A competency framework for clinical pharmacists and heart failure

Forsyth, Paul; Warren, Alison; Thomson, Clare; Bateman, J. Carroll; Greenwood, Elizabeth; Williams, H.; Khatib, Rani; Hadland, Rocco; McGlynn, Steve; Khan, Nazish; Duggan, Catherine; Beezer, Janine

doi:10.1111/ijpp.12465

Cited by 19 publications

(20 citation statements)

References 54 publications

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“…Specialisation, involving post-graduate qualifications and board certification, is becoming commonplace 31. A future opportunity, therefore, exists to develop extended roles in specialities such as cardiology, as seen in the US and the UK 32,33. Government funding models and legislation changes many ultimately be required to facilitate this 31.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of discharge prescriptions for secondary prevention in patients with acute coronary syndromes in Iraq

Nassr

Forsyth

Johnson

2019

Pharm Pract (Granada)

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Background: Optimal prescribing of secondary prevention medications after acute coronary syndrome (ACS) events has been shown to reduce morbidity and mortality. However, it is unknown whether these medications are optimally prescribed at discharge from acute care in Iraq. Objective: To evaluate whether patients with ACS received optimal secondary prevention medications: antiplatelets, statins, angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARBs), and beta-blockers at discharge from a cardiology unit, and to assess whether statins, ACEI/ARBs and beta-blockers were prescribed at target doses based on the American Heart Association/American College of Cardiology (AHA/ACC) guidelines. Methods: Observational retrospective cross-sectional study of patients with ACS admitted to a hospital in Baghdad and survived to discharge between May 2016 and January 2017. Patient-level data and secondary prevention medications at discharge were extracted from routine medical records. Optimal dosing was defined as ≥75%, moderate dosing as 50–74%, and low dosing as <50% of the target dose. Results: 45.6% (200/439) of eligible patients were included in the study who were aged 25 to 90 years (mean 57.8 years) with 78.0% (156/200) being male. Of those included, 84.5% had a myocardial infarction and 15.5% unstable angina, and the length of hospital stay ranged from 1 to 29 days (median 4 days). In total, 53.5% of patients were prescribed all five secondary prevention medications at discharge, and after accounting for contraindications, 60.0% were treated according to AHA/ACC guidelines. The prescription rate of dual antiplatelet therapy, statins, ACEI/ARBs and beta-blockers was 92.5%, 94.5%, 69.5% and 87.0% respectively. Hypertension, diabetes mellitus and the prescription of oral nitrates were associated with the prescription of optimal secondary prevention therapy. Although 80.9% of patients were prescribed target doses of antiplatelets and statins, only 12.2% and 9.2% were prescribed target doses of ACEI/ARBs, and beta-blockers respectively. Conclusions: Approximately one in two patients received the recommended secondary prevention therapy. However, only a minority of patients were prescribed optimal doses of ACEI/ARBs and beta-blockers, in line with guidance. Quality improvement strategies should be implemented, which may include greater involvement of pharmacists within the cardiology multidisciplinary team.

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Section: Discussionmentioning

confidence: 99%

Evaluation of discharge prescriptions for secondary prevention in patients with acute coronary syndromes in Iraq

Nassr

Forsyth

Johnson

2019

Pharm Pract (Granada)

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“…36 Some countries use literature review for developing a CF. 39,40 This research gained first-hand evidences using a qualitative research for developing pharmacy CF that fits for Thai society where pharmacy professional practice is very unique as it serves all activities in pharmaceutical supply chain. 11 Under Thai healthcare systems, pharmacy education and licensing systems as mentioned in the introduction, the CF emerging from this study embraces both sets of general and service-specific competencies.…”

Section: -mentioning

confidence: 99%

Development of pharmacy competency framework for the changing demands of Thailand’s pharmaceutical and health services

Suwannaprom¹,

Suttajit²,

Eakanunkul³

et al. 2020

Pharm Pract (Granada)

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Background: In Thailand, pharmacists are responsible for all activities to ensure access to medicines throughout pharmaceutical supply chain. Competency framework (CF) is an important guidance for professional development and workforce planning. Objective: This study aimed to explore needs for pharmacy services in pharmaceutical supply chain and competencies of pharmacists to serve those needs. It was the first step for developing evidence-based pharmacy CF within the context of Thailand in 2026. Methods: A qualitative method using in-depth interviews to gain rich data from practitioners and leaders in all area of practices. 99 key informants from 56 workplaces in Thailand were interviewed during January and March 2016. Data was transcribed verbatim, and thematic analysis was used. Competencies were extracted, followed by several rounds of group discussion among team members to develop an initial framework. The competencies and CF were presented, and recommendations were gained from professional leaders for refining the findings. Results: The key informants agreed that pharmacist’s works and responsibilities have gradually been drifted to support changes in healthcare and pharmaceutical systems. The upcoming pharmaceutical services call for higher standards of practice, larger number of personnel, and skillful pharmacists who have strong foundation in pharmaceutical knowledge as well as an ability to integrate knowledge into practices. Two sets of CFs were established. The general CF comprises five core domains: product focus, patient focus, healthcare system focus, community focus, and personal focus for self-improvement. These general competencies allow practitioners to perform basic professional tasks, including providing information, dispensing, and compounding. The service-specific competency is the integration of general competencies tailored into specific area of practice. Conclusions: Regarding the professional goal to evolve pharmacists from generalists to specialists for providing higher quality of professional services, the pharmacists are required to demonstrate general competencies and service-specific competencies. The findings serve as the need-based evidence for developing a national CF for pharmacists in Thailand.

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“…To support the delivery of these new advanced pharmacist roles within the cardiology multidisciplinary team, a competency framework for pharmacists has been developed40 and work is underway to accredit this with the Royal Pharmaceutical Society, in order to standardise the quality and consistency of this type of advanced practice.…”

Section: Lessons and Limitationsmentioning

confidence: 99%

Improving medication optimisation in left ventricular systolic dysfunction after acute myocardial infarction

et al. 2019

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Glasgow city has the highest cardiovascular disease (CVD) mortality rate in the UK. Patients with left ventricular systolic dysfunction after acute myocardial infarction represent a ‘high-risk’ cohort for adverse CVD outcomes. The optimisation of secondary prevention medication in this group is often suboptimal. Our aim was to improve the use and target dosing of ACE inhibitors (ACEI), angiotensin II receptor blockers (ARBs) and beta-blockers in such patients, through pharmacist-led clinics and cardiology multidisciplinary team collaboration. Retrospective audits characterised baseline care. Prospective pharmacist-led clinics were piloted and rolled out across seven hospitals and primary care localities over four Plan–Do–Study–Act cycles. ‘Hub’ and ‘spoke’ clinics utilised independent prescribing pharmacists with different levels of cardiology experience. Pharmacists were trained through a bespoke training programme—‘Teach and Treat’. Consultant cardiologists provided senior support and governance. Patients attending prospective pharmacist-led clinics were more likely to be prescribed an ACEI (or ARB) and beta-blocker (n=856/885 (97%) vs n=233/255 (91%), p<0.001 and n=813/885 (92%) vs n=224/255 (88%), p=0.048, respectively) and be on target dose of ACEI (or ARB) and beta-blocker (n=585/885 (66%) vs n=64/255 (25%), p<0.001 and n=218/885 (25%) vs n=17/255 (7%), p<0.001, respectively) compared with baseline. The mean dose of ACEI (or ARB) and beta-blocker was also higher (79% vs 48% of target dose, p<0.001% and 48% vs 33% of target dose, p<0.001, respectively) compared with baseline. Use of secondary prevention medication was significantly improved by pharmacist and cardiology collaboration. These improvements were sustained across a 4-year period, supported by a novel approach called ‘Teach and Treat’ which linked training to defined clinical service delivery. Further work is needed to assess the impact of the programme on long-term CVD outcomes.

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A competency framework for clinical pharmacists and heart failure

Cited by 19 publications

References 54 publications

Evaluation of discharge prescriptions for secondary prevention in patients with acute coronary syndromes in Iraq

Evaluation of discharge prescriptions for secondary prevention in patients with acute coronary syndromes in Iraq

Development of pharmacy competency framework for the changing demands of Thailand’s pharmaceutical and health services

Improving medication optimisation in left ventricular systolic dysfunction after acute myocardial infarction

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