A comparative analysis of pharmaceutical workforce development needs across the commonwealth

A narrative review of pharmacy workforce challenges in Indonesia

BACKGROUND

Developing a skilled and motivated pharmacy workforce is imperative for strengthening healthcare systems. This narrative review examines challenges faced by Indonesian pharmacists in practice and identifies strategies and initiatives that have been implemented to support workforce development in Indonesia.

METHOD

A systematic search of three databases (PubMed, EBSCO, and OVID) was conducted to identify research articles published from database inception to 30 June 2022. Data were synthesised narratively and mapped to a multidimensional healthcare workforce framework.

RESULT

Forty studies were included, revealing four interrelated themes of workforce challenges: (1) personal challenges, (2) workplace conditions, (3) societal contribution and recognition; and (4) regulatory aspects. Strategies identified include professional guidelines, accreditation systems, and competency-based training programmes.

CONCLUSION

The review indicates a need for Indonesian pharmacists to enhance their competencies to provide high-quality services. A multi-sectoral approach is recommended to address challenges. Providing decent working conditions for pharmacists in conjunction with workplace accreditation can support best practices of pharmaceutical care and ensure patient safety.

A call for further study and use of transformational leadership in pharmacy education and practice: Hope and reinvigoration

This paper calls for further study of transformational leadership and its further use in educating PharmD students as well as inclusion of continuing education programming and mentoring the behaviours of current pharmacists. It does not present an argument for reduction in use or diminishment of other leadership theories, many of which have at least some overlap with transformational leadership. Rather, emphasis on transformation leadership might be one of many solutions to challenges plaguing the profession currently, with some sense of negativity and challenging workplace conditions among many pharmacists; support personnel and drug shortages; and a need for more collegial citizenship behaviors and stronger organizational culture. Transformative leadership behaviors and communication, versus others particularly more transactional in nature, envisage a future for the entire profession as well as for the individuals who comprise them, articulate the value of the contributions made by the employee, and help imbue a sense of professional identity. These are things sorely needed in the modern workplace and are either explicitly stated or tacitly implied in educational standards and professional competencies. A recent study on transformational leadership as measured by the Multifactorial Leadership Questionnaire (MLQ) found more parsimonious structures toward the definition of transformational leadership and the outcomes resulting from its use, which actually makes it easier to discern and thus even more applicable to incorporate into models of pharmacy education and practice. The time to further study and employ transformational leadership is now.

Global research trends and hotspots in pharmaceutical care: a bibliometric analysis and visualisation using CiteSpace and VOSviewer

OBJECTIVE

Pharmaceutical care is closely related to the outcome and prognosis of disease treatment. This study analyses the research status, hotspots, frontiers and development trends of pharmaceutical care from the perspective of bibliometrics.

METHODS

Related literature on pharmaceutical care published in the Web of Science Core Collection database was collected and knowledge maps were drawn by science information visualisation software Citespace 6.1 .R3 and VOSviewer 1.6.17.0.

RESULTS

A total of 3289 institutions from 105 countries/regions published 2906 papers in 669 academic journals, which were cited 50 027 times. The top three countries/regions by the number of publications are the USA, UK and Brazil. The top three institutions are Utrecht University and the University of Groningen in the Netherlands, and University College London in the UK. The top three journals are American Journal of Pharmaceutical Education, International Journal of Clinical Pharmacy and American Journal of Health-System Pharmacy. The top three authors are Hersberger KE, Bouvy ML and Hughes CM. The most co-cited is Hepler CD, and the most co-cited influential is Strand LM. COVID-19 pandemic, chronic obstructive pulmonary disease and pharmacy practice are the most cutting edge topics in the field of research in pharmaceutical care. Pharmaceutical service and clinical pharmacy are research hotspots in pharmaceutical care.

CONCLUSION

In the past 10 years, papers in the field of pharmaceutical care have shown a significant growth trend and scholars have become increasingly interested in research on related content in the field of pharmaceutical care. Our research results are of great significance for improving the connotation construction of pharmaceutical care and improving patient satisfaction and prognosis, and can also be used as an important reference for relevant scholars to select scientific research topics for subsequent research. The objective basis for relevant government departments is to modify and formulate health policies or measures.

A conceptual framework to build effective medicine pricing policies for low and middle-income countries (LMICs)

Building effective medicine pricing policies is a challenging task in all high-, middle- and low-income countries. In high-income countries have stable health systems in place, trained workforce, as well as specialised agencies to evaluate innovative drugs for reimbursement. However, in low- and middle-income countries (LMICs) the challenges are manifold. A large majority of low- and middle-income countries lack technical expertise either to evaluate new medicines or to set efficient medicine prices. The countries also lack comparator reference pricing data to set prices. Also, there are significant out-of-pocket expenditures as people pay for medicines by themselves. An effective medicine pricing policy is vital in the context that it can be used as a tool to improve access and affordability among the masses. This discussion paper presents a conceptual framework to build effective medicine pricing policies for low and middle-income countries (LMICs). The enablers to build effective medicine pricing policies are also discussed. This includes (a) data and statistics on the pharmaceutical situation of the country (b) Having a national medicine policy in the country (c) The availability of the medicine pricing data and (d) Human resources and technical capacity. WHO has recommended several strategies including External Price Referencing (EPR), Internal Reference pricing, Value-based pricing, Cost-plus pricing, and Generic medicine policies to build a pricing policy. However, this information is generic and it's a complex task for countries to tailor to their needs, hence a critical analysis is provided on these policies. The concepts related to fair medicine pricing, providing information to consumers and price transparency are also discussed.

Could pharmacy technicians play a role in supporting the appropriate and safe use of traditional and complementary medicines?

Across the world traditional and complementary medicine (T&CM) product use is prevalent with some countries reporting greater than 50% of the population using these products. T&CM products are primarily self-selected through retail outlets including pharmacies. Pharmacists across the world generally agree they should play a role in ensuring the appropriate and safe use of T&CM products but report being time and resource poor to do so. In this commentary, it is proposed that pharmacy technicians as members of the pharmacy workforce, who with adequate education, and supportive technologies could support pharmacists in providing guidance to consumers and patients about the appropriate and safe use of T&CM products. Pharmacy technicians play a crucial role in the pharmacy workforce, serving as integral members of healthcare teams fulfilling a wide array of tasks essential for the efficient functioning of pharmacies and ensuring the safe dispensation of medications. They have been described by pharmacists as the "the face of the pharmacy" in the community setting and relied on not only for mitigating and triaging problems, but also be primarily responsible for developing rapport, eliciting trust and even loyalty from pharmacy patrons. As such, there is a momentous opportunity for pharmacy technicians to play a role in providing T&CM advice and triaging the need for pharmacists' intervention where harm, or risk of is identified.

Work readiness of pharmacy graduates: An exploratory study

Introduction

The recent global pandemic of Covid-19 caused various disruptions. Among them were face-to-face teaching and learning activities being switched to virtual sessions in accordance with health authorities recommendations. The impact of these changes on work readiness of pharmacy graduates is unknown.

Aim

This study aims to determine the impact of pharmacy graduate's work readiness, particularly those that had their studies disrupted from the pandemic.

Methods

Practicing pharmacists with supervisory experience were interviewed on their opinions on work readiness of early career and intern pharmacists. Specifically, they were asked to comment on work readiness of pharmacy graduates who had their later stage of pharmacy education impacted by the pandemic. Data was transcribed verbatim and thematically analysed. This was also supplemented with quantitative data from graduating students in 2020 and 2021 using the Work Readiness Scale.

Results

Qualitative feedback showed four themes related to workforce readiness: work competence, social intelligence, personal characteristics, and organizational acumen. Preceptors interviewed noted differences in communication abilities when interacting with patients. However, this improved with time. Quantitative data collected from graduates via the validated Work-Readiness Scale also showed a more positive agreement towards perceived work readiness. These graduates were comfortable with using technology as they had used these extensively in their learning during the pandemic and thus was comfortable in adopting digital health tools in their practice.

Conclusion

Although graduates reported to be work ready, there were gaps in communication skills and confidence levels when interacting with patients, as reported by supervising preceptors. Graduates also described this sense of 'missing out' from not having the opportunity to attend face-to-face activities like their originally planned hospital placements and how it impacted their choice of career. As pharmacists continue to play vital roles as members of the broader healthcare workforce, both in clinical and nonclinical settings, learnings from this study should be considered in designing educational activities to train and develop the workforce of the future.

Resources and interventions to support psychological health and wellbeing in the pharmacy workforce: Analysis and use of a health worker 'burnout' toolkit

Background

Pharmacists have experienced declines in psychological health and wellbeing post-pandemic. The phenomena of moral distress, disengagement and burnout are associated with workforce attrition, unfitness to practice and inferior quality of patient care. A working group of the Canadian Pharmacists Association (CPhA) was formed to identify resources and interventions (R&I) for occupational psychological health and wellbeing.

Objective

To characterize R&I from an evidence-based national health worker 'burnout' Toolkit with potential to support the pharmacy workforce.

Methods

All R&I included within a draft 'burnout' Toolkit from the Canadian Health Workforce Network (CHWN) were screened to determine relevancy and usefulness for the pharmacy workforce. R&I with higher grades were data-charted to capture information on topic and content delivery. Final R&I were determined through consensus meetings where 'highly rated' R&I were discussed and selected.

Results

Of 140 original CHWN Toolkit R&I, 53 (37.8%) were of potential relevance or usefulness to improve well-being for most in the pharmacy workforce. Of those 53 R&I, 28 (20% of original) were final selections. The majority of R&I at each stage were focused on 'preventing burnout' and 'promoting mental health' (>60%) rather than 'addressing burnout', 'supporting recovery' or managing specific issues in the workplace (i.e. stigma, discrimination, bullying, hostility, workload). No R&I were specifically developed or studied within the pharmacy workforce.

Conclusions

Health professions may benefit from the CHWN Toolkit and the knowledge translation activity described here. R&I relevant and useful to the pharmacy workforce generally require adaptation for dissemination and/or implementation. The set of final R&I form the basis for orchestrated plans to support the pharmacy workforce with respect to psychological health and wellbeing. There is a relative lack of R&I devoted to addressing and recovering from burnout and workload management issues.

An analysis of pharmacy workforce capacity in Saudi Arabia

Background: Previous reports have highlighted the core issues with the intelligence of the national pharmacy workforce reliance on non-native pharmacists, despite the increasing supply of local pharmacy graduates; limited participation of female pharmacists in the workforce; and inadequate proportions of pharmacists in primary healthcare centres, resulting in pharmaceutical services being provided without a pharmacist's supervision. Methods: The current study used a retrospective cross-sectional design and data was collected from January to May 2023. Data was retrieved from the Health Statistics Yearbook, 2017, 2018, 2019, 2020 and 2021. The data included the total number of pharmacists, the number of Saudi pharmacists, the number of foreign pharmacists, the distribution of the proportions of male and female pharmacists, and the distribution of the workforce by region, sector and nationality. Data was also obtained relating to pharmacy education, including the number of pharmacy colleges, the number of pharmacy students and the number of pharmacy graduates. Results and conclusion: The capacity of the pharmacy workforce, meaning the number of pharmacists per 10,000 population, fluctuated between 2017 and 2021, with the lowest number being in 2020, a mere 7.9 pharmacists per 10,000 population. However, in 2021, the overall density of pharmacists increased to (9.04), which is above the global average (7.36 per 10,000 population). The proportion of women working in the pharmacy profession increased from 12% to 22%, and in community pharmacies from 0.3% to 7.2%, between 2016 and 2021. Another issue that still exists is a lack of proportionate and imbalance in the distribution of the pharmacy workforce across the regions. The renationalisation initiatives increased the overall proportion of Saudi pharmacists to 39% in 2021, compared to 22% in 2016. There is a need for a policy mechanism that will overcome the identified issues.