Scaling up clinical pharmacy practice in Africa: Current challenges and the future

Abstract

The potential of clinical pharmacy to improve patient health outcomes is yet to be fully realized in Africa as the practice remains scarce. In this paper, we highlight the current status, gaps, and opportunities for clinical pharmacy scale‐up in the region. Persistent gaps in clinical pharmacy practice include undergraduate and postgraduate curricula that are inadequate in producing practice‐ready clinical pharmacists. Experiential training is insufficient, and its effectiveness is limited by an inadequate number of trained clinical pharmacy preceptors at practice sites. At the institutional level, a lack of formalized job descriptions, low numbers of practicing clinical pharmacists, and lack of tools to facilitate documentation of clinical pharmacy activities and interventions pose practice challenges. Finally, there is inadequate policy and legislation to guide the increase of clinical pharmacy practice. Curriculum reform of the traditional Bachelor of Pharmacy (B.Pharm) program at the undergraduate level is needed to prepare pharmacy students for direct patient care roles. In addition, there is a need to increase Doctor of Pharmacy (Pharm.D.) programs and adopt innovative postgraduate programs for clinical pharmacist specialization, such as residencies and fellowships. Experiential training can be strengthened by making it longitudinal, and conducting it in practice sites with trained clinical pharmacy preceptors. At the level of hospital institutions, clear job descriptions need to be crafted for clinical pharmacists, and systems to facilitate documentation of their activities and interventions created. Finally, national policy and legislation on clinical pharmacy practice is needed to facilitate required training and practice reforms, and guide hospital implementation of clinical pharmacy practice.

Capacity-building and collaborative curriculum development: A transition from BPharm to PharmD degree at Nnamdi Azikiwe university in Nigeria

“…The desire for curricula transition from the BPharm to the PharmD degree has been described and is similar among most African nations (Njuguna et al, 2020;Koduah et al, 2020;Supapaan et al, 2019). One study completed a needs assessment and proposed possible solutions by conducting gap analysis, looking at the challenges, opportunities, and the future within African pharmacy education (Njuguna et al, 2020).…”

“…The desire for curricula transition from the BPharm to the PharmD degree has been described and is similar among most African nations (Njuguna et al, 2020;Koduah et al, 2020;Supapaan et al, 2019). One study completed a needs assessment and proposed possible solutions by conducting gap analysis, looking at the challenges, opportunities, and the future within African pharmacy education (Njuguna et al, 2020). It would be prudent to explore the journey of some other nations toward their transition from one degree to another to understand Nigeria's challenges with the curricula transition from BPharm to PharmD.…”

“…It would be prudent to explore the journey of some other nations toward their transition from one degree to another to understand Nigeria's challenges with the curricula transition from BPharm to PharmD. Several challenges facing clinical pharmacy practice in Africa were reported, including inadequate and insufficient didactic and experiential curricula, deficiencies in clinical pharmacy practice, and inadequate policies and legislation within healthcare institutions to enhance clinical pharmacy practice (Njuguna et al, 2020). The status, gaps, and opportunities for scaling-up clinical pharmacy practice in Africa were described, and solutions were proposed, such as curriculum reform of the BPharm programme, increasing the number of PharmD programmes, and adopting innovative postgraduate pharmacy training programmes, e.g., residencies and fellowships.…”

Indian Pharmacists Contemplation on Board of Pharmacy Specialties Certification: A Multi-Centric Survey

“…10 Insufficient training, underrecognition, and poor job satisfaction warrant a positive transformation in advanced clinical pharmacy services in India. 11 Pharmacists from developing countries must appraise certification programs and their decision will certainly influence the people they serve. 12 BPS considers the essentiality of more than 30,000 certified pharmacists who are yet to be distributed worldwide, and all pharmacy practitioners should be board certified.…”

Clinical Pharmacy Services Provided in Public Sector Hospitals in Nigeria: A National Survey

“…Although clinical pharmacy is well established in several high income countries [3][4][5][6][7]; its uptake has varied across the world regions and within nations [8][9][10][11]. Until recently, the delivery of these services in countries in Africa has been limited and/or non-existent [12][13][14]. The revised Basel Statements on the Future of Hospital Pharmacy, published in 2014, emphasized the pharmacists' role in the clinical team, including their influence on prescribing and monitoring of medicines use [15,16].…”