"Tech-Check-Tech"

A Review of the Evidence on Its Safety and Benefits

Alex J. Adams; Steven J. Martin; Samuel F. Stolpe

Am J Health Syst Pharm. 2011;68(19):1824-1833.

Demonstrating the Benefits of TCT

To assess the published evidence on TCT, a literature review was conducted using MEDLINE (1948–November 2010) and International Pharmaceutical Abstracts (1970– November 2010) and searching for "tech* and check" and "tech-check-tech." The bibliographies of all identified articles were examined to identify additional relevant literature. The 2009 National Association of Boards of Pharmacy (NABP) Survey of Pharmacy Law was used to identify states with active or pilot TCT programs;^[17] the websites of the boards of pharmacy in those states were accessed, and applicable sections relating to laws, rules, and regulations were reviewed.

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Cite this: "Tech-Check-Tech" - Medscape - Oct 01, 2011.

Abstract and Introduction
The Role of TCT in the Drug Distribution Process
Demonstrating the Benefits of TCT
Accuracy of Technicians Versus Pharmacists
Core Elements of Existing Programs
Discussion
Conclusion
References

Table 1. Results of Same-Sample "Tech-Check-Tech" Studies
Ref.	Facility	Practice Situation	Sample Size	Accuracy Rate (%)^b		Error-Detection Rate (%)^c		p ^a
Ref.	Facility	Practice Situation	Sample Size	Technician	Pharmacist	Technician	Pharmacist	p ^a
24	Tertiary care institution	Checking unit dose envelopes	15,252	99.9	99.8	97.0	94.3	<0.05
25	Specialty pharmacy	Checking prefilled medication syringes	10,608	99.83	99.86	…^d	…	NS
26	Children's hospital	Checking unit dose cart fills	8,645	98.95^e	…	100	100	…

^aNS = not significant.
^bPercentage of orders checked that were free from error.
^cPercentage of errors in sample that were detected by the checker.
^dNot reported.
^eCalculated by authors.

Table 2. Published Research on Enhanced Clinical Roles of Pharmacists in Institutions With "Tech-Check-Tech" Programs
Ref.	Time Saved	Pharmacists' Clinical Activities
12	10 hr of pharmacist time per mo	…^a
19	1 hr per day per pharmacist	Dosing recommendations and responding to pharmacotherapy-related requests from physicians
25	3 hr of pharmacist time per day	…
28	…	Increased time in direct communication with other health care practitioners, documentation of adverse drug reactions, drug therapy interventions, drug- use evaluation, therapeutic drug monitoring, discharge counseling

^aNot reported.

Table 3. Core Elements of "Tech-Check-Tech" (TCT) Programs, as Defined by State Laws and Regulations
State	Allowable Practice Settings		Technician Education or Training^a	Quality Assurance^b	Pharmacist Redeployment^c
State	Hospital or Institutional Pharmacy	Community Pharmacy	Technician Education or Training^a	Quality Assurance^b	Pharmacist Redeployment^c
California³³	Y	N	Y	Y	Y
Idaho³⁵	Y	N	Y	Y	…^d
Iowa³⁷	Y	N	Y	Y	…
Kansas³⁸	Y	N	Y	…	…
Kentucky³⁹	Y	N	Y	…	…
Minnesota⁴²	Y	N	Y	Y	Y
Montana⁴³	Y	N	Y	Y	Y
North Dakota⁴⁵	Y	Y	Y	Y	…
South Carolina⁴⁷	Y	N	Y	…	…

^aState sets specific requirements for technician education or training as a prerequisite for TCT participation.
^bState requires ongoing monitoring of safety and accuracy of TCT program.
^cState explicitly calls for use of pharmacists in more clinically oriented roles.
^dNot reported.

Table 4. Pharmacy Manpower Aggregate Demand Index for States Permitting "Tech-Check-Tech" Programs⁵
State	Pharmacist Demand^a
California	3.85
Idaho	3.57
Iowa	3.14
Kansas	3.86
Kentucky	3.56
Minnesota	3.00
Montana	3.00
North Dakota	3.33
South Carolina	3.14
National average	3.44

^aData reported for August 2010; higher number correlates to higher reported pharmacist demand; range, 1.0 (low demand) to 5.0 (high demand).

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"Tech-Check-Tech"

A Review of the Evidence on Its Safety and Benefits

Demonstrating the Benefits of TCT

Tables

Tables

Tables

Tables

References

Authors and Disclosures

Authors and Disclosures

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