Study Finds Mistakes by Pharmacy Technicians

Assistants' Role in the Spotlight

From the WebMD Archives

Feb. 23, 2000 (Washington) Pharmacy technicians are dispensing more and moreprescription medications, and one survey finds some are averaging more than 6mistakes a week, some of which could be life-threatening if undetected. Thisrelatively new occupation is in the spotlight as pharmacists are inincreasingly short supply and, in an era of strict managed care requirements,are forced to depend more on assistants paid $6 to $12 an hour.

By contrast, a pharmacist can make from $30 to $60 an hour.

"There's a lot of nontrained people out there, and I suspect that thepublic would be terrified if they really knew," Douglas Scribner, apharmacy technician who is president of the American Association of PharmacyTechnicians, tells WebMD. He says his group is trying to upgrade the occupationby imposing certification and education requirements.

In a report commissioned for the Virginia Assembly in 1998, the state Boardof Pharmacy noted that pharmacists found their technicians, on average, made6.5 errors a week. The finding was based on a survey of the state's 1,590licensed pharmacies.

The consequences of a dispensing mistake can be catastrophic. When then5-year-old Brittany Buckley was given Compazine for nausea in 1997 at a PortRichey, Fla., Walgreens store, a pharmacy technician told the child's motherthe medication was all right for her daughter to take, according to a lawsuitfiled over the incident. But the dose was for an adult, and it caused areaction that left Brittany with a serious learning disability, the lawsuitsays.

Though Walgreens won't comment on the case, company spokesman Michael Polzinsays the 2,941-store chain is an industry leader in training technicians andgives them a $1,000 raise if they pass a certification test. "Any timethere's an error ... we will investigate the incident, try to determine exactlywhat happened, how it happened, and whether we can do anything differently toprevent it from happening in the future," Polzin tells WebMD.

The episode points out what pharmacy technicians can and cannot do understate regulations. For instance, they can accept a prescription from acustomer, handle administrative tasks, put claims in the computer system,select drugs off the shelf, and count pills into a bottle. They cannot counselpatients or determine whether a prescription might cause an interaction with adrug a person is already taking.

Although the estimated 200,000 technicians in the U.S. must operate under apharmacist's direct supervision, their training levels vary dramatically. Onlyan estimated 55,000 applicants have passed the exam developed by the PharmacyTechnician Certification Board, a voluntary accreditation program.

According to the National Association of Boards of Pharmacy, only Alaska,Utah, Washington, and Wyoming license pharmacy technicians, while acertification exam is required in just Louisiana and Wyoming. Nineteen statessimply register the technicians.

"There's no standard, and ... the vast majority of today's certifiedtechnicians receive on-the-job training," Lucinda Maine, PhD, RPH, tellsWebMD.

"We do know that errors are made, and we do know there is not a completeor systematic error capture and reporting and analysis system," says Maine,who deals with accreditation issues at the American Pharmaceutical Association(APA), a pharmacists' trade group. Maine says the APA favors registration, butstops short at licensing because pharmacists work so closely withtechnicians.

While there are horror stories involving errors by pharmacy technicians,Phil Schneider of the National Association of Chain Drug Stores says they'reisolated. "We have thousands of well-trained, highly competent,appropriately supervised technicians assisting pharmacists day in and dayout," Schneider tells WebMD.

There's also the question of how many technicians a pharmacist should beallowed to supervise. According to a survey by the National Association ofBoards of Pharmacy, the number varies from two to four.

Tony Grasha, PhD, is a psychologist at the University of Cincinnati whoconsults for chain drug stores. He says a technician's workload is less likelyto contribute to errors than the variety of tasks. "On the surface, itseems simple, but it's much more complex than a lot of people imagine,"Grasha tells WebMD. He says drug companies are trying to train theirtechnicians, and many technicians have even learned to spot pharmacists'errors.

One way to prevent problems is for consumers to know the credentials of theperson behind the counter. "At a minimum, [the technician's] name tag ...should be distinct," Maine says.

Vital Information:

  • As pharmacists are increasingly in short supply, more stores are relying onpharmacy technicians.
  • A report in Virginia found that pharmacy technicians make an average of 6.5errors per week.
  • Certification of these technicians varies greatly, and only 55,000 of200,000 technicians have passed a voluntary accreditation program.