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Community Pharmacy Check Up
Sponsored by RxSafe
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1
Name
First Name
Last Name
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2
Email
example@example.com
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3
Your Role
Pharmacist
Pharmacy Technician
Pharmacy Manager
Pharmacist Owner
Pharmacy Corporate Role
PGY1 Community Pharmacy Resident
Student Pharmacist
Other
Pharmacist
Pharmacy Technician
Pharmacy Manager
Pharmacist Owner
Pharmacy Corporate Role
PGY1 Community Pharmacy Resident
Student Pharmacist
Other
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4
Describe your Community Pharmacy Practice Setting:
Independent
Grocery
Chain
Health Care System
Other
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5
Where is your Pharmacy located?
List each state below
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6
Describe your Community Pharmacy location setting
Urban
Rural
Suburban
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7
How often does your pharmacy have extra help available during normal business hours?
Almost always
About half the time
Rarely
Never
Almost always
About half the time
Rarely
Never
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8
Which option below best describes how your pharmacy consistently offers counseling to patients receiving new prescriptions?
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Select the answer that describes the scenario that occurs in your pharmacy the majority of the time.
We ask patients if they want to talk to a pharmacist. If they say no - they don't receive counseling on new prescriptions.
All patients picking up a new prescription are counseled by the pharmacist. Counseling includes reviewing indication, how to take the medication, what to expect and how to know if it is working.
We don't often have the time to counsel on new prescriptions.
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9
About what percentage of patients know at least one Pharmacist by name?
Almost all patients have a personal relationship with a pharmacist on our team
Over 50% of patients
Type option 3
About 25%
Less than 10%
Probably zero
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10
How important do you feel it is to counsel on refill prescriptions?
We try to always to counsel on refills! Refill counseling is an opportunity to monitor drug therapy.
We' like to do this but we don't counsel on refill prescriptions (unless the patient has a specific question).
Hardly ever. If a patient doesn't have questions and has been on the medication before, there is no point to counseling on refills.
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11
Which statement best describes your pharmacy's workflow goals?
Process accurate prescriptions as fast as possible
Ensure patients are on safe and efficacious medications
Identify and resolve drug therapy problems
All of the above
Process accurate prescriptions as fast as possible
Ensure patients are on safe and efficacious medications
Identify and resolve drug therapy problems
All of the above
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12
What automation tools do you use in your dispensing process?
Robot
Pill counter
Other
None
Robot
Pill counter
Other
None
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13
Is your workflow dispensing process run primarily by pharmacy technicians?
YES
NO
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14
Is your workflow structured around medication synchronization?
YES
NO
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15
When checking prescriptions, which of the following items are reviewed by the pharmacist? Check all that apply
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The Pharmacist:
Reviews that the medication and dose on the prescription label match what is on the prescription
Ensures the medication prescribed has an indication and that the dose is safe
Ensures the medication prescribed has an indication and that the dose is effective
Documents any identified drug therapy problems
Follows up to resolve any drug therapy problems identified
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16
Do you use automation for appointment scheduling?
YES
NO
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17
Which services does your Pharmacy offer?
*
This field is required.
Check all that apply
Comprehensive Medication Reviews
Diabetes Care
Immunizations
Medication Synchronization
Point of Care Testing
Compounding
Other
None
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