MEDICATION USE PROCESS: COMMUNITY

PHARMACY
DAVID PINO, PHARM.D.

1
 OBJECTIVES
 Identify the different elements that make up the medication use process
 Define procurement and purchasing in community pharmacy
 Recognize the structure of drug distribution process and the major
distributors utilized in community pharmacy
 Describe the basics of drug inventory to have a sufficiently stock
pharmacy
 Define the factors that affect drug inventory in a community pharmacy
 Differentiate between expiration date and beyond use date of a drug 2

product
 OBJECTIVES
 Recognize how returning drugs to stock and drug recalls affect drug
inventory
 Implement a plan to respond to drug shortages
 State the storage requirements and temperatures for drug storage in a
community pharmacy
 Recall the legal requirements for managing a controlled substance drug
inventory
 Recognize the workflow process of preparing and dispensing 3

prescriptions
 OBJECTIVES

 Recognize the process of a REMS dispensation

 Recognize the components of good customer service and
communication

4
 COMMUNITY PHARMACY: OVERVIEW
Also known as a retail pharmacy, the community pharmacy is the most well-known type of pharmacy.

Independent Chain

• Owned by a pharmacist or group of • Consists of several similar pharmacies in the region

pharmacists (or nation) that are corporately owned 5
• Most compounding of prescriptions is done • Allows for a large-volume dispensing utilizing
here pharmacy technicians and automation
 COMMUNITY PHARMACY: OVERVIEW
Food Store Pharmacies Mass Merchandiser Pharmacies Mail Order Pharmacy

• Regional or national food store
chains
• Regional and national
community pharmacy that sells
mass merchandise with in-
store pharmacies
• Also referred to as online
pharmacy or internet pharmacy
• Operates over the internet and
sends orders to customers
through mail or shipping
companies 6
 COMMUNITY PHARMACY: OVERVIEW
Outpatient Hospital Pharmacy Point of Care Drug Dispensing

• Owned by the hospital system

• Dispensing prescription medications in-
• A service to help bridge care between the
office
hospital and community by filling discharge
• Ensures that patients get their prescription
scripts of hospital patients
drugs immediately 7
• Access to patient charts (EMR) to ensure
correct dosing
MEDICATION USE PROCESS

8
DRUG INVENTORY: SELECTION AND PROCUREMENT
 A pharmacy procurement officer:

Coordinates all activities relating to pharmacy procurement, including

storage, inventory, and quality management of supplies

Drafts, reviews, and ensures purchase orders are accurate and on par
with the budgetary allocation

Develops relationships with suppliers and distributors and negotiates for

suitable prices
9
 DRUG DISTRIBUTION

10

SOURCE: FDA, 2011b.

 DRUG DISTRIBUTORS
 About 92 percent of prescription drugs in the United States are distributed through wholesalers, with
three — AmerisourceBergen, Cardinal Health, and McKesson Corporation — accounting for more
than 90 percent of wholesale drug distribution in the United States.1

11
 DRUG INVENTORY: DELIVERY TO PHARMACY

Purchase drug supplies from Consumer/Patient

wholesale distributor or directly
from manufacturer

After purchasing, pharmacies assume

responsibility for safe storage and
Pharmacies dispensing to consumers
12
 DRUG INVENTORY: DELIVERY TO PHARMACY

Pharmacy Operations

Provide information Facilitate bill and

Maintain an adequate about safe and effective payment for
stock of products use of Rx drugs to consumers in health
consumers benefit plans 13
 DRUG INVENTORY: MANAGEMENT
Inventory management conducted by
 Pharmacy technicians
 Pharmacist on duty
 Pharmacist manager
Duties:
 Maintain proper inventory stock
 Ensure effective inventory procedures are established and maintained
 Return unneeded drugs and overstock drugs to wholesalers
 Monitor for expired products 14
 DRUG INVENTORY BASICS
Sufficient stocked pharmacy inventory includes
 Basic stock: Amount of inventory available on hand to meet an
average demand
 Safety stock: Amount of inventory available on shelves to account
for fluctuations in demand
Benchmarks to determine if store is selling through stock adequately
 Inventory turnover: # of times the inventory is used up in one
year
 Inventory days on hand: Average # of days worth of stock on hand 15
 DRUG INVENTORY BASICS: DAYS ON HAND
Inventory days on hand: Average # of days worth of stock on hand
Days on Hand =
Days in the period
(Cost of goods sold / Average inventory for the same time period)

E.i. : 365 Days

We sold $1,000,000 in cost of items for the year.
The cost of our inventory (sitting on my shelf) at the start of the year
was $100,000 and at the end of the year was $120,000 16
 DRUG INVENTORY BASICS: DAYS ON HAND
Days on Hand = Days in the period / (Cost of goods sold / Average
inventory for the same time period)
365
= ~40 Days
($1,000,000 / $110,000)

Useful for identifying trends and what they mean for the store in question.

Upwards trend?

Downwards trend? 17
 DRUG INVENTORY BASICS: DAYS ON HAND
Days on Hand = Days in the period / (Cost of goods sold / Average
inventory for the same time period)
365
= ~40 Days
($1,000,000 / $110,000)

Useful for identifying trends and what they mean for the store in question.

Upwards trend? Either Sales down, or Amount of inventory is up.

Downwards trend? Either sales up, or Amount of inventory is down. 18

 DRUG INVENTORY: AFFECTING FACTORS

New or first-in-line medications

 Consider ordering newly approved and expensive medications
Patent expirations
 Monitor newly released generic medications
 Discuss patents about to expire with pharmacy staff to transition
patients to generic products
 Educate patients on new available generic formulations
19
 DRUG INVENTORY: AFFECTING FACTORS
Inventory Spoilage
 Expired medicines or inappropriate storage can alter drug activity,
reduce potency, and bring possible harm to patients
 Expiration date: defined by USP to meet requirements of the
pharmacopeia monograph
 Beyond-Use-Date(BUD): the date which medications have been
manipulated/repackaged and stored/dispensed in a container other
than original manufacturer’s container
 BUD should be not be later than manufacturer expiration date or 1
year from the date the drug is dispensed
20
 DRUG INVENTORY: AFFECTING FACTORS
 Return to stock
 Medication has not been picked up by a patient (credited back to profile)
 Keep medication in its amber container instead of original
manufacturer’s container. Lot number must be added from original container.
 Medication should not return to stock once it been dispensed/delivered
to patient
 Product now has a BUD of 1 year from the date repackaged or the
manufacturers expiration date, whichever is earliest.
 Unable to deliver medication must meet requirements to RTS
 Return package must maintained drug’s integrity and stability
21

 Return medication must be evaluated by pharmacy staff to ensure that it is

not adulterated or misbranded
 DRUG INVENTORY: AFFECTING FACTORS
Drug Recalls: to remove a product from the market. This can be
conducted by firm’s own initiative, FDA request, or FDA mandate
o Class I recall: A situation in which use of or exposure to the
recalled product will cause serious health consequences or death
o Class II recall: A situation in which use of or exposure to the
recalled product may cause temporary or reversible health
consequences or the health consequences is remote
o Class III recall: A situation that is not likely to cause health
consequence due to the use of or exposure to the recalled product 22
 DRUG INVENTORY: SHORTAGES

Lack of incentives for

Lack of raw materials to
manufacturers to produce
produce the drug
less profitable drugs

Logistical and regulatory

challenges
23
 DRUG INVENTORY: SHORTAGE RESPONSE

Pharmacy technicians
and buyers

How much
How long it will Alternative Alternative
medication is
last? medication therapy
available?
24
DRUG INVENTORY: SHORTAGE RECOMMENDATIONS

Alert patient on Order different Order different Alert physician on

therapy package sizes manufacturers alternative therapy

Determine
Restrict any Identify safety whether patient
Determine financial
drugs in short precautions with receive short
implications
supply alternative supply or
alternative 25
 INVENTORY STORAGE REGULATIONS

USP 1079: Good practices are necessary for all temperature-

controlled pharmaceuticals
 All pharmacies required to be kept at controlled room
temperature (CRT)
 Room temperature storage: 20°C – 25°C(68°F to 77°F)
 Refrigerator storage: 2°C – 8°C(35°F to 46°F)
 Freezer storage: -25°C – -10°C(-13°F to 14°F) 26
COLD CHAIN

27
 DRUG INVENTORY: ARRANGEMENT

Alphabetical
OTC drugs and
order by Fast movers
DME
generic

C2 locked in secure C3-C5 locked in secure

cabinet or dispersed Alphabetical by cabinet or dispersed
throughout
noncontrolled product name throughout
inventory noncontrolled inventory

Quarantine area: storage of

outdated/damaged/deteriorated/misbranded/or 28

adulterated (send back to distributor)

 A diagram or visual presentation that
indicates how and where to place the front-
end products on a shelf that helps increase
OTC profits
PRODUCTS
USING A
PLANOGRAM Factors for product placement
Current product
Product sales and Product demand
and industry
profitability and availability
trends

29
 Arrange products based on general
categories and subcategories

PLANOGRAM: Cone of vision: 30 to 54

inches from the floor, the Place the most
ARRANGEMENT average shopper's line of profitable products
vision

Destination items: products Place on the shelf

that shoppers seek out no outside of the cone
matter where they are of vision

30
GENERAL
CATEGORIES VS
SUBCATEGORIES

31
 GENERAL
CATEGORIES VS
SUBCATEGORIES
 Cone of Vision
 Contains the items that are either higher priced or
impulse buys
 Typically will not contain “must haves” or destination
items.
 Companies pay to ensure their product is located in
these high sell through areas
 Larger sized items on the right side, never left., Why?? 32
 REASONS TO USE PLANOGRAM

 Maximize pharmacy revenue

 Optimize space in pharmacy
 Make products visible to customers
 Help to cross-promote and cross-selling
o Technique that helps sell additional items to existing customers
 Analyze consumers behavior
o Use analyzed information to expand pharmacy business 33
 DRUG INVENTORY: LEGAL REQUIREMENTS
Initial Inventory Date: Every person required to keep records shall take an
inventory of all stocks of controlled substances on hand on the date he/she first
engages in the manufacture, distribution, or dispensing of controlled substances.

In the event a person commences business with no controlled substances on

hand, he/she shall record this fact as the initial inventory.

Biennial Inventory Date: After initial inventory, a new inventory of

controlled substances stocks shall be done at least every 2 years
 Can be done any day within 2 years of the previous biennial inventory date 34

 Must be done before opening or after closing the pharmacy

 DRUG INVENTORY: COMPOUNDING

 Master formulation: a general formula sheet that will be used each

time a particular CNSP is compounded, a recipe to follow to make the
product

 Compounding nonsterile preparations (CNSP): documentation is

necessary to be able to systematically trace, evaluate, and replicate the
steps throughout the compounding process
35
36
DRUG
INVENTORY:
COMPOUNDING

37
 CONTROLLED SUBSTANCES ORDERING SYSTEM
 Purpose: issue and revoke digital signatures to DEA Registrants (
manufacturers, distributors, or pharmacies) to digitally sign electronic
orders for controlled substances
o Allows DEA Registrants to order controlled substances without DEA
form 222
 CSOS required purchasers to enroll with DEA to acquires CSOS digital
certificate
o Digital certificate obtain by enroll in the CSOS program through the
DEA website 38
CONTROLLED SUBSTANCES ORDERING SYSTEM
(CSOS)

39
CSOS BENEFITS

Faster transaction: order

Ordering freedom received and shipped out
the same day

Accurate orders: Decreased cost, increase

minimize manual form security and comply with
errors DEA regulations
40
 DEA FORM 222
 Form still used to order or transfer Schedule II controlled substances
 C2 orders will not be accepted without form 222
 Form 222 must be securely stored and be readily available if requested
 Supplier and receiver must keep a copy of the form
 Supplier will keep original
 Receiver will keep a copy
 DEA receives a scanned copy through email or regular mail (At your local DEA
office) 41
NEW
DEA
FORM
222

42
 PREPARING AND DISPENSING

Pre-
Drop Off Data Entry
Verification

Filling and Final Dispensing and

Labeling Verification counseling
43
DROP OFF
44
 PREPARING AND DISPENSING: DROP OFF
 Prescription can be brought in by patient (not as common with e-
prescribing anymore)
 Will want to inquire and document DOB
 Will want to clarify name of the patient if difficult to read
 Will want to provide time table to patient to set expectations
 If they are a new patient, they may need to fill out a “New Patient Form”

45
NEW PATIENT FORM
 Includes information on Allergies
 Includes medical history
 Information on other medications
being taken
 Demographic info:
 Name
 Address
 Phone
 DOB
 Insurance information 46
 PRESCRIPTION

 Example prescription
 Sections
 Doctor
 Patient
 Medication
47
PRESCRIPTION

48
 RX DROP OFF TIPS
 Make sure the prescription has all the information before patient leaves
 If new patient, make sure to ask for insurance
 Make sure we have the medication in stock (may also be done in data entry)
 Back-order medications
 Brand medication
 Uncommon medication
 Scan in all prescription before doing next task
49
DATA ENTRY
50
PREPARING AND DISPENSING: DATA ENTRY
 Overview
 Prescription is entered into pharmacy
system
 Insurance information is entered
 Stock is checked to ensure availability
(system should tell you on hand quantity)
 Claim transmitted
 Processes through with Co-Pay amount
to charge patient or,
 Rejects processing
 Sent to pharmacist for pre-verification
51
 PREPARING AND DISPENSING: DATA ENTRY

 Good practices in Data Entry

 Ensure we have medication available before patient leaves the window,
or call patient to inform of ordering delay if they have left
 Call physician to clarify any discrepancies or issues (Intern or RPh)
 Ensure claim processes through insurance, if not, inform patient of
issue (Correct if possible)
52
PREPARING AND DISPENSING: DATA ENTRY

 Example Rejections for Claims:

 Refill too soon
 Drug not covered
 Pharmacy not contracted
 Quantity limit exceeded

53
PREPARING AND DISPENSING: DATA ENTRY

54
 Prescription discount cards: saving card
from a third-party company, not your
RX DISCOUNT insurance provider or drug manufacturer

CARDS AND
COPAY COUPONS Manufacturer coupons: aka copay coupons
or copay assistance program

55
Rx Discount Cards Copay Coupons

No refill limits Limited number of refills

No expiration date Have expiration date and a savings maximum
Used regardless of insurance status Many coupons exclude people with Medicare,
Medicaid or other government insurance

Patient can only use either their insurance or the Can be use together with insurance for additional
saving card saving

Discounts on brand or generic prescriptions Offset the price of medications to help save out-of-
pocket costs

Simple as Google to find Rx discount cards Access through the medication or manufacturer
websites

DISCOUNT CARDS VS COPAY CARDS

56
RX
DISCOUNT
CARDS

57
COPAY
CARDS

58
 DATA ENTRY TIPS
 Select the preferred manufacturer when typing
 Make sure to double check the prescription is scanned under the right
patient
 Make sure to enter prescriber DEA with controlled medications
 Double check the enter date
 The date the prescription is written

 Enter or calculate the right supply days

 Eye drops 59

 Injection pens
PRE-VERIFICATION
60
WHAT HAPPENS IN PRE-VERIFICATION
 Overview
o Utilize the 5 "Rs" (right patient, right drug, right dose...)
o Drug Utilization Review
o Overuse/underuse
o Drug-drug interactions
o Drug-allergy contraindications

o Review PDMP if controlled substances

o REMS and IPEDGE for certain medications 61
THE FIVE
RIGHTS

62
 PRESCRIPTION DRUG MONITORING
PROGRAMS (PDMP)
 Help clinicians and pharmacists recognize substance abuse through medication
history checks. FL: E-FORCSE
 Electronic database that tracks controlled substance prescriptions in a state
(multiple states have a similar system)
 Dispensers of controlled substances are required to report to the PDMP each
time a controlled substance are dispensed to the patient
 PDMP data must be reviewed prior to dispensing for a controlled substance
 You can check most other states that have a similar system through the 63

platform, not all states have this system in place

PRESCRIPTION DRUG MONITORING PROGRAMS
(PDMP)

 Patients under 16 years of age will not be in

the system (not required)
 Only use this system for your patients
 Per Florida Statute §893.055(7)(b), access to a
person’s E-FORCSE is designated for
prescription drug program management only.
It is a third-degree felony to obtain an
individual’s E-FORCSE when it is not related
to a patient’s care.

64
65
66
RISK EVALUATION AND MITIGATION STRATEGIES (REMS)
 A drug safety program that the FDA can require for certain medications
with serious safety concerns to help ensure the benefits outweigh the
risks
 Focus on preventing, monitoring or managing serious risk by informing,
educating or reinforcing actions to reduce the frequency or severity of
the event
 Other REMS require prescribers, dispensers, or patients to document a
“safe use condition” (e.g., a monthly lab test) before the drug can be
dispensed to the patient. 67
REMS PROGRAM

68
DRUGS ON
REMS

69
 IPLEDGE REMS

 Safety program to manage the risk of isotretinoin's teratogenicity and to

minimize fetal exposure
 Required by the FDA to ensure the benefits of isotretinoin outweigh its
risks
 Isotretinoin: treatment of severe recalcitrant nodular acne in non-
pregnant patients 12 years of age and older with multiple inflammatory
nodules
76
 IPLEDGE REMS OVERVIEW
 Only enrolled and activated healthcare providers can prescribe
isotretinoin.
 Only enrolled and activated pharmacies can dispense isotretinoin
 Educate patients on the risks of isotretinoin and the contraception
requirements of the iPLEDGE REMS
 Enroll those patients in the REMS who meet all the requirements of the
iPLEDGE REMS.
 Isotretinoin is only available through this restricted distribution program
77
IPLEDGE REMS

78
 PRE- VERIFICATION TIPS

 Make sure the right drug is selected

 Make sure the name on the prescription matches the patient's profile
 Double check the days' supply and dispensed quantity
 Make sure to PDMP all controlled medications
 If drug required special program, make sure to fill out the form
o REMS
o IPLEDGE
o RDA 79
FILLING AND LABELING

80
 PREPARING AND
DISPENSING: FILLING AND
LABELING
 Overview
o Print patient's leaflet
o Pick medication from shelves according to the
prescription, matching National Drug Code
(NDC)
o Scan the leaflet and the product barcode to
print label
o Count the medication and label on the vial
o Place the labeled medication for pharmacist
verification 81
NATIONAL DRUG CODE (NDC)

82
 Clean the tray after counting medications that are known to be potent
or hazardous

FILLING :
HAZARDOUS Clean using a damp cloth or alcohol spray on cotton

/ALLERGY DRUGS
CONSIDERATIONS
Air dry the tray before using it again
(USP 800)

Clean the tray after counting these medications

83 Methotrexate Penicillin Tamoxifen Finasteride Sulfa

FILLING AND LABELING

84
 LABELING / FILLING TIPS

 Make sure to do one prescription at a time

 Make sure to label the correct vial
 Make sure the labeled vial matches the leaflet
 Make sure to scan the leaflet and the medication bottle before labeling (if
available)
 If no scanner, make sure the drug bottle NDC matches the NDC on the
leaflet
85
FINAL VERIFICATION
86
PREPARING AND DISPENSING: FINAL VERIFICATION
 Overview
o Re-verify the 5Rs in the pre-
verification step (right patient, right
drug...)
o Verify to make sure the product and
its NDC match with patient's leaflet
o Pack up the medication
o Add any additional notes for the
patient outside of the package 87
  Overview
o Expiration date check
PREPARING AND
o Fridge storage
DISPENSING:
o Additional items (syringes for oral
FINAL
dosing)
VERIFICATION
o Right label on right bag (common
error)

88
 FINAL VERIFICATION TIPS

 Make sure to open medication vial to check the pill shape/color

 Make sure the labeled vial is bagged with the correct patient's leaflet
 If medication in original container, make sure to check the NDC
 Also check quantity is accurate (is bottle sealed?)

 Add notes or counseling advise inside the medication package or on

label

89
DISPENSING AND COUNSELING
90
 DISPENSING AND COUNSELING
 Overview
o Verify patient name and address before dispensing
 For controlled substance medications, will need driver license of
entity that is picking up the medication
o Inform patients all the medications they are picking up and the prices
o Cash out the medications
o Ask if the patient has any question for the pharmacist (required by
law)
91

 Only pharmacists and interns are allowed to provide counseling to patients

 COUNSELING TIPS
 Verify patient's knowledge and understanding of medication use by
asking:
 What did your doctor tell you the medication is for?
 How did your doctor tell you to take the medications?
 What did your doctor tell you to expect?

 Open ended questions help us guide the conversation to finding what

knowledge the patient needs
 Keep verbage simple and avoid heavy medical terminology
92
PREVENTING ERRORS
93
QUALITY RELATED
EVENTS (QRE)

 Documentation of
errors that have
occurred and what is
thought to be the
cause
 Needs to be
specific enough to
identify patterns
 No HIPAA should
be included

94
 CONTINUOUS QUALITY IMPROVEMENT (CQI)
 Process improvement technique that focuses on improvement
efforts by:
 Identifying root causes of problems
 Intervening to reduce or eliminate these causes
 Reassessing the process
 CQI
 Empowers health care providers to improve quality
 Recognizes that problems result from a failure in the process
 Required by the Florida Board of Pharmacy (F.A.C. 64B16-27.300) 95

 Requires a review of Quality Related Events at least every 3 months

CONTINUOUS QUALITY IMPROVEMENT (CQI)
There are many CQI models and that all
include elements that reflect the
following core concepts:
1. Plan
2. Design
3. Measure
4. Assess
5. Improve
96
 CONTINUOUS
QUALITY
IMPROVEMENT(CQI)
 Analysis of QRE’s that
occurred in the last
quarter
 Data parsed to find
patterns
 Plan made to
prevent errors that
are occurring
 Should be
discussion on
previously
implemented plans
and their outcomes
97
TECHNOLOGY IN PHARMACY PRACTICE
 Internet: Secure web-based platforms
that enhanced pharmacy services and
public health initiatives.
 Mobile apps: refill reminders, refill
reordering, refill ready alerts, disease
state monitoring,
 Computerized Physician Order
Entry (CPOE) AKA Electronic
prescribing: transmission of
prescription electronically to
pharmacy to reduce prescribing
errors
98
TECHNOLOGY IN PHARMACY PRACTICE
 Barcode Medication
Administration (BCMA)
 Help fulfill the “five rights” of
medication management
 Barcode scanners: to verify accuracy
of filled medication in community
and hospital
 Barcode identification: Help prevent
medical errors by making accurate
and reliable information readily
available information 99
PARATA

100
 Improve Improve efficiency with speed and accuracy

Increase Increase medication adherence and reduce readmissions

Provide Provide a patient experience of convenience and reliability

Maximize Maximize workflow productivity and manage inventory while lowering costs

Expand Expand your reach while improving operational costs with fully customized solutions

AUTOMATION ENHANCES
102
 TECHNOLOGY IN PHARMACY PRACTICE
 Adherence monitoring: Smart pill bottles that are internet-linked
devices created to remind people to take their pills. Several vendors
have developed “smart” packaging, where a microchip-containing tablet
blister pack is able to monitor when doses are popped out (not
necessarily taken)
 Medication synchronization software: Sync up a patient’s
medications for a single monthly pickup.
 Telehealth: Use digital communications technology (audio and visual)
to provide healthcare consultations and services to patients remotely at 103

home.
COMMUNICATION
104
DISPENSING AND COUNSELING
105
 BAD DAY?

 Communication isn’t always

verbal…

106
 COMMUNICATION: EXAMPLE

HTTPS://WWW.YOUTUBE.COM/WA
TCH?V=EXUGYXYWCEE
107
 COMMUNICATION: EXAMPLE

HTTPS://WWW.YOUTUBE.COM/WA
TCH?V=LYLAJ5GHER4&T
108
COMMUNICATION SKILLS: COMMUNITY

 Active listening
 Make eye contact
 Being aware of your own
body language
 Recognize and interpret nonverbal
cues
 Empathize and apologize
 Reframe the issue, you and the
patient versus the problem

109
CONFLICT MANAGEMENT

110
COMMUNICATION

111
QUESTIONS?

David Pino, Pharm.D.

dpino@nova.edu

112
 REFERENCES
1. Deloitte and Healthcare Distribution Alliance, The Role of Distributors in the U.S. Health Care Industry (Deloitte and HDA, 2019).
2. USP. USP 39–NF 34. Good Storage and Distribution Practices for Drug Products, Rockville, MD: United States Pharmacopeial Convention; 2016
3. Katzki, Dan. “Temperature-Sensitive Medications.” Specialty Pharmacy Times, 17 Dec. 2013, www.specialtypharmacytimes.com/publications/ specialty-pharmacy-times/2013/nov_dec-
2013/temperature-sensitivemedications/p-2
4. Technician Tutorial, Drug Expiration and Beyond-Use Dates. Pharmacist’s Letter/Pharmacy Technician’s Letter. November 2017. Therapeutic Research Center website.
https://pharmacist.therapeuticresearch.com/Content/Segments/PRL/2015/Oct/The-Ins-and-Outs-of-Pharmacy-Inventory-9046. [subscription required.] Accessed April 6, 2019.
5. Technician training tutorial: the ins and outs of pharmacy inventory. Pharmacy Technician's Letter. November 2018. Therapeutic Research Center website.
https://pharmacist.therapeuticresearch.com/Content/Segments/PRL/2015/Oct/The-Ins-and-Outs-of-Pharmacy-Inventory-9046. [subscription required.] Accessed April 6, 2019.
6. Drug Recalls. U.S. Food and Drug Administration website. April 2, 2019. http://www.fda.gov/drugs/drugsafety/DrugRecalls/. Accessed April 6, 2019.
7. Guidance for Industry: Product Recalls, Including Removals and Corrections. U.S. Food and Drug Administration website. November 2003.
http://www.fda.gov/Safety/Recalls/IndustryGuidance/ucm129259.htm. Accessed April 6, 2019.
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