Exploring the expanded role of the pharmacy technician in medication therapy management service implementation in the community pharmacy.

Objectives: To explore the current roles of the pharmacy technician in the provision of medication therapy management (MTM) and their relation to organizational behavior at "high-performing" community pharmacies within a nationwide supermarket chain.

Design: Qualitative research study using methodologic triangulation with the use of semistructured interviews of key informants, direct observation at "high-performing" pharmacy sites, and respondent journals.

Setting And Participants: High-performing pharmacy sites within a large supermarket pharmacy chain in Tennessee. A high-performing site was defined as a pharmacy that has successfully implemented MTM into its pharmacy workflow.

Main Outcome Measures: Themes related to pharmacy technician roles in the delivery of direct patient care services.

Results: A total of 28 key informants were interviewed from May 2015 to May 2016. Key informants included 10 certified technicians, 5 noncertified technicians, and 13 pharmacists across 8 pharmacies in central and eastern Tennessee. Three themes were identified. At high-performing sites, pharmacy technicians were engaged in both clinical support activities as well as nonclinical support activities with the goal of improving clinical service implementation. Several barriers and facilitators were revealed.

Conclusion: Within high-performing teams, expanded technician roles to support patient care service delivery were associated with successful clinical service implementation. Future studies should further explore these expanded technician duties, as well as the role of organizational culture, climate, and team dynamics, in the delivery of patient care and clinical services across a heterogeneous pharmacy setting.