Oregon News: Patient Counseling and Changes in Generic Manufacturer

August 1, 2008 3:41 pm Topics: Pharmacy technicians and Patient counseling

Published in the August 2008 Oregon State Board of Pharmacy Newsletter

Another topic demanding much discussion among Board members and staff over the past year is the topic of pharmacy technicians and clerks regarding their interactions with patients. It has long been the Board’s position that technicians and clerks are not allowed to counsel patients about their medications. That being so, the question still remains, “What can the technicians and clerks say to the patient?”

Clearly, the Board cannot answer such a broad question. However, some guidelines may be useful. For a new prescription or a refilled prescription on which the pharmacist has determined that counseling is needed, the pharmacist must talk with the patient, regardless of what the technician or clerk might say. The clerk or technician may not accept a patient’s refusal in lieu of the pharmacist. For a refilled prescription that does not require counseling, the clerk or technician may ask the patient if he or she has any questions or would like to talk with the pharmacist. The pharmacist must be called to answer any questions.

In the case of a change of generic manufacturer when the prescription does not require counseling, the auxiliary label or the “green sticker” with the notation, “This is the same medication you have been getting. Color, size, or shape may appear different,” may be applied. In this instance, the pharmacist may allow the clerk or technician to point out the sticker or inform the patient of a change in the appearance or the manufacturer. Any questions that arise at that time must then be referred to the pharmacist. The Board has issued the following guidelines:

• The pharmacy must have a policy and procedure in place. The technicians and clerks must have been trained and the training documented.
• The technician or clerk may inform the patient that the pharmacist has changed the manufacturer and the medication may appear different.
• The technician or clerk points out the Product Identification Label (PIL) and tells the patient that the PIL should match the contents of the prescription container.
• The technician or clerk then offers the patient an opportunity to talk to the pharmacist.

The suggestion was offered to the Board that the pharmacist should not have to be called to the counter each time a generic change was dispensed. Applying these guidelines judiciously may be a reasonable alternative. The Board does not consider this to be “counseling” by the technician.