Use of pharmacy technicians in elements of medication therapy management delivery: A systematic review

Background: Documented barriers to Medication Therapy Management (MTM) delivery, such as limited time and inefficient workflow may be overcome by utilizing support staff for administrative services. However, it is unknown how pharmacy technicians have been historically utilized to assist pharmacists in MTM-delivery. Objective: To characterize literature describing pharmacy technicians' participation in actions commonly undertaken in the provision of MTM services. Methods: In August 2016, a PubMed (MEDLINE) and Journal of Pharmacy Technology search was conducted using the term "pharmacy technician" with services outlined within the MTM Core Elements Version 2.0, and with terms related to administrative actions in the provision of MTM. References were searched using identified studies. Eligible articles described pharmacy technicians' performance and/or assistance in at least one MTM Core Element or related administrative action to the provision of MTM. Data was independently extracted by two researchers; any variation in extraction was reconciled via with discussion until consensus reached. A standardized data extraction template was used. Results: Forty-four manuscripts were included. Manuscripts were most likely to describe pharmacy technicians' assistance with medication reconciliation (70%), documentation (41%) and medication therapy review (30%). Actions least likely to be described included personal medication record development (5%), physical assessment (5%), follow-up (2%), and medication action plan development (0%). Most articles were written in the United States (73%), or Europe (16%), while the remaining articles were Canadian (11%); no articles were found originating from Asia, Africa, Australia or the Middle East. Conclusion: Pharmacy technicians are utilized most often to support MTM through assistance in medication reconciliation. Standardized training for pharmacy technicians that delineates administrative support from pharmacists' role of clinical decision making could help pharmacists obtain greater efficiency in MTM delivery.