proportion of AC work that might be appropriate for a CPT was estimated. Results. Two levels of CPT-appropriate tasks were identified: those appropriate for any CPT and those appropriate only for an "advanced-practice CPT" the latter category of tasks included conducting follow-up phone interviews with patients found to have in-range International Normalized Ratio values. The results of the time study indicated that 21% of the AC workload could be handled by a CPT and 41% could be handled by an advanced-practice CPT. Conclusion. Investigation of AC roles within the VA system suggested that well-trained pharmacy technicians can perform a substantial proportion of work in an AC, including some tasks performed by pharmacists.