Exploring Factors Associated With the Motivation of Clinical Pharmacists: A Focus on the South African Context

Abstract

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.

Understanding of healthcare professionals towards the roles and competencies of clinical pharmacists in South Africa

“…Work environments in which collegial support is received motivates clinical pharmacists and improves their wellbeing. This supports the implementation of clinical services, prevents possible adverse events (burnout) and keeps the quality of patient care as high as possible [ 18 ]. Knowledge, attitude and perceptions of other HCPs towards the role of the clinical pharmacist are important factors that can either facilitate or hinder the implementation and expansion of clinical pharmacy services [ 5 , 13 , 14 , 19 ].…”

“…Among individuals not appointed in dedicated clinical pharmacy positions, higher amotivation (lack or absence of motivation) for delivering clinical pharmacy services were found. These pharmacists did not feel supported and related to other HCPs, compared to those in dedicated positions [ 18 ]. If allocated more ward-based time, the majority of pharmacists in a study by Bronkhorst et al, felt that they can improve the rational use of medication.…”

Research on the use of motivational tools in the practical activity of pharmaceutical specialists

“…It has been shown that among South African clinical pharmacists, higher motivation to work is found in graduates who do not practice as a clinical pharmacist, as well as in graduates who do not receive additional financial benefits for clinical services [16]. In turn, among hospital pharmacists of the specialized hospital Tikur Anbesa (Addis Ababa, Ethiopia), 53.0 % of respondents were satisfied with their work [17].…”

Clinical Pharmacy in South Africa: Qualitative investigation of perspectives of practicing pharmacists

“…Training of clinical pharmacists in SA includes a Master's degree in clinical pharmacy. This was originally initiated in 2000 by one University, who graduated around 114 students since (Crafford et al, 2021). Four other universities followed, however not with a modular Master's degree, and graduated much less students (around 18).…”

“…Rhodes University offered a PharmD programme (Gous and Schellack, 2014), who graduated around 16 students before discontinuing the course. The slow uptake of clinical pharmacy services can be related to infrastructure and resource limitations (Crafford et al, 2021).…”