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      Evolving role of pharmacy technicians in pharmaceutical care services: Involvement in counselling and medication reviews

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          Abstract

          Background

          Previous non-clinical traditional role of pharmacy technicians (PTs) has evolved considerably. Therefore, adequate understanding of PTs' practice of pharmaceutical care (PC) services is essential for appropriate skill mix in provision of services.

          Objectives

          The objectives of the study were to: (1) assess PTs' sources of information and practice of pharmaceutical care, and (2) assess differences in patient-centered care practices between PTs in hospital and community pharmacy settings.

          Methods

          Cross-sectional survey was conducted among 100 pharmacy technicians using a structured questionnaire. Descriptive analysis was performed using SPSS version 24.0, and involvement in pharmaceutical care practices was assessed on a 3-point Likert scale. P < 0.05 was significant.

          Results

          A total of 73 (73.0%) PTs participated in the study and 44 (60.3%) practiced in hospitals. Almost all 70 (95.9%) had previously heard of PC. Sources of information was associated with place of practice ( p = 0.001), highest degree ( p = 0.003) and age ( p = 0.000). Only a quarter 21 (28.8%) indicated it was patient-centered. The majority often assisted in dispensing/counselling 62 (84.9%). Over half often provided responsible advice on over-the-counter medicines 50 (68.5%), assisted in managing patients' medication information 49 (67.1%), initiated pharmaceutical care 43 (58.9%) and answered questions on side effects/interactions of medicines 40 (54.8%), respectively. The least often performed task was discussing possible change in therapy 21(34.2%). Significant differences were found between hospital PTs and community PTs in the frequency of intake of patients/clients for PC ( p = 0.026) and assisting in dispensing/counselling ( p = 0.018).

          Conclusions

          Various sources of information was observed and this was associated with selected socio-demographics. Several PC activities were often undertaken by PTs, and some differences in practice of these activities was seen between the practice areas.

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          Pharmaceutical care: the PCNE definition 2013.

          Samuel Allemann, J. W. Foppe van Mil, Lea Botermann … (2014)
          Twenty-three years after Hepler and Strand published their well-known definition of Pharmaceutical Care (PhC), confusion remains about what the term includes and how to differentiate it from other terms. The board of the Pharmaceutical Care Network Europe (PCNE) felt the need to redefine PhC and to answer the question: "What is Pharmaceutical Care in 2013". The aims of this paper were to review existing definitions of PhC and to describe the process of developing a redefined definition. A literature search was conducted in the MEDLINE database (1964-January 2013). Keywords included "Pharmaceutical Care", "Medication (Therapy) Management", "Medicine Management", and "Pharmacist Care" in the title or abstract together with the term "defin*". To ease comparison between definitions, we developed a standardised syntax to paraphrase the definitions. During a dedicated meeting, a moderated discussion about the definition of PhC was organised. The initial literature search produced 186 hits, with eight unique PhC definitions. Hand searching identified a further 11 unique definitions. These 19 definitions were paraphrased using the standardised syntax (provider, recipient, subject, outcome, activities). Fourteen members of PCNE and 10 additional experts attended the moderated discussion. Working groups of increasing size developed intermediate definitions, which had similarities and differences to those retrieved in the literature search. At the end of the session, participants reached a consensus on a "PCNE definition of Pharmaceutical Care" reading: "Pharmaceutical Care is the pharmacist's contribution to the care of individuals in order to optimize medicines use and improve health outcomes". It was possible to paraphrase definitions of PhC using a standardised syntax focusing on the provider, recipient, subject, outcomes, and activities included in PhC practice. During a one-day workshop, experts in PhC research agreed on a definition, intended to be applicable for the present time, representative for various work settings, and valid for countries inside and outside of Europe.
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            Awareness, knowledge, attitude and practice of adverse drug reaction reporting among health workers and patients in selected primary healthcare centres in Ibadan, southwestern Nigeria

            Rasaq Adisa, Tomilayo Omitogun (2019)
            Background Higher incidence of adverse drug reactions (ADRs) is a global health problem requiring attention of all stakeholders regardless of the practice settings. This study therefore aimed to evaluate awareness, knowledge, attitude and practice of ADR reporting among health workers and patients in 10 primary healthcare centres (PHCs) in Ibadan, southwestern Nigeria. Methods Questionnaire-guided cross-sectional survey among 80 health workers and 360 patients enrolled from the selected PHCs between October and December 2018. The semi-structured questionnaires generally comprised open-ended and closed-ended questions to explore general knowledge and awareness of ADRs and pharmacovigilance, while other question-items evaluated attitude towards ADR reporting and ADR reporting practice. Overall percent score in the knowledge and attitude domains for the health workers was developed into binary categories of > 80 versus ≤80% for “adequate” and “inadequate” knowledge, as well as “positive” and “negative” attitude, respectively. Data were summarised using descriptive statistics, while Chi-square test was used to evaluate categorical variables at p < 0.05. Results Overall, 58(72.5%) health workers had heard of pharmacovigilance, but only 3(5.2%) correctly understood the pharmacovigilance concept. Twelve (15.0%) showed adequate knowledge of ADRs, while 37(46.2%) demonstrated positive attitude towards ADR reporting. Thirty (37.5%) health workers had come across ADR reporting form, while 79(98.8%) expressed willingness to report all ADRs encountered. Of the patients, 31(8.6%) had heard of pharmacovigilance, 143(39.7%) correctly cited ADR definition, while 67(18.6%) reported the previously experienced ADRs. Informing healthcare professional (38; 38.8%) was the most common measure taken by patients when they experienced reaction(s). Nurses significantly had adequate knowledge of ADRs (p < 0.001) compared to other cadres. Conclusions Health workers in the selected PHCs were largely aware of pharmacovigilance but show low level of knowledge about ADRs and pharmacovigilance concept, with moderately positive attitude towards ADR reporting. Patients on the other hand demonstrate low level of awareness of pharmacovigilance and ADR reporting, with less than one-fifth who reported the previously experienced ADRs. This perhaps underscores a need for regular mandatory education and training on ADRs/pharmacovigilance concept among the PHC health workers, while continuous public enlightenment and awareness campaign on spontaneous reporting of ADRs is advocated in order to enhance reporting rate.
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              An analysis of pharmacy workforce capacity in Nigeria

              Aniekan Ekpenyong, Arit Udoh, Eneyi Kpokiri … (2018)
              Background Pharmacists are critical for attaining the goal of universal health coverage and equitable access to essential health services, particularly in relation to access to medicines and medicines expertise. We describe an analysis of the pharmacy workforce in Nigeria from 2011 to 2016 in order to gain insight on capacity and to inform pharmacy workforce planning and policy development in the country. Method The study was conducted using census data obtained from the Pharmacists Council of Nigeria (PCN) via a validated data collection tool. The statistical methods used for analysis were descriptive (frequencies, percentages, mean) and linear regression. Secondary data on population distribution per state was obtained from the Federal Bureau of Statistics and the National Population Commission (NPC) of Nigeria. Result The data showed 21,892 registered pharmacists with only 59% (n = 12,807) in active professional practice. There are also more male (62%) compared to female pharmacists while 42% of the licensed workforce with known area of practice are in community practice followed by hospital pharmacy (11%). A rise in number of pharmacists (0.53–0.66) and new pharmacy graduates per year (0.062–0.083) per 10,000 population was observed over the five years analysed; however the overall density remains significantly low. Pharmacists’ density also varied considerably between states (Median = 0.39; Min - Max: 0.05–4.3). Regionally, more than a third (~ 40%) of the licensed workforce and community pharmacies are situated in the South West region with fewer than 10% of the total in the North East and North West regions combined. A steady decline in number of pharmacists requesting a “letter of good standing” from PCN, a proxy measure of intent to migrate was also observed. Conclusion The data indicate ongoing deficits in availability and supply of pharmacists in the country with widespread variance in distribution observed across the 36 states and the Federal Capital Territory (FCT). The findings suggest that observed deficits are not solely related to out-migration and highlights the need for policies that will promote increased within-country availability, equitable distribution and retention, especially in the underserved regions of North East and North West of Nigeria. Electronic supplementary material The online version of this article (10.1186/s40545-018-0147-9) contains supplementary material, which is available to authorized users.
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                Author and article information

                Contributors
                Chinonyerem O. Iheanacho
                Journal
                Journal ID (nlm-ta): Explor Res Clin Soc Pharm
                Journal ID (iso-abbrev): Explor Res Clin Soc Pharm
                Title: Exploratory Research in Clinical and Social Pharmacy
                Publisher: Elsevier
                ISSN (Electronic): 2667-2766
                Publication date PMC-release: 03 February 2022
                Publication date Collection: March 2022
                Publication date (Electronic): 03 February 2022
                Volume: 5
                Electronic Location Identifier: 100113
                Affiliations
                [a ]Department of Clinical Pharmacy and Public Health, Faculty of Pharmacy, University of Calabar, Cross River State, Nigeria
                [b ]Department of Clinical Pharmacy and Biopharmacy, Faculty of Pharmacy, Olabisi Onabanjo University, Sagamu, Ogun State, Nigeria
                Author notes
                [* ]Corresponding author at: Department of Clinical Pharmacy and Public Health, University of Calabar, Cross River State PMB 1115, Nigeria. coiheanacho@ 123456unical.edu.ng
                Article
                Publisher Item ID: S2667-2766(22)00012-9 Publisher ID: 100113
                DOI: 10.1016/j.rcsop.2022.100113
                PMC ID: 9029913
                SO-VID: 75dc6955-2636-4713-8d18-d73baed550c3
                Copyright © © 2022 The Authors
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 8 October 2021
                Date revision received : 1 February 2022
                Date accepted : 1 February 2022
                Categories
                Subject: Article

                Keywords: nigeria,pharmacy technicians,pharmaceutical care,hospital pharmacy technicians,community pharmacy technicians,medication counselling,pts, pharmacy technicians,pc, pharmaceutical care,otc medicines, over-the-counter medicines,pcn, pharmacists council of nigeria
                Data availability:
                Keywords: nigeria, pharmacy technicians, pharmaceutical care, hospital pharmacy technicians, community pharmacy technicians, medication counselling, pts, pharmacy technicians, pc, pharmaceutical care, otc medicines, over-the-counter medicines, pcn, pharmacists council of nigeria

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