Applicability of American College of Clinical Pharmacy (ACCP) competencies to clinical pharmacy practice in Egypt
Background: The American College of Clinical Pharmacy (ACCP) prepared clinical pharmacist competencies that have specific recommendations. Recently, many efforts to advance clinical pharmacy services in Egypt exist. The literature revealed that no country has assessed the extent of applicability of ACCP competencies in its current pharmacy practice setting. Egyptian pharmacists can provide feedback about applicability of such competencies in clinical pharmacy settings in Egypt.
Objective: The objective of this study was to investigate the extent to which ACCP competencies were implemented by Egyptian clinical pharmacists and therefore evaluate development of clinical pharmacy practice in Egypt. The study also investigated factors affecting the applicability of such competencies in the current clinical pharmacy practice setting in Egypt.
Methods: Four hundred and ninety-five randomly selected clinical pharmacists from several hospitals were invited to participate in a cross sectional survey using a self-administered validated questionnaire composed of 31 questions classified into six domains. This questionnaire was designed to determine the pharmacists’ perception about applicability of ACCP competencies to clinical pharmacy practice in Egypt.
Results: The response rate was 64% as 317 out of 495 pharmacists completed the questionnaire. These pharmacists were categorized according to age; gender; qualifications; years of previous work experience, years since BSc. and type of hospitals they are currently working at. Analysis of data revealed the professionalism domain to have the highest percentage of acceptance among pharmacists, while the system-based care & population health domain had the lowest percentage of acceptance. Results also showed that qualifications of participants did not affect their response in three domains; “Direct Patient Care”, “Systems-based Care & Population Health” and “Continuing Professional Development” (p=0.082, 0.081, 0.060), respectively. Nevertheless, qualifications of participants did affect their response in the other three domains; “Pharmacotherapy Knowledge”, “Communication” and “Professionalism” (p<0.05). The age of pharmacists, gender, years of previous work experience, and graduation year did not affect their responses in all six domains. The type of hospital they are currently working at, though, affected their responses where, there was a highly statistically significant increase of the mean score of all domains among participants working at the NGOs/private hospitals compared to governmental hospitals (p<0.001).
Conclusions: Egyptian pharmacists generally apply high percentage of ACCP competencies but the provided clinical pharmacy services need to be improved through applying the standards of best practice.
Francke GN. Evolvement of "clinical pharmacy". Drug Intell Clin Pharm. 1969;3(12):348-354.
Youngken H. The Washington Experiment—Clinical Pharmacy. Am J Pharm Educ.1953;17:64-70.
Patient-Centered Primary Care Collaborative. The patient-centered medical home: integrating comprehensive medication management to optimize patient outcomes. Available at: https://www.pcpcc.org/sites/default/files/media/medmanagement.pdf (accessed Jul 1, 2020).
American College of Clinical Pharmacy. Standards of practice for clinical pharmacists. Pharmacotherapy. 2014;34(8):794-797. https://doi.org/10.1002/phar.1438
Yee GC, Haas CE. Standards of practice for clinical pharmacists: the time has come. Pharmacotherapy. 2014;34(8):769-770. https://doi.org/10.1002/phar.1450
Spady WG. Competency based education: A bandwagon in search of a definition. Educ Res. 1977;6(1):9-14. https://doi.org/10.3102%2F0013189X006001009
Gervais J. The operational definition of competency‐based education. The Journal of Competency‐Based Education. 2016;1(2):98-106. https://doi.org/10.1002/cbe2.1011
Medina MS, Plaza CM, Stowe CD, Robinson ET, DeLander G, Beck DE, Melchert RB, Supernaw RB, Roche VF, Gleason BL, Strong MN, Bain A, Meyer GE, Dong BJ, Rochon J, Johnston P. Center for the Advancement of Pharmacy Education 2013 educational outcomes. Am J Pharm Educ. 2013;77(8):162. https://doi.org/10.5688/ajpe778162
Stupans I, McAllister S, Clifford R, Hughes J, Krass I, March G, Owen S, Woulfe J. Nationwide collaborative development of learning outcomes and exemplar standards for Australian pharmacy programmes. Int J Pharm Pract. 2015;23(4):283-291. https://doi.org/10.1111/ijpp.12163
Atkinson J, De Paepe K, Pozo AS, Rekkas D, Volmer D, Hirvonen J, Bozic B, Skowron A, Mircioiu C, Marcincal A, Koster A, Wilson K, van Schravendijk C. The Second Round of the PHAR-QA Survey of Competences for Pharmacy Practice. Pharmacy (Basel). 2016;4(3):27. https://doi.org/10.3390/pharmacy4030027
Frank JR, Snell LS, Cate OT, Holmboe ES, Carraccio C, Swing SR, Harris P, Glasgow NJ, Campbell C, Dath D, Harden RM, Iobst W, Long DM, Mungroo R, Richardson DL, Sherbino J, Silver I, Taber S, Talbot M, Harris KA. Competency-based medical education: theory to practice. Med Teach. 2010;32(8):638-645. https://doi.org/10.3109/0142159x.2010.501190
Koster A, Schalekamp T, Meijerman I. Implementation of Competency-Based Pharmacy Education (CBPE). Pharmacy (Basel). 2017;5(1):10. Published 2017 Feb 21. https://doi.org/10.3390/pharmacy5010010
McRobbie D, Webb D, Bates I, Wright J, Davies J. Assessment of clinical competence: designing a competence grid for junior pharmacists. Pharm Educ. 2018;1(2):10.
Medina MS. Does Competency-Based Education Have a Role in Academic Pharmacy in the United States?. Pharmacy (Basel). 2017;5(1):13.
Tran TT, El-Ibiary S, Tindula R, Rai N, Nguyen A, Le J. Unique pharmacist competency program at community-based, teaching hospitals. J Hosp Adm. 2013;2(3):119. https://doi.org/10.5430/jha.v2n3p119
Engle JP, et al. ACCP clinical pharmacist competencies: Advocating alignment between student, resident, and practitioner competencies. Journal of the American College of Clinical Pharm. 2020;3(1):124-132. https://doi.org/10.1002/jac5.1200
Murdaugh L, Gomez A. Designing and managing a competence assessment program. Bethesda, MD: Oxford University Press; 2008.
Raichki RS, Nicha V, Panovska TK. [Professional competences, credentialing and continuing professional development in the pharmacy profession]. Skopje: Macedonian Pharmaceutical Society.
American College of Clinical Pharmacy, Burke JM, Miller WA, Spencer AP, Crank CW, Adkins L, Bertch KE, Ragucci DP, Smith WE, Valley AW. Clinical pharmacist competencies. Pharmacotherapy. 2008;28(6):806-815. https://doi.org/10.1592/phco.28.6.806
Saseen JJ, Ripley TL, Bondi D, Burke JM, Cohen LJ, McBane S, McConnell KJ, Sackey B, Sanoski C, Simonyan A, Taylor J, Vande Griend JP. ACCP Clinical Pharmacist Competencies. Pharmacotherapy. 2017;37(5):630-636. https://doi.org/10.1002/phar.1923
Ambrose AJ, Lin SY, Chun MB. Cultural competency training requirements in graduate medical education. J Grad Med Educ. 2013;5(2):227-231. https://doi.org/10.4300/jgme-d-12-00085.1
Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47(3):533-543.
Weiss SL, et al. Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children. Intensive Care Med. 2020;46(Suppl 1):10-67. https://doi.org/10.1007/s00134-019-05878-6
Pierce D, Peyton C. A historical cross-disciplinary perspective on the professional doctorate in occupational therapy. Am J Occup Ther. 1999;53(1):64-71. https://doi.org/10.5014/ajot.53.1.64
Supapaan T, Low BY, Wongpoowarak P, Moolasarn S, Anderson C. A transition from the BPharm to the PharmD degree in five selected countries. Pharm Pract (Granada). 2019;17(3):1611. https://doi.org/10.18549/pharmpract.2019.3.1611
Carter BL. Evolution of Clinical Pharmacy in the USA and Future Directions for Patient Care. Drugs Aging. 2016;33(3):169-177. https://doi.org/10.1007/s40266-016-0349-2
Odegard PS, Tadeg H, Downing D, et al. Strengthening pharmaceutical care education in Ethiopia through instructional collaboration. Am J Pharm Educ. 2011;75(7):134. https://doi.org/10.5688/ajpe757134
Mekonnen AB, Yesuf EA, Odegard PS, Wega SS. Implementing ward based clinical pharmacy services in an Ethiopian University Hospital. Pharm Pract (Granada). 2013;11(1):51-57. https://doi.org/10.4321/s1886-36552013000100009
Auta A, Strickland-Hodge B, Maz J. Challenges to clinical pharmacy practice in Nigerian hospitals: a qualitative exploration of stakeholders' views. J Eval Clin Pract. 2016;22(5):699-706. https://doi.org/10.1111/jep.12520
Mehmood SI, Kumar A, Al-Binali A, Borleffs JC. Specialty preferences: trends and perceptions among Saudi undergraduate medical students. Med Teach. 2012;34 Suppl 1:S51-S60. https://doi.org/10.3109/0142159x.2012.656753
Eltorki Y, Abdallah O, Omar N, Zolezzi M. Perceptions and expectations of health care providers towards clinical pharmacy services in a mental health hospital in Qatar. Asian J Psychiatr. 2019;42:62-66. https://doi.org/10.1016/j.ajp.2019.03.018
Abu-Gharbieh E, Fahmy S, Rasool BA, Abduelkarem A, Basheti I. Attitudes and perceptions of healthcare providers and medical students towards clinical pharmacy services in United Arab Emirates. Trop J Pharm Res. 2010;9(5):61050. https://doi.org/10.4314/tjpr.v9i5.61050
Central Agency for Public Mobilization and Statistics. Homepage. www.capmas.gov.eg/default.aspx (accessed Jul 1, 2020).
Egyptian Pharmacists Syndicate. Homepage. www.eps-egypt.net (accessed Jul 1, 2020).
Abdel-Latif MM, Sabra K. Clinical pharmacy practice in Egyptian hospitals. Am J Health Syst Pharm. 2016;73(1):e63-e66. https://doi.org/10.2146/ajhp150250
El-Awady el-SE, Moss S, Mottram D, O'Donnell J. Student perspectives on pharmacy curriculum and instruction in Egyptian schools. Am J Pharm Educ. 2006;70(1):9. https://doi.org/10.5688/aj700109
Sabry NA, Farid SF. The role of clinical pharmacists as perceived by Egyptian physicians. Int J Pharm Pract. 2014;22(5):354-359. https://doi.org/10.1111/ijpp.12087
El-Anor WM. History of Clinical Pharmacy Practice in Egypt (Part 2). Int J Pharm Teach Pract. 2011;2(2):61-63.
Lambert BL. Face and politeness in pharmacist-physician interaction. Soc Sci Med. 1996;43(8):1189-1198. https://doi.org/10.1016/0277-9536(95)00370-3
Ranelli PL, Biss J. Physicians' perceptions of communication with and responsibilities of pharmacists. J Am Pharm Assoc (Wash). 2000;40(5):625-630. https://doi.org/10.1016/s1086-5802(16)31102-0
Bradshaw SJ, Doucette WR. Community pharmacists as patient advocates: physician attitudes. J Am Pharm Assoc (Wash). 1998;38(5):598-602. https://doi.org/10.1016/s1086-5802(16)30373-4
Nesbit F, Chaplin DC, Edwards JA Jr, Fleming GR, Harker MN, Work DR, Neelon FA. Counseling of patients by pharmacists. Blessing or curse?. N C Med J. 1995;56(2):115-118.
Matowe L, Abahussain EA, Al-Saffar N, Bihzad SM, Al-Foraih A, Al-Kandery AA. Physicians' perceptions and expectations of pharmacists' professional duties in government hospitals in Kuwait. Med Princ Pract. 2006;15(3):185-189. https://doi.org/10.1159/000092179
Fahmy SA, Rasool BK, Abdu S. Health-care professionals' perceptions and expectations of pharmacists' role in the emergency department, United Arab Emirates. East Mediterr Health J. 2013;19(9):794-801.
Francis J, Abraham S. Clinical pharmacists: Bridging the gap between patients and physicians. Saudi Pharm J. 2014;22(6):600-602. https://doi.org/10.1016/j.jsps.2014.02.011
Tahaineh LM, Wazaify M, Albsoul-Younes A, Khader Y, Zaidan M. Perceptions, experiences, and expectations of physicians in hospital settings in Jordan regarding the role of the pharmacist. Res Social Adm Pharm. 2009;5(1):63-70. https://doi.org/10.1016/j.sapharm.2008.05.003
Awad A, Matowe L, Capps P. Medical doctors' perceptions and expectations of the role of hospital pharmacists in Sudan. Pharm World Sci. 2007;29(5):557-564. https://doi.org/10.1007/s11096-007-9111-5
Copyright (c) 2020 Pharmacy Practice and the Authors
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.