RESEARCH ARTICLE: An assessment of oncology pharmacy educational needs among community pharmacists in Zimbabwe
DOI:
https://doi.org/10.46542/pe.2021.211.546554Keywords:
Advanced practice, Continuous professional development, Oncology pharmacy, Pharmacy educationAbstract
Background: Oncology pharmacy is a specialty that is central to provision and use of anti-cancer medications. In Zimbabwe, pharmacists rely on a Bachelor of Pharmacy degree (B.Pharm.) and in-house training in the provision of oncology services. This study sought to assess knowledge, perceptions, current practices and prior education in oncology pharmacy among community pharmacists.
Methods: A cross-sectional survey was carried out among pharmacists working in community pharmacies in Harare.
Results: A response rate of 93.0% was achieved. The mean knowledge score was 4.0%. Up to 96.8% of pharmacists thought that prior training in oncology was inadequate. Only ten pharmacists in the sample actually dispensed chemotherapy regularly. Of these, none comprehensive measures for the safe handling of hazardous drugs.
Conclusion: A B.Pharm. degree does not provide pharmacists with adequate scientific knowledge and competencies required for the provision of oncology pharmacy services. Structured educational programmes for pharmacists in oncology should be implemented.
References
ASHP. (2006). ASHP Guidelines on handling of hazardous drugs. American Journal of Health System Pharmacy, 63, 1172–1193.
Babar, Z., & Scahill, S. (2014). Barriers to effective pharmacy practice in low- and middle-income countries. Integrated Pharmacy Research and Practice, 25. https://doi.org/10.2147/IPRP.S35379
Bloom, B.S. (1956). Taxonomy of educational objectives: The classification of educational goals Handbook I, Handbook I,. McKay ; Longman.
Boiano, J.M., Steege, A.L., & Sweeney, M.H. (2014). Adherence to safe handling guidelines by health care workers who administer antineoplastic drugs. Journal of Occupational and Environmental Hygiene, 11(11), 728–740. PubMed. https://doi.org/10.1080/15459624.2014.916809
Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R.L., Torre, L.A., & Jemal, A. (2018). Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, 68(6), 394–424. https://doi.org/10.3322/caac.21492
Burgaz, S., Karahalil, B., Canli, Z., Terzioglu, F., Ançel, G., Anzion, R.B., Bos, R.P., & Hüttner, E. (2002). Assessment of genotoxic damage in nurses occupationally exposed to antineoplastics by the analysis of chromosomal aberrations. Human & Experimental Toxicology, 21(3), 129–135. https://doi.org/10.1191/0960327102ht230oa
Casper, C. (2011). The Increasing Burden of HIV-Associated Malignancies in Resource-Limited Regions. Annual Review of Medicine, 62(1), 157–170. https://doi.org/10.1146/annurev-med-050409-103711
Chinula, L., Moses, A., & Gopal, S. (2017). HIV-associated malignancies in sub-Saharan Africa: progress, challenges, and opportunities. Current opinion in HIV and AIDS, 12(1), 89–95. https://doi.org/10.1097/COH.0000000000000329
da Conceição, A.V., Bernardo, D., Lopes, L.V., Miguel, F., Bessa, F., Monteiro, F., Santos, C., Oliveira, B., & Santos, L.L. (2015). Oncology pharmacy units: A safety policy for handling hazardous drugs and related waste in low- and middle-income African countries-Angolan experience. Ecancermedicalscience, 9, 575–575. PubMed. https://doi.org/10.3332/ecancer.2015.575
Dreyfus, S.E., & Dreyfus, H. (1980). A Five-Stage Model of the Mental Activities Involved in Directed Skill Acquisition. Distribution, 22.
FIP (International Pharmaceutical Federation) (2015). Advanced Practice and Specialisation in Pharmacy: Global Report (online). International Pharmaceutical Federation. Available from: https://www.fip.org/file/1397
Fjortoft, N. (2007). The effectiveness of commitment to change statements on improving practice behaviors following continuing pharmacy education. American Journal of Pharmaceutical Education, 71(6), 112. https://doi.org/10.5688/aj7106112
HOPA (Hematology/ Oncology Pharmacy Association). (2019). Further defining the scope of haematology/ oncology pharmacy practice (online). HOPA. Available from: http://www.hoparx.org/images/hopa/resource-library/guidelines-standards/HOPA18_Scope-2_Web2.pdf
International Pharmaceutical Federation. (2014). Continuing Professional Development/Continuing Education in Pharmacy: Global Report (online). International Pharmaceutical Federation (FIP). Available from: https://www.fip.org/file/1407
Jemal, A., Bray, F., Forman, D., O’Brien, M., Ferlay, J., Center, M., & Parkin, D.M. (2012). Cancer burden in Africa and opportunities for prevention: Cancer in Africa. Cancer, 118(18), 4372–4384. https://doi.org/10.1002/cncr.27410
Ishikawa, K., Katz, M., & Hill-Besinque, K. (2010). Graduate programs in advanced pharmacy practice in oncology in Japan. American Journal of Pharmaceutical Education, 74(6), Article 111.
Katajavuori, N., Lindblom-Ylänne, S., & Hirvonen, J. (2006). The Significance of Practical Training in Linking Theoretical Studies with Practice. Higher Education, 51(3), 439–464. https://doi.org/10.1007/s10734-004-6391-8
LeBlanc, T.W., McNeil, M.J., Kamal, A.H., Currow, D.C., & Abernethy, A.P. (2015). Polypharmacy in patients with advanced cancer and the role of medication discontinuation. The Lancet Oncology, 16(7), e333–e341. https://doi.org/10.1016/S1470-2045(15)00080-7
Falck, K., Gröhn, P., Sorsa, M., Vainio, H., Heinonen, E., & Holsti, L.R. (1979). Mutagenicity in urine of nurses handling cytostatic drugs. Lancet (London, England), 1(8128), 1250–1251. https://doi.org/10.1016/s0140-6736(79)91939-1
Ministry of Health and Child Care. (2015). National cancer prevention and control strategy for Zimbabwe. www.cancerzimbabwe.org
MoHCC Zimbabwe. (2015). Ministry of Health and Child Care: National Cance Prevention and Control Strategy for Zimbabwe 2014-2018. MoHCC.
Motycka, C.A., Rose, R.L., Ried, L.D., & Brazeau, G. (2010). Self-assessment in pharmacy and health science education and professional practice. American Journal of Pharmaceutical Education, 74(5).
Nguyen, T.V., Theiss, J.C., & Matney, T.S. (1982). Exposure of Pharmacy Personnel to Mutagenic Antineoplastic Drugs. Cancer Research, 42, 4792–4796.
Stull, D.M., Iannucci, A., & Bertin, R.J. (2006). Board-certified oncology pharmacists: Partners in multidisciplinary care of cancer patients. Community Oncology, 3, 284–286.
Schlösser, T., Dunning, D., Johnson, K.L., & Kruger, J. (2013). How unaware are the unskilled? Empirical tests of the “signal extraction” counterexplanation for the Dunning–Kruger effect in self-evaluation of performance. Journal of Economic Psychology, 39, 85–100. https://doi.org/10.1016/j.joep.2013.07.004
Smith, F. (2009). The quality of private pharmacy services in low and middle-income countries: A systematic review. Pharmacy World & Science, 31(3), 351–361. https://doi.org/10.1007/s11096-009-9294-z
Steuber, T.D., Janzen, K.M., Walton, A.M., & Nisly, S.A. (2017). Assessment of Learner Metacognition in a Professional Pharmacy Elective Course. American Journal of Pharmaceutical Education, 81(10), 6034. https://doi.org/10.5688/ajpe6034
Strother, R.M., Rao, K.V., Gregory, K.M., Jakait, B., Busakhala, N., Schellhase, E., Pastakia, S., Krzyzanowska, M., & Loehrer, P.J. (2012). The oncology pharmacy in cancer care delivery in a resource-constrained setting in western Kenya. Journal of Oncology Pharmacy Practice, 18(4), 406–416. https://doi.org/10.1177/1078155211434852
USP 800 | USP. (2019). Available from: https://www.usp.org/compounding/general-chapter-hazardous-drugs-handling-healthcare
WHO (World Health Organisation) (1995). National Cancer Control Programmes: Policies and material guidelines.
WHO Action Programme on Essential Drugs. (1998). Revision of undergraduate pharmacy curricula: Report on an informal consultation in Nyanga, Zimbabwe, 18-20 April 1997. WHO/DAP/98.1. WHO IRIS. https://apps.who.int/iris/handle/10665/63940
World Health Organization. (2002). Harmonization of undergraduate pharmacy curricula in southern and eastern Africa: Future trends: Report of a workshop in Kariba, Zimbabwe 8-11 April 2001. WHO/EDM/PAR/2002.4. WHO IRIS. https://apps.who.int/iris/handle/10665/67717
ZNCR, M. (2016). Zimbabwe National Registry Cancer Regisry: 2016 Annual Report. ZNCR.