BackgroundCompetency frameworks that prompt personal and professional development have become an important component of lifelong learning; they are driven by healthcare professionals’ need for development and professional recognition. This study aimed to evaluate the self-assessed competencies of community pharmacist-preceptors by using Croatian Competency Framework (CCF) and to identify competencies to be improved. The secondary aim was to explore the association between community pharmacists’ characteristics (i.e. age, education etc.) and self-assessed competency performance.MethodsThe study subjects were community pharmacist-preceptors who provide support to and mentor student trainees enrolled in pre-registration training for pharmacy students. At the beginning of their mentorship, the pharmacist-preceptors assessed their competencies on a four-point Likert scale by using the Croatian Competency Framework (CCF), a validated tool for assessment and self-assessment of community and hospital pharmacists. Data were collected via e-mail in the period from October 2015 to April 2016.ResultsOf the 260 community pharmacists approached, final analysis included 223 respondents. The response rate was 85.8%. Community pharmacist-preceptors assessed themselves as the most competent in competencies pertaining to the cluster “Organization and management competencies” (M = 3.64, SD = 0.34), while they considered themselves as the least competent in the competencies pertaining to the cluster “Pharmaceutical public health competencies” (M = 2.75, SD = 0.77). Younger pharmacists with a postgraduate qualification who worked for large pharmacy chains in the capital city area and who had been in their current posts for a shorter period perceived themselves to be more competent.ConclusionThis research represents the first analysis of the CCF in practice and identifies community pharmacist-preceptor competencies that require improvement. Consequently, areas for additional professional education were defined. Implementing modalities to measure and support development of preceptors’ competences is essential for improvement of student training programmes.
Medications and doses are often similarly prescribed to older and younger adult patients (Somers 2016). This is a problem that must be viewed as ageist, because pharmacological studies have shown for decades that many medications act differently in older and younger people due to the physiological and pathological changes that accompany ageing. Many medications have different efficacy and safety profiles in younger and older age groups (American Geriatrics Society (AGS) 2015; Fialová and Onder 2009; Pazan et al. 2016). For this reason, treating older adults the same as younger adults when prescribing medication, without respecting age-specific needs in terms of such issues as individual dose adjustments, geriatric drug forms, and geriatric medication management, can be seen as a form of ageism. Among older adults, the selection of medication, dosing schedules, and combined drug regimens, as well as appropriate follow-up and management of medication treatment, should always be age-specific and highly individualized. Unfortunately, this is not a common clinical practice (Fialová and Onder 2009; Petrovic et al. 2016).
Community-based pharmacists are an important stakeholder in providing continuing care for chronic multi-morbid patients, and their role is steadily expanding.The aim of this study is to examine the literature exploring community-based pharmacist-initiated and/or -led deprescribing and to evaluate the impact on the success of deprescribing and clinical outcomes. Methods: Library and clinical trials databases were searched from inception to March 2020. Studies were included if they explored deprescribing in adults, by communitybased pharmacists and were available in English. Two reviewers extracted data independently using a pre-agreed data extraction template. Meta-analysis was not performed due to heterogeneity of study designs, types of intervention and outcomes. Results: A total of 24 studies were included in the review. Results were grouped based on intervention method into four categories: educational interventions; interventions involving medication review, consultation or therapy management; predefined pharmacist-led deprescribing interventions; and pharmacist-led collaborative interventions. All types of interventions resulted in greater discontinuation of medications in comparison to usual care. Educational interventions reported financial benefits as well. Medication review by community-based pharmacist can lead to successful deprescribing of high-risk medication, but do not affect the risk or rate of falls, rate of hospitalisations, mortality or quality of life. Pharmacist-led medication review, in patients with mental illness, resulting in deprescribing improves anticholinergic side effects, memory and quality of life. Pre-defined pharmacist-led deprescribing did not reduce healthcare resource consumptions but can contribute to financial savings. Short follow-up periods prevent evaluation of long-term sustainability of deprescribing interventions. Conclusion: This systematic review suggests community-based pharmacists can lead deprescribing interventions and that they are valuable partners in deprescribing collaborations, providing necessary monitoring throughout tapering and post-follow-up to ensure the success of an intervention.
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