Introduction: Pharmacy practice in many middle to low-income countries has slowly transitioned from being product-focused to a more patient-focused clinical practice. Lack of motivation is one of the factors contributing to the scarcity of pharmacists in the wards. As little is known about motivation in clinical pharmacists, this study aimed to obtain insight into the quantity and quality of their work motivation and factors associated with it.Methods: Self-determination Theory, used as the framework, describes autonomous motivation as being generated from within or through personal endorsement and controlled motivation as originating from external factors. An online questionnaire including the Academic Motivation Scale to measure autonomous motivation, controlled motivation and amotivation, was sent to clinical pharmacy graduates from 2000 to 2020 across South Africa, followed by interviews to explain some results. Independent t-test was used to analyze differences in motivation of clinical pharmacists to perform clinical services based on personal and environmental factors. Interview data were transcribed and analyzed to explain significant quantitative findings.Results: Higher amotivation was found in graduates who are currently not practicing in dedicated clinical pharmacist positions, as well as in graduates who do not receive additional financial benefits for clinical services. We found no significant differences in the work motivation of clinical pharmacists based on their gender, age, current practice setting, work experience and additional training received. The interviews revealed that relatedness and autonomy are the most important factors for clinical pharmacists' work motivation.Discussion: Overall participants had a high mean autonomous motivation, a high mean controlled motivation and low mean amotivation. In line with Self-determination Theory literature, considering the basic psychological needs for relatedness and autonomy could assist with designing interventions, like creating a supportive work environment, to optimize motivation. This could improve professional wellbeing, service implementation and prevent possible adverse events. Future research is necessary to understand barriers and facilitators of clinical pharmacists' work motivation.
highlighting improved access to quality healthcare in South Africa.Clinical pharmacists play a vital role in various settings, including medication safety, therapeutic drug monitoring and antimicrobial stewardship. Healthcare-related key performance indicators measures quality that ensure accountability, improve patient safety and assist decision-making. To understand the perceptions of pharmacists regarding education, barriers and outcome measures on practices of clinical pharmacy, this study employed qualitative research, with focus-group discussions and in-depth interviews.Dialogue from interviews and focus-groups were audio-taped, transcribed and stored as MS-Word™ documents. NVivo® were utilised to identify themes.Pseudo-names ensured participant confidentiality.Ethics approval was obtained from the Sefako Makgatho University Research and Ethics committee, participating privatehealthcare groups and Government Research Offices. Pharmacists were interviewed in eight provinces, identifying seven themes. The majority of pharmacists felt that notable differences exist between the scope of practice of ward-and clinical pharmacists. Most pharmacists did not know the definition of pharmaceutical care.The consensus was that clinical functions require more in-depth work than functions by general pharmacists. All pharmacists experienced barriers to performing their functions. Mostly outcome measures used by pharmacists pertain to antimicrobial stewardship, pharmacists felt that additional training is necessary to perform clinical functions. Clinical work is considered more intense and requires greater involvement in multidisciplinary teams. The study contributes to the state of clinical pharmacy in South Africa. It provides insight into the different levels of clinical pharmacy practice. The findings provide insights into the implementation of Clinical pharmacy services in developing countries.
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