Background: Inconsistency in the practice of clinical pharmacy at a junior level encouraged our group to develop a general level competency framework (GLF) to facilitate practitioner development and assessment. The framework consists of patientrelated, personal and problem-solving clusters of competencies assessed on a four-point frequency scale. This study describes a large, controlled study to determine whether the framework could improve the clinical practice of junior hospital pharmacists.Method: One hundred and two junior grade pharmacists in 22 acute NHS trusts in the south of England were recruited. The hospitals were enrolled as either intervention (n ¼ 13; 72 pharmacists) or non-intervention sites (n ¼ 9; 30 pharmacists). The pharmacists ("tutees") and senior supervisors ("tutors") in the active sites used the competency framework for practice development. Tutees and tutors in the control sites did not have access to the competency framework, and measures were taken to ensure these trusts remained isolated from the assessment outcomes. All pharmacists were assessed at baseline, 3, 6 and 12 months. Non-intervention pharmacists were assessed by external evaluators.Results: A repeat measures analysis (month-6 compared to baseline, month-12 compared to baseline) revealed that the intervention group showed an improvement in 24 of the 25 competencies at month-6, which was sustained at month-12. In contrast, the non-intervention pharmacists demonstrated an improvement in just 7 of the competencies at month-6 increasing to 12 competencies by month-12 (Table III). Using an aggregated competency score for each recruit, intervention and nonintervention pharmacists were compared using an application of Kaplan-Meier analysis. Event status was defined as the achievement of competence, detected by the attainment of a predefined threshold score. A significant difference existed between the groups at all time points (log rank ¼ 7.97, p ¼ 0.0048).Discussion: This controlled study demonstrates that tutees in the intervention sites improved significantly in 24 of the 25 patient-related competencies at 6 months and that this was sustained at 12 months. By contrast, non-intervention candidates showed progression in only 12 of the 25 competencies.

These findings suggest that the diagnosis and disease have a significant bearing on patients' medicine-information desires and recommend that healthcare professionals view patients as individuals when providing information that meets their needs. It will be important for healthcare professionals to identify and understand that patients with different diseases have different desires for information about their disease and their drugs which may influence the way they take their medicines and subsequently the ways we manage their long-term disease. We need to determine if the EID scale is an efficient and effective way to identify patients' desires for drug information and a useful tool for practitioners to effectively target interventions in healthcare provision over time.

Background: The World Health Organization (WHO) estimates that there is a global healthcare workforce shortage of 7.2 million, which is predicted to grow to 12.9 million by 2035. Globally, people are living longer with multiple co-morbidities and require increased access and use of medicines. Pharmacists are a key component of the healthcare workforce, and in many countries, pharmacists are the most accessible healthcare profession. This paper identifies key issues and current trends affecting the global pharmacy workforce, in particular workforce distribution, country economic status, capacity, and workforce gender balance. Methods: National professional pharmacy leadership bodies, together with other contacts for professional bodies, regulatory bodies, and universities, were approached to provide country-level data on pharmacy workforce. A descriptive and comparative analysis was conducted to assess each country's pharmacy workforce. Results: A total of 89 countries and territories responded to the survey. To standardise the capacity measure, an analysis of the population density of pharmacists (per 10 000 population) was performed. The sample mean was 6 pharmacists per 10 000 population (n = 80). There is considerable variation between the surveyed countries/territories ranging from 0.02 (Somalia) to 25.07 (Malta) pharmacists per 10 000 population. African nations have significantly fewer pharmacists per capita. Pharmacist density correlates with gross national income (GNI) and health expenditure. The majority of pharmacists are employed in community settings, followed by hospital, industry-related, academia, and regulation. There is a greater proportion of females in the pharmacy workforce globally, with some WHO regions showing female representation of more than 65 % with an increasing trend trajectory. Conclusions: Pharmacy workforce capacity varies considerably between countries and regions and generally correlates with population-and country-level economic indicators. Those countries and territories with lower economic indicators tend to have fewer pharmacists and pharmacy technicians; this has implications for inequalities regarding access to medicines and medicine expertise.

BackgroundPharmacists 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.MethodThe 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.ResultThe 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.ConclusionThe 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 materialThe online version of this article (10.1186/s40545-018-0147-9) contains supplementary material, which is available to authorized users.

PURPOSE.To describe clinical pharmacist interventions across a range of critical care units (CCUs) throughout the United Kingdom (UK). To identify CCU medication error rate, prescription optimisation and to identify the type and impact of each intervention in the prevention of harm and improvement of patient therapy. MATERIALS AND METHODS.A prospective observational study was undertaken in 21 UK CCUs from [5][6][7][8][9][10][11][12][13][14][15][16][17][18] th Nov 2012. A data collection web portal was designed where the specialist critical care pharmacist (SCCP) reported all interventions at their site. Each intervention was classified as either: medication error, optimisation or consult. In addition, a clinical impact scale was used to code the interventions. Interventions were scored as low, moderate, high impact and life saving. The final coding was moderated by blinded independent multidisciplinary trialists. RESULTS. 20,517 prescriptions were reviewed with 3,294 interventions recorded during the weekdays. This resulted in an overall intervention rate of 16.1%: 6.8% were classified as medication errors, 8.3 % optimisations and 1.0% consults. The interventions were classified as: low impact (34.0%), moderate impact (46.7%) high impact (19.3%) and one case was life saving. Almost three-quarters of interventions were to optimise the effectiveness of and improve safety of pharmacotherapy. CONCLUSIONS. This observational study demonstrated that both medication error resolution and pharmacist led optimisation rates were substantial. Almost 1 in 6 prescriptions required an intervention from the clinical pharmacist. The error rate was slightly lower than an earlier UK prescribing error study (EQUIP). Two thirds of the interventions were of moderate to high impact. Key wordsCritical care, interventions, specialist critical care pharmacist, medication errors, optimisations, impact coding IntroductionThe critically ill patient is at risk of medicines-related adverse events [1], drug interactions and on some occasions inadequate therapy [2]. This risk can be exacerbated by the presence of organ failure or by supportive therapies such as renal replacement therapy. Consequently, interventions to reduce medication errors and optimise therapy are an essential component of patient care. These include electronic prescribing, smart infusion pumps, medicines reconciliation, clinical guidelines and services normally led by a specialist critical care pharmacist (SCCP) [3]. Improving the safety and efficacy of medication therapy in critical care patients is the cornerstone of SCCP activity. Since the first reports of clinical pharmacist interventions in critical care in the mid-1980s [4], there has been a gradual progression from those focused on financial savings in medicine use, to reducing medication errors and more recently to the optimisation of medication therapy [5]. Clinical pharmacists have been reported to improve medicines-related patient outcomes in the use of sedation [6], antimicrobial therapy [7], therapeutic drug m...

Although these results allow for the development of a framework to describe the perceptions of community pharmacy users, further research is needed to determine the prevalence of these and other possible results.

Pharmacists' roles are evolving from that of compounders and dispensers of medicines to that of experts on medicines within multidisciplinary health care teams. In the developing country context, the pharmacy is often the most accessible or even the sole point of access to health care advice and services.Because of their knowledge of medicines and clinical therapeutics, pharmacists are suitably placed for task shifting in health care and could be further trained to undertake functions such as clinical management and laboratory diagnostics. Indeed, pharmacists have been shown to be willing, competent, and cost-effective providers of what the professional literature calls "pharmaceutical care interventions"; however, internationally, there is an underuse of pharmacists for patient care and public health efforts. A coordinated and multifaceted effort to advance workforce planning, training and education is needed in order to prepare an adequate number of well-trained pharmacists for such roles.Acknowledging that health care needs can vary across geography and culture, an international group of key stakeholders in pharmacy education and global health has reached unanimous agreement that pharmacy education must be quality-driven and directed towards societal health care needs, the services required to meet those needs, the competences necessary to provide these services and the education needed to ensure those competences. Using that framework, this commentary describes the Pharmacy Education Taskforce of the World Health Organization, United Nations Educational, Scientific and Cultural Organization and the International Pharmaceutical Federation Global Pharmacy and the Education Action Plan 2008–2010, including the foundation, domains, objectives and outcome measures, and includes several examples of current activities within this scope.

Objectives To compare practice pharmacists and community pharmacists based on the use of the General Level Framework (GLF) as a tool to support continuing professional development (CPD). Setting Primary care and community pharmacy in London and the East of England. Method The study pharmacists were self‐selected after distribution of recruitment packs in the study area through local pharmaceutical committees, primary care trusts and two large multiples. Sixty‐nine pharmacists used the framework to support their CPD (42 community pharmacists and 27 with a role in primary care pharmacy). Pharmacists made an initial self‐assessment against the GLF and then used the framework over a 12‐month period to identify learning needs for CPD. Pharmacists identified their desired performance levels for the behaviours in the framework, based on guidance from the project team, and then identified their learning needs by comparing the desired performance level with their self‐assessment. Pharmacists were visited at 4 and 8months by a trained facilitator to support their self‐assessment and progress with CPD. Final self‐assessments were collected at 12months. Assessment ratings for the delivery of patient‐care competencies were compared. Key findings There was no difference in the probability of either group achieving their desired performance level (log rank = 0.023, 1 df, P = 0.878): pharmacists achieved their desired performance level irrespective of their sector of work, demonstrating the applicability of the GLF to the different sectors of practice. Practice pharmacists had a higher aggregated score for the desired performance levels than the community pharmacists (Mann‐Whitney U = 10.500, P < 0.001; median = 133.0 and 119.5 respectively). Conclusion Both groups of pharmacists were able to apply the framework to their practice and use it to support their CPD, resulting in increasing self‐assessed competency scores over time. The higher desired performance level for practice pharmacists compared with community pharmacists conveys a difference, perceived or actual, between the two roles. Irrespective of the difference in desired performance levels, both groups of pharmacists have improved, to meet their level of expectation, over the 12‐month period.