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Auimekhakul T, Suttajit S, Suwannaprom P. Pharmaceutical public health competencies for Thai pharmacists: A scoping review with expert consultation. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2024; 14:100444. [PMID: 38712325 PMCID: PMC11070631 DOI: 10.1016/j.rcsop.2024.100444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 04/11/2024] [Accepted: 04/15/2024] [Indexed: 05/08/2024] Open
Abstract
Background Thai pharmacists' roles have increasingly shifted to a system-focused role in providing public health services. A competency framework in this area is essential to workforce development. Objective This study aimed to summarize and synthesize the literature on pharmaceutical public health competencies of Thai pharmacists. Methods The Scopus, MEDLINE, and Web of Science (Clarivate) databases were searched. The search criteria included "public health", "health promotion", "primary care", "community pharmacy", "pharmacy" and "pharmacist". Documents published in English and Thai between January 2011 and December 2020 were also examined. Unpublished documents were included. A 3-step inductive coding technique was used to develop the competency framework. To validate the findings, a 2-round, modified Delphi method was employed with 20 Thai pharmaceutical specialists between August 2022 and January 2023. The Scale-level Content Validity Index (S-CVI) was used to assess validity. Results The database search yielded 1429 articles. Fifty-seven articles were selected. The analysis identified 5 competency domains. The domains, along with their related competency elements and behavioral statements, were provided for expert assessment. The S-CVI scores in the first and second rounds were 0.78 and 0.93, respectively. The terminology and categories of competencies have been improved. This outcome resulted in a pharmaceutical public health competency framework for Thai pharmacists. The framework consists of 5 competency domains: 1) individual and family health promotion (3 competency elements with 10 behavioral statements), 2) community empowerment for well-being communities (6 competency elements with 23 behavioral statements), 3) information management and evidence-based practice (3 competency elements with 10 behavioral statements), 4) communication for health promotion (3 competency elements with 6 behavioral statements), and 5) pharmacoepidemiology and support for public health emergencies and epidemics (2 competency elements with 5 behavioral statements). Conclusion Pharmaceutical public health competencies for Thai pharmacists were developed through extensive literature review and expert consultation.
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Affiliation(s)
- Thanayut Auimekhakul
- Consumer Health Protection and Pharmaceutical Public Health, Chiang Mai Provincial Public Health Office, Chiang Mai 50200, Thailand
- Master's Degree Program in Pharmacy Management, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Siritree Suttajit
- Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Puckwipa Suwannaprom
- Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand
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Han Z, Barton KC, Ho LC, Yap KZ, Tan DSY, Lee SS, Neo CXR, Tan AHL, Boey BMY, Soon CJY, Gallagher PJ. Applying narrative medicine to prepare empathetic healthcare providers in undergraduate pharmacy education in Singapore: a mixed methods study. BMC MEDICAL EDUCATION 2024; 24:292. [PMID: 38491363 PMCID: PMC10943898 DOI: 10.1186/s12909-024-05254-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 03/04/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Narrative medicine demonstrated positive impact on empathy in medicine and nursing students. However, this pedagogical approach had not been evaluated in pharmacy education. This study sought to apply and evaluate the narrative medicine approach in extending empathy in Asian undergraduate pharmacy students. METHODS Narrative medicine was applied through workshops which used narratives of people with different experiences and perspectives. First-year undergraduate pharmacy students who volunteered and attended these workshops formed the intervention group (N = 31) and the remaining first-year cohort formed the control group (N = 112). A sequential explanatory mixed methods approach was adopted in which quantitative methods were first used to measure impact on pharmacy students' empathy using the Jefferson Scale of Empathy- Health Professions Student (JSE-HPS), and qualitative methods (i.e. group interviews) were then used to assess pharmacy students' emotional responses to narratives, and the perspectives of pharmacy students and faculty of this pedagogical approach. RESULTS There was no difference in JSE-HPS scores between intervention and control groups across baseline (i.e. upon matriculation), pre-intervention, and post-intervention timepoints. Pharmacy students in the intervention group had lower scores in Factor 3 ("Standing in People's Shoes") following the intervention. Five themes, guided by internal and external factors in cognition, emerged from the Group Interviews: (1) incongruence between students' motivation and faculty's perception, (2) learning context, (3) academic context, (4) cognitive system, and (5) affective system. Themes 1, 4 and 5 referred to internal factors such as students' motivation, perceived learnings, and feelings. Themes 2 and 3 referred to external factors including workshop materials, activities, content, and facilitation. CONCLUSION This study is the first to demonstrate that pharmacy students engaged with the narrative medicine approach as narratives elicited emotional responses, exposed them to diverse perspectives, and deepened their appreciation of the importance of empathy and complexities of understanding patients' perspectives. Scaffolded educational interventions using narratives and real-life patient encounters, alongside longitudinal measurements of empathy, are necessary to bring about meaningful and sustained improvements in empathy.
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Affiliation(s)
- Zhe Han
- Department of Pharmacy and Pharmaceutical Sciences, Faculty of Science, National University of Singapore, Block S4A, Level 3, 18 Science Drive 4, 117543, Singapore, Singapore.
| | - Keith C Barton
- Department of Curriculum and Instruction, School of Education, Indiana University, 201 N. Rose Avenue, 47405, Bloomington, IN, USA
| | - Li-Ching Ho
- Department of Curriculum and Instruction, School of Education, University of Wisconsin- Madison, 225 N. Mills Street, 53706, Madison, WI, USA
| | - Kai Zhen Yap
- Department of Pharmacy and Pharmaceutical Sciences, Faculty of Science, National University of Singapore, Block S4A, Level 3, 18 Science Drive 4, 117543, Singapore, Singapore
| | - Doreen Su-Yin Tan
- Department of Pharmacy and Pharmaceutical Sciences, Faculty of Science, National University of Singapore, Block S4A, Level 3, 18 Science Drive 4, 117543, Singapore, Singapore
| | - Shuh Shing Lee
- Center for Medical Education, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, 117597, Singapore, Singapore
| | - Constance Xue Rui Neo
- Department of Pharmacy, Khoo Teck Puat Hospital, 90 Yishun Central, 768828, Singapore, Singapore
| | - Amanda Han Lin Tan
- Department of Pharmacy and Pharmaceutical Sciences, Faculty of Science, National University of Singapore, Block S4A, Level 3, 18 Science Drive 4, 117543, Singapore, Singapore
| | - Brian Ming Yao Boey
- Department of Pharmacy and Pharmaceutical Sciences, Faculty of Science, National University of Singapore, Block S4A, Level 3, 18 Science Drive 4, 117543, Singapore, Singapore
| | - Charis Jia Yan Soon
- Department of Pharmacy and Pharmaceutical Sciences, Faculty of Science, National University of Singapore, Block S4A, Level 3, 18 Science Drive 4, 117543, Singapore, Singapore
| | - Paul J Gallagher
- Department of Pharmacy and Pharmaceutical Sciences, Faculty of Science, National University of Singapore, Block S4A, Level 3, 18 Science Drive 4, 117543, Singapore, Singapore
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MacKay M, Ford C, Grant LE, Papadopoulos A, McWhirter JE. Developing competencies in public health: a scoping review of the literature on developing competency frameworks and student and workforce development. Front Public Health 2024; 12:1332412. [PMID: 38500736 PMCID: PMC10944919 DOI: 10.3389/fpubh.2024.1332412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/19/2024] [Indexed: 03/20/2024] Open
Abstract
Effective and precise public health practice relies on a skilled and interdisciplinary workforce equipped with integrated knowledge, values, skills, and behaviors as defined by competency frameworks. Competency frameworks inform academic and professional development training, support performance evaluation, and identify professional development needs. The aim of this research was to systematically identify and examine trends in the extent, nature, and range of the literature related to developing competencies in public health. This includes developing public health competency frameworks, and how competencies are developed and maintained in students and practitioners. We used a scoping review methodology to systematically identify and report on trends in the literature. Two independent reviewers conducted title and abstract and full-text screening to assess the literature for relevance. Articles were included if they were original primary research or gray literature and published in English. No date or geographic restrictions were applied. Articles were included if they focused on developing competency statements or frameworks for public health and/or training public health students or practitioners to develop competencies. The review encompassed a range of methods and target populations, with an emphasis on building competencies through student and professional development. Foundational competency development was a primary focus, and we found a gap in discipline-specific competency research, especially within developing discipline-specific competency statements and frameworks. Several evidence-based practices for competency development were highlighted, including the importance of governance and resources to oversee competency framework development and implementation, and workforce planning. Experiential learning and competency-based training were commonly identified as best practices for building competencies. A comprehensive understanding of public health competency development-through developing and incorporating foundational and discipline-specific competencies, mapping student and practitioner training to competency frameworks, and incorporating best practices-will enable public health to create skills and an adaptable workforce capable of addressing complex public health issues.
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Affiliation(s)
| | | | | | | | - Jennifer E. McWhirter
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
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Queiroz NS, Vilela FC, Cavaco AM, Melo AC. Evaluation of Clinical Communication in Pharmacy Undergraduates in Brazil: A Multicentric Study. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2024; 88:100671. [PMID: 38360187 DOI: 10.1016/j.ajpe.2024.100671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/02/2024] [Accepted: 02/08/2024] [Indexed: 02/17/2024]
Abstract
OBJECTIVE To assess the clinical communication characteristics of pharmacy undergraduates, estimate differences in this specific competency, and produce recommendations for further education and training. METHODS Analysis of communication competence between 110 pharmacy students in the last graduation year from each of the 5 Brazilian regions and a simulated patient with complaints of mild allergic rhinitis passive of resolution with non-prescription medicines. The simulated appointment was recorded, and the video was analyzed using the 2 main elements: biomedical/task-focused and socio-emotional exchange of the Roter Interaction Analysis System. RESULTS The total of utterances/speech from the pharmacist to the patient was 183.4; there was a statistically significant difference according to the Brazilian region. In the consultation, the frequency with which pharmacy students returned to the segment was evaluated, with a total mean clinical history segment 2 of mean 5.60; in segment 4, which is the counseling phase, an average of 4.80. In the task codes and the socio-emotional codes, there was a statistically significant difference between the codes when compared by region. We compare by sex because it is said that women talk more than men. There was a statistically significant difference in socio-emotional code and biomedical/focused and task being higher for women. CONCLUSION The level of communication competence of students should be that desired for graduation, in all regions. There seems to be a difference between training and level of competence. Considering gender, although the consultation time is similar, it appears that the quality of communication is higher for women.
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Affiliation(s)
- Nathane S Queiroz
- Federal University of São João Del Rei (UFSJ), São João del Rei, Brazil
| | | | | | - Angelita C Melo
- Department of Clinical Pharmacy, Federal University of São João del Rei, Brazil.
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Raza MA, Aziz S, Iftikhar D, Anjum I, Fialova D. Addressing quality medication use among migrant patients: Establishment of an organization to provide culturally competent medication care. Saudi Pharm J 2024; 32:101922. [PMID: 38318317 PMCID: PMC10840353 DOI: 10.1016/j.jsps.2023.101922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 12/12/2023] [Indexed: 02/07/2024] Open
Abstract
As the global landscape continues to witness an increase in migration, the healthcare community faces an evolving challenge: the provision of quality medication care to migrant patients. Language barriers, cultural differences, and a lack of understanding of the local healthcare system can often impede the effective management of medications and access to healthcare services among migrant populations. Pharmacists, as medication experts, are dignified to make a substantial impact in bridging the gap between migrants and quality healthcare. Their expertise in medication management, accessibility, and counseling positions them as critical healthcare providers for this patient population. Pharmacies and pharmacists can serve as trusted hubs where migrants receive not only essential medications but also culturally sensitive support in navigating the healthcare system. This commentary article highlights the critical importance of culturally competent medication care for migrant patients and the central role that pharmacists can play in this endeavor. By establishing organization dedicated to this cause lead by pharmacists, we can not only address an urgent healthcare concern but also set a precedent for a healthcare system that values inclusivity, cultural competence, and equitable access to quality medication care for all, regardless of their cultural background.
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Affiliation(s)
- Muhammad Ahmer Raza
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Prague, Czech Republic
| | - Shireen Aziz
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Prague, Czech Republic
| | | | - Irfan Anjum
- Department of Basic Medical Sciences, Shifa College of Pharmaceutical Sciences, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Daniela Fialova
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Prague, Czech Republic
- Department of Geriatrics and Gerontology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
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Stephens KS, White BP. Keeping Up With the Literature: New Solutions for an Old Problem. J Pharm Pract 2024; 37:11-13. [PMID: 36189654 DOI: 10.1177/08971900221131907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Pharmacists utilize medical literature to provide evidence-based care to patients. However, staying up to date with current literature can be challenging, especially with the increasing number of publications produced in a growing number of journals. While evaluating literature is a standard in pharmacy education and training, the specific skill of keeping up with the literature is often not included. We explore the following 5 strategies to help pharmacists stay up to date with the literature: medical journals, social media, podcasts, teaching/precepting, and continuing education/board certification. Pharmacists are encouraged to evaluate which tactics fit best into their practice and incorporate them into their workflow, as well as routinely reflect on the system they create and continue to modify as needed.
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Affiliation(s)
- Katy S Stephens
- Clinical Pharmacy Specialist, Oklahoma Children's Hospital at OU Health, Oklahoma, OK, USA
| | - Bryan P White
- Clinical Pharmacy Specialist, University of Oklahoma Medical Center at OU Health, Oklahoma, OK, USA
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Hatem NAH, Yousuf SA, Mohamed Ibrahim MI, Al-Galal GS. Insights into participation in ward rounds in hospitals: A survey of clinical pharmacists' perceptions. J Pharm Policy Pract 2023; 17:2285957. [PMID: 38205197 PMCID: PMC10775710 DOI: 10.1080/20523211.2023.2285957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 11/10/2023] [Indexed: 01/12/2024] Open
Abstract
Introduction Clinical pharmacists' participation in ward rounds (WRs) has been a great chance to contribute to team-based care in the hospital setting and significantly improve patient outcomes and quality of life. Hence, the objective of this investigation was to explore the perceptions of clinical pharmacists in Yemen regarding their participation in WRs and the factors influencing their involvement. Methods An online survey of Yemeni clinical pharmacists was conducted and lasted for two months. Descriptive statistics were used to analyse the survey responses. Results a total of 120 participants were involved. About 3 out of 10 pharmacists had not previously participated in WRs, with only 30% having always or most of the time participated in word rounds alongside physicians. The results showed a positive perception of WR participation, with a median and IQR of 5(4-5). However, a lack of awareness of WR roles and the time-consuming nature of participation were the reasons for non-involvement. Conclusion The study highlights the positive perceptions of Yemeni clinical pharmacists towards ward rounds, but emphasises the need to address awareness and time constraints. Emphasising patient-centered care and longer internship durations can improve clinical pharmacist involvement. Future research should focus on optimising clinical pharmacist participation for better patient outcomes and care quality.
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Affiliation(s)
- Najmaddin A. H. Hatem
- Department of Clinical Pharmacy, College of Clinical Pharmacy, Hodeidah University, Al-Hudaydah, Yemen
| | - Seena A. Yousuf
- Social Medicine and Public Health Department, Faculty of Medicine and Health Sciences, Aden University, Aden, Yemen
| | | | - Gubran S. Al-Galal
- Clinical Pharmacy Department, University of Science and Technology, Sana’a, Yemen
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Bayked EM, Taye GN, Zewdie S, Aklilu T, Kahissay MH, Toleha HN. Pharmacy professionals' perceptions of their professional duties in the Ethiopian health care system: a mixed methods study. J Pharm Policy Pract 2023; 16:152. [PMID: 37990338 PMCID: PMC10664507 DOI: 10.1186/s40545-023-00656-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/07/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Pharmacy professionals are experts in therapeutic knowledge, experience, and skills that are used to ensure desired patient outcomes, utilizing the best available clinical evidence and interventions in collaboration with the health care team. They perceive themselves as a provider of technical, standardized, and individualized advice. The objective of this study was thus to assess the perception of pharmacy professionals towards their current professional roles in the health care system in Dessie, a city in the north-east Ethiopian region. METHODS A mixed-methods sequential explanatory study was used to assess the perception of pharmacy professionals towards their professional roles in Dessie city administration from December 15-30, 2019. The study participants were all pharmacy professionals working at health facilities in Dessie. Self-administered questionnaires were used to collect quantitative data, and face-to-face key informant interviews were used for qualitative data collection. Data were entered, processed, and analyzed using SPSS 25.0 statistical software, and thematic analysis was used for the qualitative exploration using QDA Miner Lite software (v2.0.7, free edition version). RESULT The study had a 97.7% response rate. Of the 301 participants, 173 (57.5%) were male. Most of the participants had a positive perception, while 38 (12.6%) had a poor perception of their current professional roles. Lack of physical access, poor initiatives, poor communication skills, and a lack of administrative support for pharmaceutical care were statistically significant at a p value of 0.05 and a 95% confidence interval. From the qualitative data, two major themes emerged: perceived roles and determinants (perceived facilitators and barriers). CONCLUSION Pharmacy professionals' roles were found to be influenced by a lack of physical access, poor initiatives, poor communication skills, and poor administrator support. Pharmaceutical care requires everyone's involvement in addressing these factors for successful performance and a better outcome and in considering perceived facilitators and barriers.
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Affiliation(s)
- Ewunetie Mekashaw Bayked
- Department of Pharmacy, College of Medicine and Health Sciences (CMHS), Wollo University, P.O. Box: 1145, Dessie, Ethiopia.
| | - Getachew Nigatu Taye
- Department of Pharmacy, Dessie Comprehensive Specialized Hospital (DCSH), Dessie, Ethiopia
| | - Segenet Zewdie
- Department of Pharmacy, College of Medicine and Health Science, Injibara University, Injibara, Ethiopia
| | - Teshager Aklilu
- Department of Pharmacy, College of Medicine and Health Sciences (CMHS), Wollo University, P.O. Box: 1145, Dessie, Ethiopia
| | - Mesfin Haile Kahissay
- Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Husien Nurahmed Toleha
- Department of Pharmacy, College of Medicine and Health Sciences (CMHS), Wollo University, P.O. Box: 1145, Dessie, Ethiopia
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Wu J, Qiu L, Huang X, Zhou Q, Shen Y. Building a novel self-iterative clinical pharmacist intervention model in psychiatric hospital: Application and evaluation. Asian J Psychiatr 2023; 88:103748. [PMID: 37619417 DOI: 10.1016/j.ajp.2023.103748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/26/2023] [Accepted: 08/17/2023] [Indexed: 08/26/2023]
Abstract
Clinical pharmacist intervention (CPI) in psychiatric hospital has not been widely developed in China. This study aimed to establish a real-time dynamic self-iterative CPI model in The Affiliated Mental Health Center of Jiangnan University and evaluated its effect. We focused on the running data in 2021 and 2022. The number of interventions, intervention types and intervention strategies were evaluated. In 2021 and 2022, a total of 443 interventions were reported. Among them, 271 (61.17 %) were identified during ward rounds by physicians, pharmacists and nurses. The proportion of CPI through ward rounds and information system gradually decreased while intervention through other ways increased. Meanwhile, there are various of CPI types including adverse drug reactions (26.86 %), therapeutic drug monitoring recommendations (13.32 %), drug usage and dose adjustment (10.61 %) and among them, adverse reactions are the focus of pharmacists' attention. Besides, the intervention strategies of pharmacists mainly concentrated in medication change (18.74 %), medication discontinuation (15.58 %) and dose reduction (12.19 %). In addition, the self-iterative function can continuously optimize the intervention level of clinical pharmacists. Overall, the CPI model established in this study effectively promote pharmacist intervention and accelerate pharmaceutical transformation.
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Affiliation(s)
- Jianhong Wu
- The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu 214151, China
| | - Linghe Qiu
- The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu 214151, China
| | - Xiaoyan Huang
- Wuxi Drug Safety Inspection and Testing Center, Wuxi, Jiangsu, 214151, China
| | - Qin Zhou
- The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu 214151, China
| | - Yuan Shen
- The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu 214151, China.
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Frymoyer A, Schwenk HT, Brockmeyer JM, Bio L. Impact of model-informed precision dosing on achievement of vancomycin exposure targets in pediatric patients with cystic fibrosis. Pharmacotherapy 2023; 43:1007-1014. [PMID: 37401162 DOI: 10.1002/phar.2845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/02/2023] [Accepted: 05/04/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND Vancomycin is commonly used to treat acute pulmonary exacerbations in pediatric patients with cystic fibrosis (CF) and a history of methicillin-resistant Staphylococcus aureus. Optimizing vancomycin exposure during therapy is essential and area under-the-curve (AUC)-guided dosing is now recommended. Model-informed precision dosing (MIPD) utilizing Bayesian forecasting is a powerful approach that can support AUC-guided dose individualization. The objective of the current study was to examine the impact of implementing an AUC-guided dose individualization approach supported via a MIPD clinical decision support (CDS) tool on vancomycin exposure, target attainment rate, and safety in pediatric patients with CF treated with vancomycin during clinical care. METHODS A retrospective chart review was performed in patients with CF at a single children's hospital comparing pre- and post-implementation of a MIPD approach for vancomycin supported by a cloud-based, CDS tool integrated into the electronic health record (EHR). In the pre-MIPD period, vancomycin starting doses of 60 mg/kg/day (<13 years) or 45 mg/kg/day (≥13 years) were used. Dose adjustment was guided by therapeutic drug monitoring (TDM) with a target trough 10-20 mg/L. In the post-MIPD period, starting dose and dose adjustment were based on the MIPD CDS tool predictions with a target 24 h AUC (AUC24 ) 400-600 mg*h/L. Exposure and target achievement rates were retrospectively calculated and compared. Rates of acute kidney injury (AKI) were also compared. RESULTS Overall, 23 patient courses were included in the pre-MIPD period and 21 patient courses in the post-MIPD period. In the post-MIPD period, an individualized MIPD starting dose resulted in 71% of patients achieving target AUC24 compared to 39% in the pre-MIPD period (p < 0.05). After the first TDM and dose adjustment, target AUC24 achievement was also higher post-MIPD versus pre-MIPD (86% vs. 57%; p < 0.05). AKI rates were low and similar between periods (pre-MIPD 8.7% vs. post-MIPD 9.5%; p = 0.9). CONCLUSION An MIPD approach implemented within a cloud-based, EHR-integrated CDS tool safely supported vancomycin AUC-guided dosing and resulted in high rates of target achievement.
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Affiliation(s)
- Adam Frymoyer
- Department of Pediatrics, Stanford University, Palo Alto, California, USA
| | - Hayden T Schwenk
- Department of Pediatrics, Stanford University, Palo Alto, California, USA
| | - Jake M Brockmeyer
- Department of Pharmacy, Lucile Packard Children's Hospital Stanford, Palo Alto, California, USA
| | - Laura Bio
- Department of Pharmacy, Lucile Packard Children's Hospital Stanford, Palo Alto, California, USA
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Karpa K, Ward J, Stegman M, Berg A, Leong SL. IPEx: A gamification tool for learner application of pharmacologic principles of opioid use, misuse, and addiction. Pharmacol Res Perspect 2023; 11:e01141. [PMID: 37759385 PMCID: PMC10533953 DOI: 10.1002/prp2.1141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
Opioids are often prescribed to treat chronic pain ailments, despite lack of evidence for many conditions. Prescriptions frequently become the gateway to opioid misuse and abuse. In response to the opioid crisis, medical school educators in the state of Pennsylvania developed core competencies pertaining to opioids and addiction for which all medical students should demonstrate proficiency before graduation. To enable students to achieve these competencies, we developed a web-based app (IPEx) that delivers a gamified experience for learners in which they are (re)exposed to opioid competencies and practice applying pharmacologic principles in the context of a series of longitudinal patient scenarios. Learning and application are measured by student responses to application questions before and after each of five modules. Prior to launching the IPEx tool broadly, we wished to test the application questions; thus, we invited fourth year medical students to complete a 45 question quiz based on IPEx module content. Students had no specific preparation prior to taking the quiz but had been exposed to all content elsewhere in the curriculum. A total of 45 of 141 medical students (32%) opted to complete the quiz (mean score was 47% ± 13%; range 18%-73%). Cronbach alpha for the instrument was .74. These results suggest that the instrument has internal validity, and medical students have room for growth when it comes to application of opioid related competencies, a situation that the IPEx tool may be uniquely suited to remedy.
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Affiliation(s)
- Kelly Karpa
- Department of Medical EducationEast Tennessee State University Quillen College of MedicineJohnson CityTennesseeUSA
| | - Josie Ward
- East Tennessee State University Quillen College of MedicineJohnson CityTennesseeUSA
| | | | - Arthur Berg
- Department of Public Health SciencesPennsylvania State University College of MedicineHersheyPennsylvaniaUSA
| | - Shou Ling Leong
- Department of Family and Community MedicinePennsylvania State University College of MedicineHersheyPennsylvaniaUSA
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Cheng J, Dang C, Li X, Wang J, Huang X, Li Y, Cui X. The participation of clinical pharmacists in the treatment of patients with central nervous system infection can improve the effectiveness and appropriateness of anti-infective treatments: a retrospective cohort study. Front Pharmacol 2023; 14:1226333. [PMID: 37745082 PMCID: PMC10512419 DOI: 10.3389/fphar.2023.1226333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 08/28/2023] [Indexed: 09/26/2023] Open
Abstract
Background: Central nervous system infection (CNSI) treatment in hospital neurosurgery emphasizes the importance of optimizing antimicrobial therapy. Timely and appropriate empiric antibiotic treatment is critical for managing patients with bacterial meningitis. Objectives: To evaluate the activities of clinical pharmacists in the anti-infective treatment of patients with CNSI in neurosurgery. Method: A single-center retrospective cohort study was carried out from January 2021 to March 2023 at a tertiary teaching hospital in China. The study sample included a group that received pharmacy services and a group that did not. In the pharmacy services group, the anti-infective treatment plan was led and developed by pharmacists. Pharmaceutical care, including medication therapy and all CNSI treatment regimens, was administered in daily unit rounds by pharmacists. Baseline demographics, treatment outcomes, and rational use of antibiotics were compared between the two groups, and the impact of a antimicrobial stewardship (AMS) program was evaluated. Results: Of the 306 patients assessed according to the inclusion and exclusion criteria, 151 patients were included, and 155 patients were excluded due to abnormal data and missing information on antibiotic costs or antimicrobial use. Eventually, 73 were included in the pharmacy services group and 78 in the group without pharmacist participation. The antibiotic use density (AUD) of the pharmacy services group decreased from 167.68 to 127.63 compared to the group without pharmacist participation. After the pharmacist services, the AUD for linezolid decreased from 9.15% to 5.23% and that for miscellaneous agents decreased from 17.91% to 6.72%. The pharmacy services group had better improvement (p < 0.05) and a significantly higher score for the rational use of antibiotics (p < 0.05) than the group without pharmacist participation. Conclusion: The clinical pharmacist services evaluation results demonstrated an essential role of clinical pharmacist-led AMS programs in the effective and appropriate use of anti-infective treatments in neurosurgery with patients with CNSI.
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Affiliation(s)
- Jie Cheng
- Department of Clinical Pharmacy, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Clinical Pharmacy, Jinan, China
- Department of Clinical Pharmacy, The First Affiliated Hospital of Baotou Medical College, Baotou, China
| | - ChuanDong Dang
- Department of Clinical Pharmacy, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Clinical Pharmacy, Jinan, China
| | - Xiao Li
- Department of Clinical Pharmacy, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Clinical Pharmacy, Jinan, China
| | - JianJun Wang
- Department of Neurosurgery, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Neurosurgery, Jinan, China
| | - Xin Huang
- Department of Clinical Pharmacy, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Clinical Pharmacy, Jinan, China
| | - Yan Li
- Department of Clinical Pharmacy, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Clinical Pharmacy, Jinan, China
| | - XueYan Cui
- Department of Clinical Pharmacy, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Clinical Pharmacy, Jinan, China
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13
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Bhat S, Lyu R, Agarwal M, Becker M, Bloomfeld R, Bruining DH, Cohen BL, Ivanov M, Leighton JA, Stewart AP, Trocke L, Tse SS, Ungaro RC, Vaughn BP, Regueiro M, Sokn E, Rieder F. Defining the Roles of Inflammatory Bowel Disease Clinical Pharmacists in the United States: A Systematic Review and National RAND/UCLA Consensus. Inflamm Bowel Dis 2023:izad143. [PMID: 37650888 DOI: 10.1093/ibd/izad143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Given the complexity of inflammatory bowel disease (IBD) care, utilization of multidisciplinary teams is recommended to optimize outcomes. There is a growing recognition that clinical pharmacists should be an integral part of this care model. We sought to define the roles of IBD clinical pharmacists in the United States. METHODS A national multidisciplinary expert panel of 12 gastroenterologists and clinical pharmacists practicing in IBD clinics was assembled. We used the RAND/University of California, Los Angeles appropriateness method, with a total of 281 statements generated based on a systematic literature review and expert opinion. Each statement was anonymously rated as appropriate, uncertain, or inappropriate in 2 rounds of voting. RESULTS The number of publications evaluating the clinical pharmacists' roles in IBD is limited, primarily focusing on thiopurine initiation and monitoring, medication adherence, and switching to biosimilars. Medication education; medication initiation and monitoring; therapeutic drug monitoring; biosimilar management; health maintenance review; and transitions of care were deemed by the panel to be appropriate roles for IBD clinical pharmacists. In considering real-world settings, IBD clinical pharmacists should practice clinically under a predefined scope and primarily focus on complex treatments (eg, immunomodulators, biologics, and small molecules). Clinical pharmacists should also be included in practice settings with IBD specialized physicians. Additionally, clinical pharmacists caring for patients with IBD should be residency trained and board certified. CONCLUSIONS This consensus defines IBD clinical pharmacists' roles and provides a framework for embedded clinical pharmacists in IBD care.
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Affiliation(s)
- Shubha Bhat
- Department of Pharmacy, Cleveland Clinic Foundation, Cleveland, OH, USA
- Department of Gastroenterology, Hepatology and Nutrition, Digestive Disease Institute, Cleveland Clinic Foundation, OH, USA
| | - Ruishen Lyu
- Department of Quantitative Health Science, Cleveland Clinic Foundation, OH, USA
| | - Mitali Agarwal
- Department of Gastroenterology, Hepatology and Nutrition, Digestive Disease Institute, Cleveland Clinic Foundation, OH, USA
| | | | - Richard Bloomfeld
- Section of Gastroenterology, Atrium Health Wake Forest Baptist, Winston-Salem, NC, USA
| | - David H Bruining
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Benjamin L Cohen
- Department of Gastroenterology, Hepatology and Nutrition, Digestive Disease Institute, Cleveland Clinic Foundation, OH, USA
| | - Marina Ivanov
- Department of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, AZ, USA
| | - Jonathan A Leighton
- Department of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, AZ, USA
| | - Alyssa P Stewart
- Department of Pharmacy, Atrium Health Wake Forest Baptist, Winston-Salem, NC, USA
| | - Lindsay Trocke
- Department of Gastroenterology, M Health Fairview, Minneapolis, MN, USA
| | - Stacy S Tse
- Susan and Leonard Feinstein IBD Clinical Center, Mount Sinai Hospital, New York, NY, USA
| | - Ryan C Ungaro
- Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Byron P Vaughn
- Department of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, MN, USA
| | - Miguel Regueiro
- Department of Gastroenterology, Hepatology and Nutrition, Digestive Disease Institute, Cleveland Clinic Foundation, OH, USA
| | - Erick Sokn
- Department of Pharmacy, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Florian Rieder
- Department of Gastroenterology, Hepatology and Nutrition, Digestive Disease Institute, Cleveland Clinic Foundation, OH, USA
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Foundation, OH, USA
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14
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Chamoun N, Ramia E, Sacre H, Haddad M, Haddad C, Hajj A, Namnoum J, Zeenny RM, Iskandar K, Akel M, Salameh P. Validation of the specialized competency framework for pharmacists in hospital settings (SCF-PHS): a cross-sectional study. J Pharm Policy Pract 2023; 16:86. [PMID: 37430355 DOI: 10.1186/s40545-023-00592-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 06/26/2023] [Indexed: 07/12/2023] Open
Abstract
OBJECTIVES This study aimed to validate the content of the specialized competency frameworks for pharmacists working in hospital settings (hospital and clinical pharmacists) and pilot the frameworks for practice assessment. METHODS This online cross-sectional study was carried out between March and October 2022 among a sample of 96 Lebanese pharmacists working in hospital settings. The frameworks were distributed to full-time hospital and clinical pharmacists, who filled them out according to their role in the hospital. RESULTS Overall, the competencies were distributed over five domains for hospital pharmacists (fundamental skills, safe and rational use of medicines, patient-centered care, professional skills, and preparedness for emergencies), while for clinical pharmacists, competencies were distributed over seven domains (quality improvement, clinical knowledge and skills, soft skills, ability to conduct clinical research, ability to provide effective education, use information technology to make decisions and reduce errors, and emergency preparedness). Moreover, Cronbach alpha values were appropriate, indicating sufficient to high internal consistency. Pharmacists were highly confident in most competencies, with some exceptions related to research in emergency settings (data evaluation, research, and reporting). CONCLUSIONS This study could validate competency frameworks for clinical and hospital pharmacists, with the competencies and their respective behaviors showing an adequate construct analysis. It also identified the domains that require further development, i.e., soft skills and research in emergency settings. Both these domains are timely and needed to overcome the current practice challenges in Lebanon.
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Affiliation(s)
- Nibal Chamoun
- Department of Pharmacy Practice, Lebanese American University School of Pharmacy, Byblos, Lebanon
| | - Elsy Ramia
- Department of Pharmacy Practice, Lebanese American University School of Pharmacy, Byblos, Lebanon
| | - Hala Sacre
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
| | - Mansour Haddad
- Faculty of Pharmacy, Yarmouk University, Irbid, 21163, Jordan
| | - Chadia Haddad
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon.
- School of Medicine, Lebanese American University, Byblos, Lebanon.
- Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon.
- School of Health Sciences, Modern University for Business and Science, Beirut, Lebanon.
| | - Aline Hajj
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Laboratoire de Pharmacologie, Pharmacie Clinique et Contrôle de Qualité des Médicament (LPCQM), Faculty of Pharmacy, Saint Joseph University of Beirut, Beirut, Lebanon
- Faculté de Pharmacie, Université Laval, Quebec, Canada
- Oncology Division, CHU de Québec Université Laval Research Center, Quebec, Canada
| | - Joya Namnoum
- Methodology and Statistics in Biomedical Research Unit, Faculty of Medicine, Paris-Saclay University, Kremlin-Bicêtre, Paris, France
| | - Rony M Zeenny
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Department of Pharmacy, American University of Beirut Medical Center, Beirut, Lebanon
| | - Katia Iskandar
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | - Marwan Akel
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- School of Education, Lebanese International University, Beirut, Lebanon
| | - Pascale Salameh
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- School of Medicine, Lebanese American University, Byblos, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, 2417, Nicosia, Cyprus
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15
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Duncan N, Moreno-Martinez ME, Pires V, Domingos V, Bonnin A, Nezvalova-Henriksen K, Admiraal R, Bauters T, Langebrake C. Role and competencies of the EBMT clinical pharmacists and clinical pharmacologists: a pan-European survey. Bone Marrow Transplant 2023; 58:829-831. [PMID: 37029183 DOI: 10.1038/s41409-023-01983-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/23/2023] [Accepted: 03/30/2023] [Indexed: 04/09/2023]
Affiliation(s)
| | - Maria-Estela Moreno-Martinez
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- School of Health Sciences Blanquerna, University Ramon Lull, Barcelona, Spain
| | - Vera Pires
- Insituto Português de Oncologia de Lisboa, Lisbon, Portugal
| | - Vera Domingos
- Insituto Português de Oncologia de Lisboa, Lisbon, Portugal
| | - Agnes Bonnin
- Assistance Publique - Hôpitaux de Paris, Paris, France
| | | | - Rick Admiraal
- Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | | | - Claudia Langebrake
- University Medical Centre Hamburg-Eppendorf, Department of Stem Cell Transplantation, Hamburg, Germany
- University Medical Centre Hamburg-Eppendorf, Hospital Pharmacy, Hamburg, Germany
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16
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Sakr F, Akel M, Sacre H, Haddad C, Tawil S, Safwan J, Hajj A, Zeenny RM, Iskandar K, Salameh P. The specialized competency framework for community pharmacists (SCF-CP) in Lebanon: validation and evaluation of the revised version. J Pharm Policy Pract 2023; 16:77. [PMID: 37344915 DOI: 10.1186/s40545-023-00585-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/13/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND In the absence of similar studies in Lebanon, this study aimed at upgrading and validating the Lebanese specialized competencies framework for community pharmacists (SCF-CP) as a tool to transform community practice and support the professional development and career progression of community pharmacists. METHODS Content validity was assessed and improved through a team of experts. After a thorough literature review and utilizing the Delphi technique, six domains were defined in the framework, with their respective competencies and behaviors. A cross-sectional study was then carried out from March to October 2022 using an online questionnaire created on Google Forms. The snowball technique was applied to reach community pharmacists across all the Lebanese governorates. RESULTS The final sample included 512 community pharmacists. The construct validity of the framework was confirmed by factor analysis. The Kaiser-Meyer-Olkin measures of sampling adequacy were satisfactory for all models ranging from 0.500 to 0.956 with a significant Bartlett's test of sphericity (P < 0.001). The internal consistency of all competency domains was confirmed by Cronbach's alpha, with values ranging from 0.803 to 0.953. All competencies were significantly correlated with their respective domains (P < 0.001), and all domains were significantly correlated with each other and with the framework (P < 0.001). The participants declared being competent in all domains relating to fundamental skills, safe and rational use of medicines, pharmacy management, professional skills, public health fundamentals, and emergency preparedness and response, with some exceptions, such as compounding, management, and emergency preparedness. A higher declared competency level was associated with having more experience and receiving more than 50 patients per day. CONCLUSION Our findings could demonstrate that the Lebanese specialized competency framework is a valid and reliable tool. This framework could help assess the minimum competencies that community pharmacists should possess or acquire and direct initial and continuing education for better practice. Hence, it could be adopted by the authorities and implemented in the Lebanese community pharmacy setting.
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Affiliation(s)
- Fouad Sakr
- School of Pharmacy, Lebanese International University, Beirut, Lebanon.
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon.
| | - Marwan Akel
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon
- School of Education, Lebanese International University, Beirut, Lebanon
| | - Hala Sacre
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon
| | - Chadia Haddad
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
- School of Health Sciences, Modern University of Business and Science, Beirut, Lebanon
- Research Department, Psychiatric Hospital of the Cross, Jal El Dib, Lebanon
| | - Samah Tawil
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Jihan Safwan
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon
| | - Aline Hajj
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon
- Laboratoire de Pharmacologie, Faculty of Pharmacy, Pharmacie Clinique et Contrôle de Qualité Des Médicament (LPCQM), Saint Joseph University of Beirut, Beirut, Lebanon
- Faculté de Pharmacie, Université Laval, Québec, Canada
- Oncology Division, CHU de Québec Université Laval Research Center, Québec, Canada
| | - Rony M Zeenny
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon
- Department of Pharmacy, American University of Beirut Medical Center, Beirut, Lebanon
| | - Katia Iskandar
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | - Pascale Salameh
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- University of Nicosia Medical School, Nicosia, Cyprus
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17
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Wang C, Li M, Huang Y, Xi X. Factors influencing clinical pharmacists' integration into the clinical multidisciplinary care team. Front Pharmacol 2023; 14:1202433. [PMID: 37377923 PMCID: PMC10291231 DOI: 10.3389/fphar.2023.1202433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
Objectives: To investigate the factors influencing clinical pharmacists' integration into the clinical multidisciplinary care team, using interprofessional collaboration between clinical pharmacists and physicians as the focus. Methods: Through stratified random sampling, a cross-sectional questionnaire survey was conducted among clinical pharmacists and physicians in secondary and tertiary hospitals in China from July to August 2022. The questionnaire, comprising the Physician-Pharmacist Collaborative Index (PPCI) scale to reflect the collaboration level and a combined scale to measure influencing factors, was made available in two versions for clinical pharmacists and physicians. Multiple linear regression was adopted to analyze the association between the collaboration level and influencing factors, as well as the heterogeneity of the significant factors in hospitals of different grades. Results: Valid self-reported data from 474 clinical pharmacists and 496 paired physicians were included, who were serving in 281 hospitals from 31 provinces. In terms of participant-related factors, standardized training and academic degree, respectively, exerted significant positive effects on the perceived collaboration level by clinical pharmacists and physicians. In terms of context characteristics, manager support and system construction were the main factors for improving collaboration. In terms of exchange characteristics, clinical pharmacists having good communication skills, physicians trusting others' professional competence and values, and both parties having consistent expectations had significant positive effects on collaboration. Conclusion: The study provides a baseline data set on the current level and associated factors of clinical pharmacists' collaboration with other professionals in China and other countries with a related health system, providing references for individuals, universities, hospitals, and national policymakers to facilitate the development of clinical pharmacy and multidisciplinary models and further improve the patient-centered integrated disease treatment system.
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Affiliation(s)
| | | | | | - Xiaoyu Xi
- *Correspondence: Xiaoyu Xi, ; Yuankai Huang,
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18
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Tan X, Ning N, Hua N, Wiley J, Sun M. Determining the core competencies for international postgraduate nursing students in internship programs: A delphi study. Nurse Educ Pract 2023; 70:103654. [PMID: 37146479 DOI: 10.1016/j.nepr.2023.103654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/26/2023] [Accepted: 04/24/2023] [Indexed: 05/07/2023]
Abstract
AIM To determine the core competencies of clinical internships for international postgraduate nursing students undertaking a two-year professional program in China. BACKGROUND Clinical internship is an important part of nursing education and is the cornerstone for the future training of nursing professionals. However, in terms of providing a basis for the training and assessment of international postgraduate nursing students undertaking a two-year professional program in China, their core competencies of clinical internships have not yet been sufficiently determined. METHODS Focus group interviews and a two-round Delphi method were conducted. The preliminary list of core competencies was determined based on a scoping review and focus group interviews. Subsequently, experts provided suggestions for modifications to the core competencies in two rounds of the Delphi survey. The response rate (RR), composite reliability (Cr), coefficient of variation and Kendall coefficient of indices were calculated. RESULTS Twenty experts completed two rounds of Delphi expert consultation and reached consensus on five first-level indices and 13 s-level indices with 27 connotations. The RR values for the two rounds of consultation were 100 %, the Cr values were 0.853 and 0.873 and the Kendall coordination coefficients were 0.134-0.250 (p < 0.05). CONCLUSION The core competencies identified in this research can provide a basis for further training international postgraduate nursing students undertaking a two-year professional program in China through internship programs. This research also provides a reference for effectively evaluating and improving clinical programs.
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Affiliation(s)
- Xiangmin Tan
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Ni Ning
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Nan Hua
- Xiangya School of Nursing, Central South University, Changsha, China
| | - James Wiley
- School of Nursing, University of California, San Francisco, CA 94118, USA
| | - Mei Sun
- Xiangya School of Nursing, Central South University, Changsha, China.
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19
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Wu J, Qiu L, Huang X, Zhou Q, Shen Y. WITHDRAWN:Construction and application of a novel clinical pharmaceutical intervention model in psychiatric hospital. Asian J Psychiatr 2023:103589. [PMID: 37142515 DOI: 10.1016/j.ajp.2023.103589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/08/2023] [Accepted: 04/12/2023] [Indexed: 05/06/2023]
Affiliation(s)
- Jianhong Wu
- The Affiliated Mental Health Center of Jiangnan University, China. Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, 214151, China
| | - Linghe Qiu
- The Affiliated Mental Health Center of Jiangnan University, China. Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, 214151, China
| | - Xiaoyan Huang
- Wuxi Drug Safety Inspection and Testing Center, Wuxi, Jiangsu, 214151, China
| | - Qin Zhou
- The Affiliated Mental Health Center of Jiangnan University, China. Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, 214151, China
| | - Yuan Shen
- The Affiliated Mental Health Center of Jiangnan University, China. Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, 214151, China.
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Westerholm A, Leiman K, Kiiski A, Pohjanoksa-Mäntylä M, Mistry A, Airaksinen M. Developing Medication Review Competency in Undergraduate Pharmacy Training: A Self-Assessment by Third-Year Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5079. [PMID: 36981990 PMCID: PMC10049528 DOI: 10.3390/ijerph20065079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 03/07/2023] [Accepted: 03/12/2023] [Indexed: 06/18/2023]
Abstract
Pharmacists are increasingly involved in medication history taking, medication reconciliation, and review in their daily practice. The objectives of this study were to investigate third-year pharmacy students' self-assessed competency in medication reviews and gather their feedback for further development of medication review training in their curriculum. The study was conducted as a self-assessment of third-year pharmacy students at the completion of their second three-month internship period in a community pharmacy in 2017-2018. The students were assigned to review medications of a real patient under the supervision of a medication review accredited pharmacist during their internship. The self-assessment was carried out via an e-form, which was created for this study. Recently established national medication review competence recommendations for pharmacists were used as a reference. Students (n = 95, participation rate: 93%) self-assessed their competency as good or very good in 91% (n = 28) of the competency areas listed in the self-assessment. The highest proportion of competencies that were self-assessed as good or very good included using medication risk management databases and evaluating the clinical importance of the information (97%, n = 92). The lowest proportion of competencies was found in applying clinical information from the key laboratory tests to patient care and knowing which laboratory tests are most important to monitor in each condition and medication (36%, n = 34). The students suggested that their pharmacy education should contain more medication review assignments as group work and that an elective course on medication reviews should be compulsory for all pharmacy students.
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Affiliation(s)
- Aleksi Westerholm
- Clinical Pharmacy Group, Department of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Viikinkaari 5 E, P.O. Box 56, 00014 Helsinki, Finland
| | - Katja Leiman
- Clinical Pharmacy Group, Department of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Viikinkaari 5 E, P.O. Box 56, 00014 Helsinki, Finland
| | - Annika Kiiski
- Clinical Pharmacy Group, Department of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Viikinkaari 5 E, P.O. Box 56, 00014 Helsinki, Finland
| | - Marika Pohjanoksa-Mäntylä
- Clinical Pharmacy Group, Department of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Viikinkaari 5 E, P.O. Box 56, 00014 Helsinki, Finland
| | - Anita Mistry
- Faculty of Pharmacy, Pharmacy and Bank Building, Camperdown/Darlington Campus, University of Sydney, Darlington, NSW 2050, Australia
| | - Marja Airaksinen
- Clinical Pharmacy Group, Department of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Viikinkaari 5 E, P.O. Box 56, 00014 Helsinki, Finland
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21
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McFarland MS, Stover KR, Bhat S, Coon S, Cooper M, DiDomenico R, Herbert S, Kessler S, Lee M, Maddox MM, Quidley AM, Rhoney D, Wooten L, Zhou Y. Charting a new path forward for pharmacy residency expansion. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2023. [DOI: 10.1002/jac5.1748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
| | | | - Shubha Bhat
- American College of Clinical Pharmacy Lenexa Kansas USA
| | - Scott Coon
- American College of Clinical Pharmacy Lenexa Kansas USA
| | | | | | | | - Sarah Kessler
- American College of Clinical Pharmacy Lenexa Kansas USA
| | - Michelle Lee
- American College of Clinical Pharmacy Lenexa Kansas USA
| | | | | | - Denise Rhoney
- American College of Clinical Pharmacy Lenexa Kansas USA
| | - Leslie Wooten
- American College of Clinical Pharmacy Lenexa Kansas USA
| | - Yi Zhou
- American College of Clinical Pharmacy Lenexa Kansas USA
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22
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Rourke W, Pagel K, Dumont Z, Len S, Roy C. Implementation of a pharmacist skill development "work-with" program. Am J Health Syst Pharm 2023; 80:e29-e45. [PMID: 36124985 DOI: 10.1093/ajhp/zxac260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Indexed: 12/30/2022] Open
Abstract
PURPOSE Pharmacists' clinical competency is necessary to ensure patient safety and medication optimization. There are many barriers to the implementation of competency assessments and scant literature on their implementation. We aimed to determine if a competency assessment program for hospital pharmacists is feasible, acceptable, and effective. METHODS Clinical competency assessments of hospital pharmacists were conducted. During the assessments, pharmacists presented a patient case or completed patient care activities while a leadership team member evaluated them using a competency rubric and provided feedback. A postevaluation electronic survey adapted from validated tools regarding perceptions of program feasibility and acceptability was emailed to the pharmacists following each competency assessment and to evaluators at study conclusion. Feasibility was also measured through reviewing rubrics for completion within the 1.5- to 2-hour assessment timeframe. Effectiveness was captured by comparing results to expected competency levels based on experience. RESULTS In total, 20 assessments were completed. Fifty percent of assessments required longer than the allotted timeframe. Most participants surveyed found the competency assessments implementable, possible, doable, and easy to use. The majority also approved of the implemented assessments and found them appealing, likable, and welcomed and commented that they aided in professional development. For 50% of the competencies assessed, most participants aligned with competency expectations based on years of experience. CONCLUSION The implementation of these competency assessments was found to be feasible and acceptable to hospital pharmacists. The rubric used was found to be moderately effective. Major implementation barriers were related to time constraints and criteria for success. Future work will be done to enhance the program's effectiveness.
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Affiliation(s)
- Wallace Rourke
- Department of Pharmacy, Saskatchewan Health Authority-Regina, Regina, SK, Canada
| | - Kaitlyn Pagel
- Department of Pharmacy, Saskatchewan Health Authority-Regina, Regina, SK, Canada
| | - Zack Dumont
- Department of Pharmacy, Saskatchewan Health Authority-Regina, Regina, SK, Canada
| | - Suzanne Len
- Department of Pharmacy, Saskatchewan Health Authority-Regina, Regina, SK, Canada
| | - Caitlin Roy
- Department of Pharmacy, Saskatchewan Health Authority-Regina, Regina, SK, Canada
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23
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Sun Q, Chen L, Huang Y, Xi X. Association of education background with clinical pharmacists' clinical pharmacy workload in tertiary hospitals of China. BMC MEDICAL EDUCATION 2022; 22:769. [PMID: 36352419 PMCID: PMC9648015 DOI: 10.1186/s12909-022-03859-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Workload of healthcare providers may affect the quality of healthcare. Practical evidences have indicated that healthcare providers are differentially associated with workload due to their different education and training background. Clinical pharmacists are an indispensable part of medical teams. Under the precondition that clinical pharmacists in China generally undertake uneven clinical pharmacy workload, the relationship of workload and clinical pharmacists' different education backgrounds remains unclear. This study aimed to assess the association between the education background of clinical pharmacists and their clinical pharmacy workload in China. METHODS A field questionnaire survey using a stratified sampling was conducted to gather data on education background and clinical pharmacy workload through a self-developed instrument. Ordinary least squares regression was used to evaluate the association of the participants' education background with their clinical pharmacy workload. RESULTS A total of 625 clinical pharmacists from 311 tertiary hospitals in China participated. Two levels of education: less than bachelor's degree in general pharmacy, or doctoral degree in clinical pharmacy was associated significantly with clinical pharmacy workload of the participants. Participants who had credentials of national level and provincial-level specialized training for clinical pharmacists had undertaken more work than those without. Moreover, the participants' specialized field, such as respiratory medicine and nephrology, was associated with their clinical pharmacy workload. CONCLUSION Enhancing several aspects of education or training among clinical pharmacists in tertiary hospitals in China may help improve their capability to provide clinical pharmacy services. Efforts are needed to improve the education and training system of clinical pharmacists in China.
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Affiliation(s)
- Qingran Sun
- National Medical Products Administration Key Laboratory for Drug Regulatory Innovation and Evaluation, No. 639, Longmian Avenue, Jiangning District, Nanjing, 211198, Jiangsu Province, China
| | - Lei Chen
- National Medical Products Administration Key Laboratory for Drug Regulatory Innovation and Evaluation, No. 639, Longmian Avenue, Jiangning District, Nanjing, 211198, Jiangsu Province, China
| | - Yuankai Huang
- National Medical Products Administration Key Laboratory for Drug Regulatory Innovation and Evaluation, No. 639, Longmian Avenue, Jiangning District, Nanjing, 211198, Jiangsu Province, China
| | - Xiaoyu Xi
- National Medical Products Administration Key Laboratory for Drug Regulatory Innovation and Evaluation, No. 639, Longmian Avenue, Jiangning District, Nanjing, 211198, Jiangsu Province, China.
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24
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Grzyb K, Meresińska M, Religioni U, Juszczyk G, Płaczek J, Neumann-Podczaska A, Szymański FM, Chełstowska B, Wieczorowska-Tobis K, Cofta S, Tobis S, Staszewski R, Vaillancourt R, Majewski R, Hernik J, Fehir Sola K, Blicharska E, Kaźmierczak J, Rutkowska E, Prygiel E, Skierska M, Nawara M, Korbiewska I, Krysiński J, Merks P. Implementation of the Patient Counselling Service at the Cancer Hospital in Radom, Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13642. [PMID: 36294222 PMCID: PMC9602852 DOI: 10.3390/ijerph192013642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/12/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023]
Abstract
Background: Non-adherence occurs in various groups of patients, including those with chronic diseases. One strategy to increase adherence among oncological patients is to individualise treatment and expand pharmaceutical care. Pharmaceutical labels that remind patients how they should take their medications are of great importance in this respect. Objective: The main objective of this study was to evaluate medication adherence in oncological patients, and to gather their opinions on the individual medication labelling system as an element of effective treatment. Methods: The study was conducted in 2021 among 82 patients of the oncological department of the Centre of Oncology in Radom. The research tool was a questionnaire consisting of personal data and two parts relating to the patient's disease and the medication labelling system. Results: Nearly half of the respondents reported that they forget to take medications and how they should take them. These problems increased with the age of the patient and the number of administered medications. Of the respondents, 89% stated that the labels with dosing information are helpful. Over 67% agreed that these labels should be affixed to all medications. Nearly 90% of the respondents believed the labels should be available in all pharmacies. Conclusions: Non-adherence is a common phenomenon among oncological patients. Pharmacists providing a labelling service for medicinal products can play a significant role in reducing this phenomenon.
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Affiliation(s)
- Katarzyna Grzyb
- Radom Oncology Center im, Bohaterów Radomskiego Czerwca 76′, 26-600 Radom, Poland
| | - Martyna Meresińska
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, 85-089 Bydgoszcz, Poland
| | - Urszula Religioni
- School of Public Health, Centre of Postgraduate Medical Education of Warsaw, Kleczewska 61/63, 01-826 Warsaw, Poland
| | - Grzegorz Juszczyk
- Department of Public Health, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Jakub Płaczek
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, 85-089 Bydgoszcz, Poland
| | | | - Filip M. Szymański
- Department of Civilization Diseases, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-938 Warsaw, Poland
| | - Beata Chełstowska
- Department of Biochemistry and Laboratory Diagnostics, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-938 Warsaw, Poland
| | - Katarzyna Wieczorowska-Tobis
- Department of Palliative Medicine, Poznan University of Medical Sciences, 61-245 Poznan, Poland
- Heliodor Swiecicki Clinical Hospital in Poznan, 60-355 Poznan, Poland
| | - Szczepan Cofta
- Heliodor Swiecicki Clinical Hospital in Poznan, 60-355 Poznan, Poland
- Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences, 60-569 Poznan, Poland
| | - Sławomir Tobis
- Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences, 60-569 Poznan, Poland
- Department of Occupational Therapy, Poznan University of Medical Sciences, 60-781 Poznan, Poland
| | - Rafał Staszewski
- Department of Hypertension, Angiology and Internal Medicine, Poznan University of Medical Sciences, 61-848 Poznań, Poland
| | - Regis Vaillancourt
- Department of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-938 Warszawa, Poland
| | - Rafał Majewski
- Radom Oncology Center im, Bohaterów Radomskiego Czerwca 76′, 26-600 Radom, Poland
| | - Justyna Hernik
- Radom Oncology Center im, Bohaterów Radomskiego Czerwca 76′, 26-600 Radom, Poland
| | | | - Eliza Blicharska
- Department of Analytical Chemistry, Medical University of Lublin, Chodźki 4a, 20-093 Lublin, Poland
| | | | - Ewa Rutkowska
- Radom Oncology Center im, Bohaterów Radomskiego Czerwca 76′, 26-600 Radom, Poland
| | - Elżbieta Prygiel
- Radom Oncology Center im, Bohaterów Radomskiego Czerwca 76′, 26-600 Radom, Poland
| | - Monika Skierska
- Radom Oncology Center im, Bohaterów Radomskiego Czerwca 76′, 26-600 Radom, Poland
| | - Monika Nawara
- Radom Oncology Center im, Bohaterów Radomskiego Czerwca 76′, 26-600 Radom, Poland
| | - Izabela Korbiewska
- Rehabilitation Faculty of Medical Sciences, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland
| | - Jerzy Krysiński
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, 85-089 Bydgoszcz, Poland
| | - Piotr Merks
- Department of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-938 Warszawa, Poland
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25
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Daugherty KK, Caldwell D, Armistead LT, Stutz MM, Castleberry AN, Nash JD, Immekus JC. A pilot study on the use of the nominal group technique to refine core pharmacy roles and to determine what competencies may be missing from pharmacy education. CURRENTS IN PHARMACY TEACHING & LEARNING 2022; 14:1122-1134. [PMID: 36117119 DOI: 10.1016/j.cptl.2022.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/07/2022] [Accepted: 07/20/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION To describe the use of the nominal group technique (NGT) to refine pharmacy core roles and to compare these roles with current pharmacy outcomes and other literature to highlight potential deficiencies. METHODS The NGT process was used for this proposal review. The process was conducted in four key stages: silent generation, round-robin, clarification, and voting. A convenience sampling of five pharmacy faculty and administrators that have researched the areas of practice-readiness and pharmacy competencies formed the panel of participants for the NGT process. RESULTS Study findings offer seven core roles that define pharmacists' scope of practice: knowledge, patient care skills, professional, scholar, system-based practice/manager, collaborator, and advocate/health promoter. Development of these core roles revealed several missing pharmacy competencies or ones only covered in optional learning objectives: conflict management, professional advocacy, scholarship, empathy, personal health, transitions of care, health outcomes, quality improvement, and health insurance. CONCLUSIONS The development of pharmacy roles is one way to ensure students are adequately prepared for pharmacy practice following graduation. Mapping of competencies to core professional roles would allow schools/colleges of pharmacy to have one cohesive document to guide pedagogical and assessment practice. More research and consensus building will be needed before these core roles could be disseminated more broadly.
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Affiliation(s)
- Kimberly K Daugherty
- Academic Affairs and Assessment, Sullivan University College of Pharmacy and Health Sciences, 2100 Gardiner Lane, Louisville, KY 40205, United States.
| | - David Caldwell
- Academic Affairs, University of Arkansas for Medical Sciences College of Pharmacy, 4301 West Markham Street, Little Rock, AR 72205, United States.
| | - Lori T Armistead
- University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC, United States.
| | - Misty M Stutz
- Sullivan University College of Pharmacy and Health Sciences, 2100 Gardiner Lane, Louisville, KY 40205, United States.
| | - Ashley N Castleberry
- Division Head and Clinical Associate Professor, The University of Texas at Austin College of Pharmacy, 110 Inner Campus Drive, Austin, TX 78705, United States.
| | - James D Nash
- Husson University College of Health and Pharmacy, 1 College Circle, Bangor, ME 04401-2929, United States.
| | - Jason C Immekus
- University of Louisville, 1905 S. 1(st) Street, Louisville, KY 40292, United States.
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26
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Li D, Dong J, Xi X, Huang G, Li W, Chen C, Liu J, Du Q, Liu S. Impact of pharmacist active consultation on clinical outcomes and quality of medical care in drug-induced liver injury inpatients in general hospital wards: A retrospective cohort study. Front Pharmacol 2022; 13:972800. [PMID: 36110542 PMCID: PMC9468675 DOI: 10.3389/fphar.2022.972800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
The utility of pharmacist consultation for drug-induced liver injury (DILI) management has not been explored. This retrospective cohort study evaluated the impact of a pharmacist active consultation (PAC) service on the management and outcome in patients with DILI. Consecutive patients meeting clinical biochemical criteria for DILI were enrolled at a tertiary teaching hospital between 1 January 2020 and 30 April 2022. The Roussel Uclaf Causality Assessment Method was used to assess causality between drug use and liver injury for each suspected DILI patient. Included patients were grouped according to whether they received PAC, and a proportional hazard model with multivariate risk adjustment, inverse probability of treatment weighting (IPTW), and propensity score matching (PSM) was used to assess DILI recovery. In the PSM cohort, the quality of medical care was compared between PAC and no PAC groups. A total of 224 patients with DILI (108 who received PAC and 116 who did not) were included in the analysis. Of these patients, 11 (10%) were classified as highly probable, 58 (54%) as probable, and 39 (36%) as possible DILI in the PAC group, while six patients (5%) were classified as highly probable, 53 (46%) as probable, and 57 (49%) as possible DILI in the no PAC group (p = 0.089). During patient recovery, PAC was associated with a ∼10% increase in the cumulative 180-day recovery rate. The PAC group had a crude hazard ratio (HR) of 1.73 [95% confidence interval (CI): 1.23–2.43, p = 0.001] for DILI 180-day recovery, which remained stable after multivariate risk adjustment (HR = 1.74, 95% CI: 1.21–2.49, p = 0.003), IPTW (HR = 1.72, 95% CI: 1.19–2.47, p = 0.003), and PSM (HR = 1.49, 95% CI: 1.01–2.23, p = 0.046). In the PSM cohort, PAC was more likely to identify suspect drugs (90% vs. 60%, p < 0.001) and lead to timely withdrawal of the medication (89% vs. 57%, p < 0.001). Thus, PAC is associated with a better quality of medical care for patients with DILI and can improve patient outcomes.
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Affiliation(s)
- Dongxuan Li
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
- College of Pharmacy, Chongqing Medical University, Chongqing, China
| | - Jie Dong
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xin Xi
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Guili Huang
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wenjun Li
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Cheng Chen
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jun Liu
- Center for Medical Information and Statistics, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qian Du
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Qian Du, ; Songqing Liu,
| | - Songqing Liu
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Qian Du, ; Songqing Liu,
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27
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Hope DL, Grant GD, Rogers GD, King MA. Impact of a gamified simulation on pharmacy students' self-assessed competencies. CURRENTS IN PHARMACY TEACHING & LEARNING 2022; 14:990-997. [PMID: 36055708 DOI: 10.1016/j.cptl.2022.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 05/11/2022] [Accepted: 07/13/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Competency-based pharmacist education develops robust professional identities and prepares graduates for future practice to ensure optimal patient outcomes. An extended gamified simulation was developed as a capstone activity for a new Australian Bachelor of Pharmacy (BPharm) program. The simulation was designed to consolidate students' knowledge, skills, and behaviors from prior learning. This research aimed to explore whether participation in an extended gamified simulation could influence pharmacy students' perceptions of their professional competencies. METHODS Data were collected over three years to compare a superseded Master of Pharmacy (MPharm) program with an incoming BPharm program. Final year students were invited to self-assess their professional competencies at the start and end of their final semester of study, using a digital self-assessment tool which replicated Australia's National Competency Standards Framework for Pharmacists. Participants rated their own competency against the 26 competency standards across five domains on a five-point Likert scale (not at all competent to very competent). This provided pre- and post-data to compare the simulation (BPharm intervention) and a traditional semester (MPharm comparison), in addition to final course grades. RESULTS From 2016 to 2019, 85 (90.4%) of 94 intervention and 50 (83.3%) of 60 comparison students completed the self-assessment of professional competencies. Participation in the gamified simulation significantly improved students' pharmacotherapeutics grades and pre-post change scores for seven of the 26 competency standards, two of the five domains, and all domains combined of the National Competency Standards. CONCLUSIONS An extended, gamified simulation enhances the development of pharmacy students' self-assessed professional competencies.
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Affiliation(s)
- Denise L Hope
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia.
| | - Gary D Grant
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia.
| | - Gary D Rogers
- School of Medicine, Deakin University, Geelong, VIC, Australia.
| | - Michelle A King
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia.
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28
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Terazono H, Tsuchiya M, Maki Y, Yoshikawa N, Kawahara Y, Nishimura K, Shinohara K, Ogawa D, Mori R, Iwamoto Y, Itagaki F, Masuko H, Yonemura M, Uchida M. Evaluation of a Webinar for Pharmacists Learning Basic Clinical-Oncology during COVID-19 Pandemic in Japan. Biol Pharm Bull 2022; 45:856-862. [PMID: 35786594 DOI: 10.1248/bpb.b21-00844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
It is essential for oncology pharmacists to update their knowledge, skills, and ethical attitudes. The Japanese Society of Pharmaceutical Oncology is an academic society for healthcare professionals involved in cancer treatment. It has conducted in-person seminars every year to cultivate the knowledge necessary for practicing advanced cancer medicine. Owing to the coronavirus disease (COVID-19) pandemic, the society was obligated to conduct a web-based seminar this year. A questionnaire survey was conducted before and after the webinar to explain how it works and to assess the learning attitudes of beginner and moderately skilled pharmacists in the field of oncology. Questionnaire surveys were conducted with the participants before and after watching the webinar. The questionnaires sought to determine participants' perspectives on the webinar and their knowledge of the seven modules. Of the 1756 webinar attendees, 1661 (94.6%) answered the pre-webinar survey and 1586 (90.3%) answered the post-webinar survey. Results indicate that the median post-webinar knowledge score was significantly higher than the median pre-webinar score (p < 0.001) in all modules. Principal component analysis of the degree of knowledge of seven modules revealed that the improved score group consisted of those from younger age groups, with less experience as pharmacists, non-society members, and those with less experience in past society seminars. Moreover, the web-based seminar provided a uniform learning effect throughout the country without distinguishing between urban and rural learners. The web-based educational program was an acceptable educational tool for Japanese oncology pharmacists.
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Affiliation(s)
- Hideyuki Terazono
- Department of Pharmacy, Kagoshima University Hospital.,Education and Training Committee, Japanese Society of Pharmaceutical Oncology (JASPO)
| | - Masami Tsuchiya
- Education and Training Committee, Japanese Society of Pharmaceutical Oncology (JASPO).,Department of Pharmacy, Miyagi Cancer Center
| | - Yosuke Maki
- Education and Training Committee, Japanese Society of Pharmaceutical Oncology (JASPO).,Department of Pharmacy, Nagasaki Medical Center
| | - Naoki Yoshikawa
- Education and Training Committee, Japanese Society of Pharmaceutical Oncology (JASPO).,Department of Pharmacy, University of Miyazaki Hospital
| | - Yosuke Kawahara
- Education and Training Committee, Japanese Society of Pharmaceutical Oncology (JASPO).,Department of Pharmacy, JR Tokyo General Hospital
| | - Keiko Nishimura
- Education and Training Committee, Japanese Society of Pharmaceutical Oncology (JASPO).,Sogo Medical Co., Ltd
| | - Keisuke Shinohara
- Education and Training Committee, Japanese Society of Pharmaceutical Oncology (JASPO).,Department of Pharmacy, Saku Central Hospital Advanced Care Center
| | - Daisuke Ogawa
- Education and Training Committee, Japanese Society of Pharmaceutical Oncology (JASPO).,Department of Pharmacy, Matsuda Hospital
| | - Riho Mori
- Education and Training Committee, Japanese Society of Pharmaceutical Oncology (JASPO).,Department of Pharmacy, Tokushima Municipal Hospital
| | - Yoshihiro Iwamoto
- Education and Training Committee, Japanese Society of Pharmaceutical Oncology (JASPO).,Department of Pharmacy, National Cancer Center Hospital East
| | - Fumio Itagaki
- Education and Training Committee, Japanese Society of Pharmaceutical Oncology (JASPO).,Department of Clinical & Pharmaceutical Sciences, Faculty of Pharma Sciences, Teikyo University
| | - Hiroyuki Masuko
- Education and Training Committee, Japanese Society of Pharmaceutical Oncology (JASPO).,Department of Pharmacy, Hokkaido Medical Center for Child Health And Rehabilitation
| | - Masahito Yonemura
- Education and Training Committee, Japanese Society of Pharmaceutical Oncology (JASPO).,Department of Pharmacy, National Cancer Center Hospital East
| | - Mayako Uchida
- Education and Training Committee, Japanese Society of Pharmaceutical Oncology (JASPO).,Department of Education and Research Center for Pharmacy Practice, Doshisha Women's College of Liberal Arts
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29
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Alqifari SF, AlMharwal B, Aldawish R, Almokhlef SA. Impact of Pharmacist-Led Clinics on Health Outcomes of Patients With Diabetes at a Ministry of Health Diabetes & Endocrinology Center, Saudi Arabia: A Retrospective Study. Cureus 2022; 14:e25923. [PMID: 35844320 PMCID: PMC9281144 DOI: 10.7759/cureus.25923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives: Saudi Arabia is one of the most diabetes-prone countries in the world. The physician‐centered model of care constitutes the standard of care around the country. The study aimed to evaluate the impact of clinical pharmacist care on diabetes management in comparison to standard physician-based care. Materials and methods: a retrospective chart review was conducted of patients with type 2 diabetes mellitus (T2DM) seen by the clinical pharmacist at the Diabetes & Endocrinology Center, King Fahad Specialist Hospital located in Buraydah, Saudi Arabia between September 2019 to June 2020. Results: Thirty-two diabetic patients were included. The mean age is 55.75±10.72 years with 65.6% of patients being females. Hemoglobin A1c (HbA1c) was significantly decreased within nine months compared to baseline (9.33±1.80 vs.10.30±1.66), p=0.017. Conclusions: The multidisciplinary collaborative care involving pharmacists achieved superior diabetes outcomes for patients with diabetes. Involving pharmacists resulted in a significant HbA1c reduction within nine months. Moreover, pharmacists’ care helped optimize medication therapy and decreased the frequency of hypoglycemia.
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30
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Parinyarux P, Dhippayom T, Wongpoowarak P, Kitikannakorn N. Development of Community Pharmacy Competencies. J Pharm Technol 2022; 38:183-190. [PMID: 35600283 PMCID: PMC9116120 DOI: 10.1177/87551225221081370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective This study aimed to develop a consensus statement of competencies for community pharmacists in Thailand. Methods A 2-round modified Delphi process was used to develop consensus among a panel of community pharmacy experts. A total of 18 experts from 6 stakeholders represented a panel of each pharmacy organization in Thailand. In the first experts were asked to rate their degree of agreement on whether a competency was essential using a 7-point Likert scale (1 = "not essential competency" to 7 = "the most essential competency"). Also, in the second round, they were asked to rate the competencies from a scale of "must be included" to "must be excluded." Competencies considered "must be excluded" by a consensus of 80% or more of experts were removed from the community pharmacy competency list. Results Nearly half the experts had experience in their position for more than 10 years. The expert panels were typically committee members of the Community Pharmacy Association (Thailand) and community pharmacy clerkship preceptors (29.4% and 23.5%, respectively). The number of community pharmacy competencies on the initial list was 55 competencies. None of them was eliminated after the first round. Of 55 competencies, 11 were eliminated after the second round. The final list of competency statements was 44 competencies divided into 4 domains: personal competencies, pharmacy professional competencies, patient care competencies, and management competencies. Conclusion Community pharmacy competencies include having a positive attitude and being accountable for individual patient care, providing disease prevention and health promotion, and addressing morality and ethics in business.
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Affiliation(s)
| | - Teerapon Dhippayom
- Department of Pharmacy Practice,
Naresuan University, Phitsanulok, Thailand
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31
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Harrington KL, Teramoto M, Black L, Carey H, Hartley G, Yung E, Osborne J, Goldberg P, Tran RT, Hillegass E. Physical Therapist Residency Competency-Based Education: Development of an Assessment Instrument. Phys Ther 2022; 102:6535133. [PMID: 35225348 DOI: 10.1093/ptj/pzac019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/20/2021] [Accepted: 01/05/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The objective of this study was to develop generic domains of competence (DoC) with associated competencies and milestones for physical therapist residency education. This work was intended to culminate in establishing validity evidence to support a competency-based assessment instrument that could be used by residency programs to evaluate resident achievement of the competencies, regardless of specialty area. METHODS Employing the modified Delphi method, a residency education work group developed an evaluation instrument that included 7 DoC and 31 associated competencies with 6 milestones as rating scales for each competency. The instrument was distributed to mentors and residents in accredited physical therapist residency programs to establish validity evidence. Evaluations (measured by milestones) and demographics were collected at 3 time points (program entry, midterm, and final). Scores across these time points were compared using Kruskal-Wallis tests. Reliability was assessed with kappa statistics (interrater reliability) and alpha reliability coefficients (internal consistency). Construct validity was examined using confirmatory factor analysis via structural equation modeling. RESULTS Overall, 237 mentors and 228 residents completed 824 evaluations (460 by mentors and 364 resident self-evaluations) across the time points. Scores significantly increased from entry through final time points. The interrater reliability of the associated behaviors ranged from moderate to substantial agreement (κ = 0.417-0.774). The internal consistency was high for all DoC at every time point (α reliability coefficients = .881-.955 for entry, .857-.925 for midterm, and .824-.902 for final). After confirmatory factor analysis with structural equation modeling was performed, a model that included 7 DoC and 20 associated competencies was proposed. CONCLUSIONS The residency assessment instrument developed demonstrates interrater reliability and validity evidence and therefore supports competency-based assessment of resident clinical performance across specialty areas. Additionally, the instrument aligns the physical therapy profession with other professions, such as medicine, dentistry, and pharmacy, that have transitioned to competency-based education. IMPACT This study outlines the benefits of moving to competency-based education for physical therapist residents, using a sound evaluation tool that evaluates residents across specialty areas. The instrument will allow for transition to competency-based education in physical therapist residency education programs.
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Affiliation(s)
- Kendra L Harrington
- Residency and Fellowship Education, American Physical Therapy Association, Alexandria, Virginia, USA
| | - Masaru Teramoto
- Division of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, Utah, USA
| | - Lisa Black
- Department of Physical Therapy, Creighton University, Omaha, Nebraska, USA
| | - Helen Carey
- Krannert School of Physical Therapy, University of Indianapolis, Indianapolis, Indiana, USA
| | - Greg Hartley
- Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, Florida, USA
| | - Emmanuel Yung
- Department of Physical Therapy, Sacred Heart University College of Health Professions, Fairfield, Connecticut, USA
| | - Jacqueline Osborne
- Brooks Rehabilitation Institute of Higher Learning, Jacksonville, Florida, USA
| | | | - Rachel Tabak Tran
- Casa Colina Hospital and Centers for Healthcare, Pomona, California, USA
| | - Ellen Hillegass
- Department of Physical Therapy, Mercer University College of Health Professions, Atlanta, Georgia, USA
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Rech MA, Jones GM, Naseman RW, Beavers C. Premature Attrition of Clinical Pharmacists: Call to Attention, Action and Potential Solutions. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2022. [DOI: 10.1002/jac5.1631] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Megan A Rech
- Department of Pharmacy Loyola University Medical Center Maywood Illinois
- Department of Emergency Medicine Loyola University Chicago, Stritch School of Medicine Maywood Illinois
| | - G. Morgan Jones
- Department of Pharmacy Methodist University Hospital Memphis Tennessee
- University of Tennessee Colleges of Pharmacy and Medicine Memphis Tennessee
| | - Ryan W. Naseman
- Department of Pharmacy Services University of Kentucky Healthcare Lexington Kentucky
- Department of Pharmacy Practice and Science University of Kentucky College of Pharmacy Lexington Kentucky
| | - Craig Beavers
- Department of Pharmacy Practice and Science University of Kentucky College of Pharmacy Lexington Kentucky
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Digital pharmacists: the new wave in pharmacy practice and education. Int J Clin Pharm 2022; 44:775-780. [PMID: 35380393 PMCID: PMC8981193 DOI: 10.1007/s11096-021-01365-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 12/11/2021] [Indexed: 11/15/2022]
Abstract
Pharmacists now face the biggest challenges in the history of the profession: the use of digital technologies in pharmacy practice and education and the outbreak of coronavirus disease 2019. Worldwide, pharmaceutical care and pharmacy education via digital technologies have significantly increased and will be incorporated into patient care and the teaching–learning process, respectively. Thus, in this new era of pharmacy practice and education, curricula should promote the development of specific competencies for the cognitive, conscious, and effective use of digital tools. This requires the training of “disruptive” educators, who are capable of using teaching–learning methods adapted to the digital environment and educational processes suitable for stimulating the use of effective disruptive technologies. This commentary argues that the pharmacy profession can no longer wait for the slow integration of digital technologies into pharmacy practice and education.
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Murry LT, Keller MS, Pevnick JM, Schnipper JL, Kennelty KA, Nguyen AT, Henreid A, Wisniewski J, Amer K, Armbruster C, Conti N, Guan J, Wu S, Leang DW, Llamas-Sandoval R, Phung E, Rosen O, Rosen SL, Salandanan A, Shane R, Ko EJM, Moriarty D, Muske AM, Matta L, Fanikos J. A qualitative dual-site analysis of the pharmacist discharge care (PHARM-DC) intervention using the CFIR framework. BMC Health Serv Res 2022; 22:186. [PMID: 35151310 PMCID: PMC8840769 DOI: 10.1186/s12913-022-07583-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 02/02/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Introduction
Older adults face several challenges when transitioning from acute hospitals to community-based care. The PHARMacist Discharge Care (PHARM-DC) intervention is a pharmacist-led Transitions of Care (TOC) program intended to reduce 30-day hospital readmissions and emergency department visits at two large hospitals. This study used the Consolidated Framework for Implementation Research (CFIR) framework to evaluate pharmacist perceptions of the PHARM-DC intervention.
Methods
Intervention pharmacists and pharmacy administrators were purposively recruited by study team members located within each participating institution. Study team members located within each institution coordinated with two study authors unaffiliated with the institutions implementing the intervention to conduct interviews and focus groups remotely via telecommunication software. Interviews were recorded and transcribed, with transcriptions imported into NVivo for qualitative analysis. Qualitative analysis was performed using an iterative process to identify “a priori” constructs based on CFIR domains (intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation) and to create overarching themes as identified during coding.
Results
In total, ten semi-structured interviews and one focus group were completed across both hospitals. At Site A, six interviews were conducted with intervention pharmacists and pharmacists in administrative roles. Also at Site A, one focus group comprised of five intervention pharmacists was conducted. At Site B, interviews were conducted with four intervention pharmacists and pharmacists in administrative roles. Three overarching themes were identified: PHARM-DC and Institutional Context, Importance of PHARM-DC Adaptability, and Recommendations for PHARM-DC Improvement and Sustainability. Increasing pharmacist support for technical tasks and navigating pharmacist-patient language barriers were important to intervention implementation and delivery. Identifying cost-savings and quantifying outcomes as a result of the intervention were particularly important when considering how to sustain and expand the PHARM-DC intervention.
Conclusion
The PHARM-DC intervention can successfully be implemented at two institutions with considerable variations in TOC initiatives, resources, and staffing. Future implementation of PHARM-DC interventions should consider the themes identified, including an examination of institution-specific contextual factors such as the roles that pharmacy technicians may play in TOC interventions, the importance of intervention adaptability to account for patient needs and institutional resources, and pharmacist recommendations for intervention improvement and sustainability.
Trial registration
NCT04071951.
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Wang X, Yao X, Jia X, Shi X, Hao J, Yang Y, Liu G, Zhang X, Du S, Yin Z. A qualitative study on the working experiences of clinical pharmacists in fighting against COVID-19. BMC Health Serv Res 2022; 22:28. [PMID: 34986824 PMCID: PMC8728479 DOI: 10.1186/s12913-021-07419-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 12/15/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The spread of coronavirus disease 2019 (COVID-19) has overwhelmed healthcare systems across the world. Along with the medical team, clinical pharmacists played a significant role during the public health emergency of COVID-19. This study aimed to explore the working experience of clinical pharmacists and provide reference for first-line clinical pharmacists to prepare for fighting against COVID-19. METHODS A qualitative study based on descriptive phenomenology was employed with face-to-face and audio-recorded interviews to study the working experience of 13 clinical pharmacists (including two clinical nutritional pharmacists). All interviews were transcribed verbatim, and the interview data were analyzed thematically using NVivo software. RESULTS Four themes emerged from interview data, including roles of clinical pharmacists, working experiences of clinical pharmacists, psychological feelings of clinical pharmacists, and career expectations of clinical pharmacists. CONCLUSIONS The results contributed to a deeper understanding of the clinical pharmacists' work experiences in COVID-19 and offered guidance to better prepare clinical pharmacists in participating in a public health crisis.
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Affiliation(s)
- Xiaojuan Wang
- Department of pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xiali Yao
- Department of pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xuedong Jia
- Department of pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xiangfen Shi
- Department of pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jie Hao
- Department of pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yantao Yang
- Department of pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Gang Liu
- Department of Pharmacology, School of Basic Medical Sciences, Guizhou Medical University, Guiyang, Guizhou, China
| | - Xiaojian Zhang
- Department of pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
| | - Shuzhang Du
- Department of pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zhao Yin
- Department of pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
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Houghton D, Arabiat D, Ireson D, Mörelius E. A Scoping Review of Non-Pharmacological Health Education Provided to Families of Children With Idiopathic Childhood Constipation Within Primary Health Care. J Prim Care Community Health 2022; 13:21501319221117781. [PMID: 36000448 PMCID: PMC9421236 DOI: 10.1177/21501319221117781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objectives: Idiopathic childhood constipation is a prevalent condition that initially
brings the child under the care of the primary health care team. Although it
is acknowledged that health education is crucial to reducing chronicity, the
range of evidenced-based non-pharmacological health education provided to
families has not previously been reviewed. For this scoping review, 4
research questions sought to identify papers that provide information on the
utilization of guidelines, the range of health education, who provides it,
and whether any gaps exist. Methods: Following a registered protocol and using the Preferred Reporting Items for
Systematic reviews and Meta-Analyses extension for Scoping Reviews, searches
of 10 online databases, reference lists, Google Scholar, and book chapter
references were made. Eligible papers were original research published in
English between January 2000 and December 2022. Results: Twelve worldwide studies (2 qualitative and 10 quantitative) reported that:
evidence-based guidelines are not consistently used by primary care
providers; the range of non-pharmacological health education provided is
inconsistent; the non-pharmacological health education is provided by
doctors, nurses, and pharmacists; and that gaps exist in non-pharmacological
health education provision. Conclusion: This review demonstrates that rather than a lack of guideline-awareness,
decreased specific idiopathic childhood constipation knowledge (and possibly
time) may be responsible for inconsistent non-pharmacological health
education. Inappropriate treatment and management of some children escalates
risk for chronicity. Improving health education provision however, may be
achieved through: increased collaboration; better utilization of nurses; and
through developing the child’s health literacy by involving both child and
family in all aspects of health education and decision-making.
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Affiliation(s)
- Davina Houghton
- Edith Cowan University, Joondalup, Perth, WA, Australia.,Joondalup Health Campus, Joondalup, Perth, WA, Australia
| | - Diana Arabiat
- Edith Cowan University, Joondalup, Perth, WA, Australia.,The University of Jordan, Amman, Jordan
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Yeung SL, Vu CA, Wang M, Lou M, Ng TMH. Prevalence of and incentives for board certification among hospital pharmacy departments in California. Am J Health Syst Pharm 2021; 79:e117-e123. [PMID: 34940831 DOI: 10.1093/ajhp/zxab481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
DISCLAIMER In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE Board of Pharmacy Specialties (BPS) certification is endorsed to distinguish pharmacists for advanced practice areas, yet perceived value to stakeholders remains poorly described. This study characterized how board certification is integrated in hospital pharmacy departments across California. METHODS A prospective, cross-sectional study was conducted in which a survey was administered to all hospital pharmacy directors in California between November 2019 and March 2020. Licensed institutions and corresponding pharmacy directors were identified from the California State Board of Pharmacy. The survey queried for institution and pharmacy director characteristics and if/how board certification was integrated. Multivariable logistic models identified predictors of institutions with at least 25% full-time board-certified pharmacists and those that reward board certification. RESULTS Surveys were completed by 29% of institutions. Most of these institutions were urban (81%) and nonteaching (57%), with fewer than 325 hospital beds (71%), and with fewer than 50 full-time pharmacist positions (86%). The majority reported that less than 25% of their pharmacists were board certified. Currently, 47% consider board certification during hiring and 38% reward board-certified employees. Predictors of institutions with 25% or more board-certified pharmacists included being a teaching institution (odds ratio [OR], 2.96; 95% confidence interval [CI], 1.24-7.06), having 325 or more beds (OR, 7.17; 95% CI, 2.86-17.97), and having a pharmacy director who was previously or currently board certified (OR, 3.69; 95% CI, 1.46-9.35). Hospitals with 100 or more pharmacist positions predicted institutions that reward board certification (OR, 16.69; 95% CI, 1.78-156.86). CONCLUSION Board certification was an employment preference for almost half of the hospital survey respondents in California. Institutions more likely to reward board-certified pharmacists are larger, urban, and teaching hospitals and have pharmacy directors who have been board certified.
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Affiliation(s)
- Samantha L Yeung
- School of Pharmacy, University of Southern California, Los Angeles, CA, USA
| | - Christina A Vu
- School of Pharmacy, University of Southern California, Los Angeles, CA, USA
| | - Mengxi Wang
- School of Pharmacy, University of Southern California, Los Angeles, CA, USA
| | - Mimi Lou
- School of Pharmacy, University of Southern California, Los Angeles, CA, USA
| | - Tien M H Ng
- School of Pharmacy, University of Southern California, Los Angeles, CA, USA
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Lias N, Lindholm T, Pohjanoksa-Mäntylä M, Westerholm A, Airaksinen M. Developing and piloting a self-assessment tool for medication review competence of practicing pharmacists based on nationally set competence criteria. BMC Health Serv Res 2021; 21:1274. [PMID: 34823529 PMCID: PMC8620234 DOI: 10.1186/s12913-021-07291-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 11/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND New competence requirements have emerged for pharmacists as a result of changing societal needs towards more patient-centred practices. Today, medication review competence can be considered as basic pharmaceutical competence. Medication review specific competence criteria and tools for self-assessing the competence are essential in building competences and a shared understanding of medication reviews as a collaborative practice. The aim of this study was to develop and pilot a self-assessment tool for medication review competence among practicing pharmacists in Finland. METHODS The development of the self-assessment tool was based on the national medication review competence criteria for pharmacists established in Finland in 2017 and piloting the tool among practicing pharmacists in a national online survey in October 2018. The pharmacists self-assessed their medication review competence with a five-point Likert scale ranging from 1 for "very poor/not at all" to 5 for "very good". RESULTS The internal consistency of the self-assessment tool was high as the range of the competence areas' Cronbach's alpha was 0.953-0.973. The competence areas consisted of prescription review competence (20 items, Cronbach's alpha 0.953), additional statements for medication review competence (11 additional items, Cronbach's alpha 0.963) and medication review as a whole, including both the statements of prescription review and medication review competence (31 items, Cronbach's alpha 0.973). Competence items closely related to routine dispensing were most commonly self-estimated to be mastered by the practicing pharmacists who responded (n = 344), while the more clinical and patient-centred competence items had the lowest self-estimates. This indicates that the self-assessment tool works logically and differentiates pharmacists according to competence. The self-assessed medication review competence was at a very good or good level among more than half (55%) of the respondents (n = 344). CONCLUSION A self-assessment tool for medication review competence was developed and validated. The piloted self-assessment tool can be used for regular evaluation of practicing pharmacists' medication review competence which is becoming an increasingly important basis for their contribution to patient care and society.
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Affiliation(s)
- Noora Lias
- Clinical Pharmacy Group, Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Viikinkaari 5 E, P.O. box 56, 00014, Helsinki, Finland.
| | - Tanja Lindholm
- Clinical Pharmacy Group, Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Viikinkaari 5 E, P.O. box 56, 00014, Helsinki, Finland
| | - Marika Pohjanoksa-Mäntylä
- Clinical Pharmacy Group, Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Viikinkaari 5 E, P.O. box 56, 00014, Helsinki, Finland
| | - Aleksi Westerholm
- Clinical Pharmacy Group, Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Viikinkaari 5 E, P.O. box 56, 00014, Helsinki, Finland
| | - Marja Airaksinen
- Clinical Pharmacy Group, Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Viikinkaari 5 E, P.O. box 56, 00014, Helsinki, Finland
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ASHP Standard for Certification as a Center of Excellence in Medication-Use Safety and Pharmacy Practice. Am J Health Syst Pharm 2021; 79:564-599. [PMID: 34729588 DOI: 10.1093/ajhp/zxab368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Cuvelier E, Robert L, Musy E, Rousselière C, Marcilly R, Gautier S, Odou P, Beuscart JB, Décaudin B. The clinical pharmacist's role in enhancing the relevance of a clinical decision support system. Int J Med Inform 2021; 155:104568. [PMID: 34537687 DOI: 10.1016/j.ijmedinf.2021.104568] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 08/18/2021] [Accepted: 08/31/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Clinical decision support systems (CDSSs) can improve the quality of patient care by helping physicians to review their prescriptions and thus to optimize drug treatments. Nevertheless, the "alert fatigue" brought on by a large number of irrelevant alerts can decrease a CDSS's effectiveness and thus clinical value. Involving a clinical pharmacist in the development and management of a CDSS can reduce the number of irrelevant alerts presented to physicians. Clinical pharmacists screen alerts and suggest PIs for physicians, corresponding to any proposed therapeutic change about health products, only for relevant alerts could improve the relevance and the acceptance of the information given to physicians about the risks faced by their patients. OBJECTIVE To assess the value of involving clinical pharmacists in the development and maintenance of decision support rules for generating alerts and pharmaceutical interventions (PIs) and to describe the level of acceptance of these PIs by the physicians. METHOD In a retrospective, single-centre study, we evaluated the number of PIs accepted from alerts generated by the CDSS when a clinical pharmacist had developed and managed this tool. During the first 7 months of development of the CDSS, a clinical pharmacist analyzed alerts triggered by the CDSS according to its technical validity and pharmaceutical relevance. Lastly, for alerts that led to a PI, the level of acceptance by physicians was documented. RESULTS During the study, 1430 alerts were analysed: 186 (13%) were considered to be technically invalid - mainly due to the characteristics of the interface. Of the 1244 (87.0%) technically valid alerts, 353 (24.6%) were pharmaceutically relevant and led to a PI. The three main causes of pharmaceutical irrelevance were a lack of specificity in the CDSS (70.8%), lack of relevance with regard to the ward's habits (15.6%), and the pharmacist's decision to recommend monitoring for the patient rather than sending a PI immediately (10.8%). 64.6% of the submitted PIs were accepted by the physicians. CONCLUSION The standardized analysis of alerts by a clinical pharmacist appears to be a good way of improving the development of CDSS by limiting the generation of irrelevant alerts and the latter's transmission to physicians. The involvement of a clinical pharmacist in the development and implementation of a CDSS appears to be novel and may help to optimize drug treatment.
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Affiliation(s)
- E Cuvelier
- Univ. Lille, CHU Lille, ULR 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France.
| | - L Robert
- CHU Lille, Institut de Pharmacie, F-59000 Lille, France.
| | - E Musy
- CHU Lille, Institut de Pharmacie, F-59000 Lille, France.
| | - C Rousselière
- CHU Lille, Institut de Pharmacie, F-59000 Lille, France.
| | - R Marcilly
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France; INSERM, CIC-IT 1403, F-59000 Lille, France.
| | - S Gautier
- Univ. Lille, CHU Lille, INSERM U1171 - Centre Régional de Pharmacovigilance, F-59000 Lille, France.
| | - P Odou
- Univ. Lille, CHU Lille, ULR 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France.
| | - J-B Beuscart
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France.
| | - B Décaudin
- Univ. Lille, CHU Lille, ULR 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France.
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Moura L, Steurbaut S, Salvesen Blix H, Addison B, Rabus S, Mota-Filipe H, Alves da Costa F. A cross-sectional survey to map Clinical Pharmacy Education and Practice in Europe. Int J Clin Pharm 2021; 44:118-126. [PMID: 34498216 DOI: 10.1007/s11096-021-01321-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 08/20/2021] [Indexed: 11/30/2022]
Abstract
Background Clinical activities provided by pharmacists are increasing worldwide, including in Europe. However, an overview of clinical pharmacy education and practice is needed. Aim To map clinical pharmacy (CP) education and practice among European countries. Method A cross-sectional web-based survey led by the Education Committee of the European Society of Clinical Pharmacy (ESCP) was conducted. The survey comprised three domains focusing on: undergraduate education, postgraduate education, and practice. A multi-phased validation process was undertaken, attributing levels of evidence according to the number of information sources for each country. Triangulation was used to seek within country consensus. Main outcome measures included the number of hours of education in CP; existence of a specialization in CP and activities delivered in practice. Results Data from 40 European countries were included (response rate 95.2%). Most respondents (86.8%) agreed with the ESCP definition of CP. Almost every country (94.9%) reported CP topics at the undergraduate level [median number = 65 h/semester (IQR: 2.0-5.6)], including practical teaching [median = 30.0% (IQR: 17.0-42.0)]. At postgraduate level, 92.5% of countries reported PhD programmes including CP and 65.0% mentioned the existence of specific CP master/diploma degrees. Continuous professional development (CPD) courses were also reported by 63.9% of respondents. More than half the countries (52.5%; n = 21) recognized CP as an area of specialization, which for 60.0% of participants was applied solely in the hospital setting. Conclusion Although CP is embedded in education and practice in European countries, there is wide variability in education and practice patterns.
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Affiliation(s)
- Laura Moura
- Faculty of Pharmacy, University of Lisbon, Lisboa, Portugal
| | - Stephane Steurbaut
- Research Group Clinical Pharmacology and Clinical Pharmacy (KFAR), Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Hege Salvesen Blix
- Norwegian Institute of Public Health, School of Pharmacy, University of Oslo, Oslo, Norway
| | - Brian Addison
- School of Pharmacy & Life Sciences, Aberdeen, Scotland
| | - Sule Rabus
- Department of Clinical Pharmacy, Faculty of Pharmacy, Marmara University, Istanbul, Turkey
| | | | - Filipa Alves da Costa
- Research Institute for Medicines (iMED.ULisboa), Faculty of Pharmacy, University of Lisbon, Lisboa, Portugal, Av. Prof. Gama Pinto, 1649-003.
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Maffre I, Leguelinel-Blache G, Soulairol I. A systematic review of clinical pharmacy services in pediatric inpatients. DRUGS & THERAPY PERSPECTIVES 2021. [DOI: 10.1007/s40267-021-00845-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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43
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Melton T, Jasmin H, Johnson HF, Coley A, Duffey S, Renfro CP. Describing the delivery of clinical pharmacy services via telehealth: A systematic review. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2021. [DOI: 10.1002/jac5.1486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Tyler Melton
- University of Tennessee Health Science Center College of Pharmacy Knoxville Tennessee USA
| | - Hilary Jasmin
- University of Tennessee Health Science Center Health Sciences Library Memphis Tennessee USA
| | - Haden F. Johnson
- University of Tennessee Health Science Center College of Pharmacy Memphis Tennessee USA
| | - Annika Coley
- University of Tennessee Health Science Center College of Pharmacy Memphis Tennessee USA
| | - Sawyer Duffey
- University of Tennessee Health Science Center College of Pharmacy Memphis Tennessee USA
| | - Chelsea P. Renfro
- University of Tennessee Health Science Center College of Pharmacy Memphis Tennessee USA
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Thomas D, Khalifa S, Sreedharan J, Bond R. Inter-rater Reliability of Preceptors on Clinical Pharmacy Competency Evaluation. CURRENT DRUG THERAPY 2021. [DOI: 10.2174/1574885515999201209202624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background::
Clinical competence of pharmacy students is better evaluated at their practice
sites compared to the classroom. A clinical pharmacy competency evaluation rubric like that of
the American College of Clinical Pharmacy (ACCP) is an effective assessment tool for clinical
skills and can be used to show item reliability. The preceptors should be trained on how to use the
rubrics as many inherent factors could influence inter-rater reliability.
Objective::
To evaluate inter-rater reliability among preceptors on evaluating clinical competence
of pharmacy students, before and after a group discussion intervention.
Materials and Methods:
In this quasi-experimental study in a United Arab Emirates teaching hospital,
Seven clinical pharmacy preceptors rated the clinical pharmacy competencies of ten recent
PharmD graduates referring to their portfolios and preceptorship. Clinical pharmacy competencies
were adopted from ACCP and mildly modified to be relevant for the local settings.
Results::
Inter-rater reliability (Cronbach's Alpha) among preceptors was reasonable being practitioners
at a single site for 2-4 years. At domain level, inter-rater reliability ranged from 0.79 - 0.93
before intervention and 0.94 - 0.99 after intervention. No inter-rater reliability was observed in relation
to certain competency elements ranging from 0.31 - 0.61 before the intervention, but improved
to 0.79 - 0.97 after the intervention. Intra-class correlation coefficient improved among all individual
preceptors being reliable with each other after group discussion though some had no reliability
with each other before group discussion.
Conclusion::
Group discussion among preceptors at the training site was found to be effective in improving
inter-rater reliability on all elements of the clinical pharmacy competency evaluation. Removing
a preceptor from the analysis did not affect inter-rater reliability after group discussion.
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Affiliation(s)
- Dixon Thomas
- Clinical, College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Sherief Khalifa
- Clinical, College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Jayadevan Sreedharan
- Clinical, College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Rucha Bond
- Department of Pharmacotherapy and Outcomes Sciences, Virginia Commonwealth University, Richmond, United States
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Luli AJ, Awdishu L, Hirsch JD, Watanabe JH, Bounthavong M, Morello CM. Transferring Key Success Factors from Ambulatory Care into the Community Pharmacy in the United States. PHARMACY 2021; 9:116. [PMID: 34201476 PMCID: PMC8293369 DOI: 10.3390/pharmacy9030116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/11/2021] [Accepted: 06/16/2021] [Indexed: 11/29/2022] Open
Abstract
In the United States, pharmacists' scope of practice continues to expand, with increasing opportunities for pharmacists in all practice settings to enhance health in society. In ambulatory care, pharmacists remain integral members on the healthcare team and have demonstrated positive impacts on patient care. Sharing similar characteristics as pharmacists in the community setting, a deeper look into common elements of a successful ambulatory care practice that can be applied in the community pharmacy setting is warranted. Key success factors identified from ambulatory care include (1) maximizing a pharmacist's unique knowledge base and skill set, (2) forming collaborations with physicians and other providers, (3) demonstrating outcomes and value, and (4) maintaining sustainability. Opportunities exist for pharmacists in the community setting to utilize these success factors when developing, implementing, and/or expanding direct patient care services that improve accessibility to quality care and population health.
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Affiliation(s)
- Alex J. Luli
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; (L.A.); (M.B.); (C.M.M.)
| | - Linda Awdishu
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; (L.A.); (M.B.); (C.M.M.)
| | - Jan D. Hirsch
- Department of Clinical Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University of California Irvine, 101 Theory, Suite 100, Irvine, CA 92612, USA; (J.D.H.); (J.H.W.)
| | - Jonathan H. Watanabe
- Department of Clinical Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University of California Irvine, 101 Theory, Suite 100, Irvine, CA 92612, USA; (J.D.H.); (J.H.W.)
| | - Mark Bounthavong
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; (L.A.); (M.B.); (C.M.M.)
| | - Candis M. Morello
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; (L.A.); (M.B.); (C.M.M.)
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Zeenny RM, Akel M, Hajj A, Sacre H, Hallit S, Salameh P. Descriptive assessment of graduates' perceptions of pharmacy-related competencies based on the Lebanese pharmacy core competencies framework. Pharm Pract (Granada) 2021; 19:2320. [PMID: 34221200 PMCID: PMC8234617 DOI: 10.18549/pharmpract.2021.2.2320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 06/13/2021] [Indexed: 11/14/2022] Open
Abstract
Background Pharmacists possess a unique and complex body of knowledge, skills, attitudes, and behaviors necessary to enable them to optimize health outcomes. Pharmacy organizations publish routinely updated versions of professional competencies that help pharmacy schools integrate advances into their curricula. In Lebanon, no national framework for pharmacy education is officially adopted yet. In 2017, the Official Pharmacists' Association in Lebanon [OPL - Order of Pharmacists of Lebanon] took the initiative to develop a pharmacy core competency framework. Objective The primary objective of this survey was to evaluate graduates' perceptions of pharmacy-related competencies "taught" across Lebanese pharmacy schools/faculties, based on the suggested Lebanese Pharmacy Competencies Framework. This study also explored the association between graduates' demographics, university attributes, and self-assessed competency performance. Methods A cross-sectional study involving pharmacists who graduated from Lebanese universities was performed through a 40-minute online questionnaire distributed over social media platforms and groups of pharmacists. Results Pharmacists perceived their competence as moderate upon graduation, the lowest scores being in fundamental knowledge and medicine supply; the highest reported scores were in personal skills and safe/rational use of medicines. Moreover, females, younger graduates, PharmD holders, and pharmacists working in hospitals/clinical settings and academia had the highest perception of their competencies. Pharmacists in the public sector and medical laboratory directors had the lowest perception of competence. Conclusions When comparing the taught curriculum to the suggested Lebanese Pharmacy Competency Framework, all domains need to be improved to optimize the perception, education, and practice of pharmacists. It is essential to emphasize fundamental knowledge, medicines supply, and public health competencies in undergraduate curricula and improve continuing professional education.
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Affiliation(s)
- Rony M Zeenny
- PharmD. Department of Clinical Pharmacy, American University Beirut Medical Center. Beirut (Lebanon).
| | - Marwan Akel
- PharmD, PhD. School of Pharmacy, Lebanese International University. Beirut (Lebanon).
| | - Aline Hajj
- PharmD, PhD. Laboratory of Pharmacology, Clinical Pharmacy and Quality Control of Drugs, Faculty of Pharmacy, Saint-Joseph University. Beirut (Lebanon).
| | - Hala Sacre
- PharmD. National Institute of Public Health, Clinical Epidemiology & Toxicology (INSPECT-LB). Beirut (Lebanon).
| | - Souheil Hallit
- PharmD, PhD. Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK). Jounieh (Lebanon).
| | - Pascale Salameh
- PharmD, PhD. Medical School, University of Nicosia. Nicosia (Cyprus).
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Downes JM, Appeddu LA, Johnson JL, Haywood KS, James BJ, Wingard KD. An exploratory survey on the awareness and usage of clinical practice guidelines among clinical pharmacists. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2021; 2:100013. [PMID: 35481123 PMCID: PMC9031035 DOI: 10.1016/j.rcsop.2021.100013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 04/18/2021] [Accepted: 04/18/2021] [Indexed: 11/27/2022] Open
Abstract
Background The NHLBI has not developed clinical practice guidelines since 2007. As a result, multiple organizations have released competing guidelines. This has created confusion and debate among clinicians as to which recommendations are most applicable for practice. Objectives To explore preliminary attitudes, awareness, and usage of clinical practice guidelines in practice and teaching for hypertension, dyslipidemia and asthma among clinical pharmacists. Methods Clinical pharmacists across the US were surveyed electronically over a two week period in Spring 2019 regarding utilization and knowledge of practice guidelines for hypertension, dyslipidemia, and asthma. Clinical cases were included to evaluate application of guidelines. Descriptive statistics, Chi-square analysis, and Wilcoxon signed-rank test were conducted. Statistical significance level was set to 0.01 to account for multiple tests conducted on the same survey participants. Results Forty-eight, 34, and 28 pharmacists voluntarily completed hypertension, dyslipidemia, and asthma survey questions, respectively. Interactions by disease state (p < 0.001) revealed more pharmacists (93%) reporting to have ≤50% patient load in managing asthma and more pharmacists (95%) had read the full summary/report of the most recent hypertension guideline. Primary reasons why the most recent guideline was not selected were also significantly different by disease state (interaction; p < 0.001). For dyslipidemia and asthma, pharmacists had a higher mean rating of agreement (p < 0.007) in having the most confidence in the most recent as compared to older guidelines. Proportionally more clinical cases were answered correctly (interaction; p < 0.001) when pharmacists applied the most recent guideline for hypertension (84%), while the opposite outcome was found for asthma (27%). Conclusion While more pharmacists selected the most recent guideline for practice and teaching, there was inconsistent application of guidelines to clinical cases. Further studies with a larger representation of pharmacists are warranted to more definitively determine factors influencing guideline preference and usage.
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Abstract
OBJECTIVES To provide a multiorganizational statement to update recommendations for critical care pharmacy practice and make recommendations for future practice. A position paper outlining critical care pharmacist activities was last published in 2000. Since that time, significant changes in healthcare and critical care have occurred. DESIGN The Society of Critical Care Medicine, American College of Clinical Pharmacy Critical Care Practice and Research Network, and the American Society of Health-Systems Pharmacists convened a joint task force of 15 pharmacists representing a broad cross-section of critical care pharmacy practice and pharmacy administration, inclusive of geography, critical care practice setting, and roles. The Task Force chairs reviewed and organized primary literature, outlined topic domains, and prepared the methodology for group review and consensus. A modified Delphi method was used until consensus (> 66% agreement) was reached for each practice recommendation. Previous position statement recommendations were reviewed and voted to either retain, revise, or retire. Recommendations were categorized by level of ICU service to be applicable by setting and grouped into five domains: patient care, quality improvement, research and scholarship, training and education, and professional development. MAIN RESULTS There are 82 recommendation statements: 44 original recommendations and 38 new recommendation statements. Thirty-four recommendations represent the domain of patient care, primarily relating to critical care pharmacist duties and pharmacy services. In the quality improvement domain, 21 recommendations address the role of the critical care pharmacist in patient and medication safety, clinical quality programs, and analytics. Nine recommendations were made in the domain of research and scholarship. Ten recommendations were made in the domain of training and education and eight recommendations regarding professional development. CONCLUSIONS Critical care pharmacists are essential members of the multiprofessional critical care team. The statements recommended by this taskforce delineate the activities of a critical care pharmacist and the scope of pharmacy services within the ICU. Effort should be made from all stakeholders to implement the recommendations provided, with continuous effort toward improving the delivery of care for critically ill patients.
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Katoue MG. Enablers and challenges to pharmacy practice change in Kuwait hospitals: a qualitative exploration of pharmacists' perceptions. J Eval Clin Pract 2021; 27:272-279. [PMID: 32929812 DOI: 10.1111/jep.13450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/04/2020] [Accepted: 07/08/2020] [Indexed: 11/28/2022]
Abstract
RATIONALE, AIMS, AND OBJECTIVES The practice of hospital pharmacists in many developing countries has been changing to include the delivery of direct patient care services, but practice change can be a challenging process. This article explores the perceptions of hospital pharmacists in Kuwait about the enablers and challenges to expanding their scope of practice to include direct patient care. METHODS A phenomenological qualitative approach was employed to conduct focus group interviews to explore pharmacists' perceptions about their professional practice at different hospitals across Kuwait. Data were collected from 110 pharmacists using 11 focus group interviews. The interviews were audio-recorded, transcribed verbatim, and analysed using framework analysis. RESULTS The practice of most hospital pharmacists includes limited direct patient care role. However, a growing number of pharmacists have been introducing clinical pharmacy services at hospitals. Three themes about enablers to practice change emerged from data: (a) increasing physicians' acceptance to pharmacists' role in patient care, (b) patients' trust in pharmacists' knowledge about medications, and (c) pharmacists' perceived benefits of providing direct patient care. These benefits includes enhancing patients' safety and adherence to therapy and improving the professional identity of pharmacists. Participants' perceived challenges to practice change include professional, individual, and organizational challenges. Most participants welcomed assuming direct patient care role. They agreed that pharmacists need to receive adequate education and training and to be equipped with a clinical degree to responsibly provide direct patient care services at hospitals. CONCLUSIONS Pharmacists have been increasingly attempting to provide clinical pharmacy services in Kuwait hospitals. This qualitative data revealed breadth of challenges hindering pharmacists' attempts to expand their professional practice to include direct patient care role. It also outlines facets of improvement and enablers to practice change. The collaboration between different stakeholders in the profession is essential to support pharmacists' efforts in achieving the change in the scope of pharmacy practice to improve patient care services.
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Affiliation(s)
- Maram Gamal Katoue
- Department of Pharmacology and Therapeutics, Kuwait University Faculty of Pharmacy, Kuwait, State of Kuwait
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Kesten KS, Beebe SL. Competency frameworks for nurse practitioner residency and fellowship programs: Comparison, analysis, and recommendations. J Am Assoc Nurse Pract 2021; 34:160-168. [PMID: 33767119 DOI: 10.1097/jxx.0000000000000591] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/02/2021] [Indexed: 11/25/2022]
Abstract
ABSTRACT Nurse practitioner (NP) education has followed the pattern of other health professions in recent years to place an emphasis on competency-based education. In recent years, postgraduate NP residency/fellowship programs to achieve competence and successful transition to practice have emerged and flourished. Currently, there is no standard competency framework in use for NP residency/fellowship programs in the United States, despite numerous published frameworks available. This article aimed to provide a comprehensive analysis of competency frameworks for NP education and to summarize and compare the competency frameworks used in NP education and residency/fellowship programs. Recommendations were sought for standardization of these competencies to create consistent evaluation and outcome measurements. Seven competency frameworks used across NP education and residency/fellowship programs were reviewed and compared in table format. Commonalities, differences, and themes were extracted from this comparison. There were more similarities than differences between the competency frameworks; however, common themes emerged as the emphasis on patient-centered, evidence-based practice, systems-based and quality improvement, and interprofessional practice and teamwork. The American Association of Colleges of Nursing Common Advanced Practice Registered Nurse Doctoral-Level Competencies, published in 2017, provided the most current, inclusive, comprehensive, and complete set of competencies for NPs at the time of graduation; however, they have not defined a progression indicator for postgraduate NP competency evaluation. This review of the competencies emphasizes (a) the need for consistent and consensus-based standards and (b) areas that NP education and residency/fellowship programs can strengthen to assess their ability to describe observable, measurable competencies. Instruments to evaluate competencies are recommended.
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Affiliation(s)
- Karen S Kesten
- Acute and Chronic Care Community, School of Nursing, The George Washington University, Washington, District of Columbia
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