**1. Introduction**

Over the last decade, pharmacy has seen a large shift in the role of both the pharmacist and pharmacy technician. For instance, pharmacists have increasingly focused on providing clinical care, and gradually fallen away from the traditional dispensing role [1]. Pharmacy technicians are personnel "working in a pharmacy who, under the supervision of the licensed pharmacist, assists in pharmacy activities that do not require the professional judgment of a pharmacist [1]." However, as pharmacists have decreased their focus on dispensing, pharmacy technicians have been given the opportunity to fill the traditional dispensing role in the pharmacist's place. These new changes have progressively become the normal pharmacy model, and many studies have shown the added value of this model in both improved quality of patient care and pharmacy efficiency [2–8]. This shift is a huge building block for the future, ye<sup>t</sup> at the same time, it has resulted in the formation of unique and evolving roles for pharmacy technicians. These new roles are still in the development process, and research is beginning to roll out on the safety and efficacy of advanced pharmacy technician positions [9–12]. These changes, in due course, may be considerable innovations, but at the same time, they may pose poignant risks to patient safety. This study helps to define pharmacy technicians' new roles through the use of pharmacy technician job advertisements.

Understanding the way pharmacy technicians are recruited through job advertisements is helpful in defining the evolving role of pharmacy technicians. The recruitment process through job listings on social forums is an important and commonly-used tool by employers to convey job requirements and responsibilities. Additionally, job advertisements a ffect the number, type, and talent of possible hires. If e ffectively used, employers can use job advertisements to increase the quality and quantity of applicants by giving applicants a clear snapshot of future roles and responsibilities as well as the requirements for the job. While advertisements do not represent the formal contractual responsibilities and requirements of a technician, they do represent what the employer needs in a technician. Ultimately, looking at pharmacy technician advertisements can serve as an indicator of both the duties and qualifications desired for pharmacy technicians.

The roles and responsibilities of pharmacy technicians have been evolving from basic pharmacy organization and prescription assembly skills to complex dispensary, verification, immunization, education, and medication synchronization skills in the past decade [13]. Recently, the American Society of Health-System Pharmacists (ASHP) has defined the role of pharmacy technicians in three categories: entry-level, advanced, and specialized [13]. The listed skills needed for entry-level roles include pharmacology for technicians, pharmacy law and regulation, compounding including low- or medium-risk sterile compounding and non-sterile compounding, basic safe medication practices, pharmacy quality assurance, medication order entry and distribution, pharmacy inventory management, pharmacy billing and reimbursement, and medication-use system technology [13]. Interestingly, many of what the ASHP calls "entry-level skills" are what used to traditionally define the role of pharmacy technician [1]. However, as the pharmacy model has evolved, pharmacy technicians are now receiving new roles that are attained through additional education, training, and competency testing. These new advanced roles are supervised by pharmacists and/or approved by each state's Board of Pharmacy [1]. According to the ASHP, pharmacy technicians need to have certain skills to be included in this advanced category [13]. These skills include advanced medication systems including "tech-check-tech" programs, purchasing or fiscal management, managemen<sup>t</sup> or supervision of other pharmacy technicians, medication history assistance, medication therapy managemen<sup>t</sup> assistance, quality improvement, immunization assistance, hazardous drug handling, patient assistance programs, pharmacy technician education and training, community outreach, drug utilization evaluation and/or adverse-drug-event monitoring, industry, and informatics [13]. Furthermore, the ASHP says that some technicians receive even more specialized roles which are dependent upon each technician's individual situation [13]. They define these specialized roles as roles that require extra certification as specified by the Pharmacy Technician Certification Board (PTCB) [13]. These advanced and specialized roles contain many unique and innovative changes for pharmacy technicians which could ultimately improve patient care [13].

Despite the fact that these new technician roles may help alleviate a pharmacist's workload and allow for a more streamlined pharmacy, they may, at the same time, present safety and e fficacy issues in patient care. For instance, many of these new roles are still in the research and development process and, therefore, require strict certification, regulation, and supervision by each state's Board of Pharmacy [9–12,14]. These innovative roles require exemptions as can be seen in the research studies done by Frost, Adams. McKeiran, Henriksen, and Bailey [9–12,14]. However, employers may knowingly or unknowingly try to utilize the added e fficiency of these new roles in their pharmacies without receiving proper exemption status. Unfortunately, without the provided exemption, many of the strict protocols and regulations put into place by Boards of Pharmacy as safeguards may be ignored or improperly implemented. Without proper regulation, there is a higher chance of errors and mistakes. As a result, employers may run into legal issues, and, more importantly, patient safety and e fficacy of care will be put at risk. A previous study on pharmacy technician training programs found that of 216 training programs, 29.6% were accredited and 46% had pharmacists as faculty of the program. It was concluded that there is little to no oversight of and consistency in pharmacy technician training [15].

While, this topic should be of grea<sup>t</sup> interest to employers, there is a lack of literature studying the hiring requirements and expectations of pharmacy technicians. A review of state regulations

concerning entry-level pharmacy technicians in 2017 found that 86% of states required board registration or licensure. While only 16 states required any training programs for entry-level pharmacy technicians. This study reveals the legal requirements for the employment of pharmacy technicians, but did not study or discuss what employers actually look for in pharmacy technician candidates [16]. Therefore, the overall objective of this study was to look at the pharmacy technician advertisement database from the Pharmacy Week to find patterns and commonalities in the duties and qualifications of pharmacy technicians.

#### **2. Materials and Methods**

This study used a retrospective analysis study design to describe the current pharmacy technician job descriptions. Pharmacy technician job advertisements were obtained from Pharmacy Week for a 14 day period (26 November 2018–9 December 2018). PharmacyWeek.com was an online database of job advertisements for pharmacists, pharmacy technicians, and pharmacy interns started in 1990. Unfortunately, it is no longer maintained and can no longer be accessed. For all pharmacy technician job advertisements, the following items were obtained: (1) job title, (2) location of job (city and state), (3) what field of pharmacy job is in (hospital system, retail, [chain versus independent], long-term care, managed care, etc.), (4) position type (full or part time), (5) job duties, and (6) listed requirements for the position. Requirements within job advertisements were noted as being either required, preferred, not required, or not specified. Duties within job advertisements were noted as being either listed or not listed. Following data collection, related requirements and duties were combined into themes. These themes are detailed in Tables 1 and 2. The decision to code requirements and duties by themes verses individually was made by all researchers after listing were made of all the individual requirements and duties found in the position listing. The final themes agreed upon are depicted in the Tables 1 and 2.


**Table 1.** Job Requirements Themes.

#### **Table 1.** *Cont.*


Data were collected and entered into an Excel document. Data were de-identified prior to Excel entry. No information was recorded in a manner that could reveal the identity. Descriptive statistics were performed for all data in IBM© SPSS v 26.0 (Armonk, NY, USA). This included frequencies and percentages.

#### **Table 2.** Job Duties by Theme.


#### **Table 2.** *Cont.*


Provides PAP assistance

**Table 2.** *Cont.*

