Training, clinical medication review performance and self-assessed competence: Investigating influences
Keywords:Clinical therapeutics training, community pharmacy, clinical medication reviews, performance, regression, self-assessed competence
AbstractThe aim of the study was to evaluate the influence of community pharmacists’ training performance on providing clinical medication reviews, and the influence of their training and medication review performances on their self-assessed competence in two Primary Care Trusts (PCT) in England. Data were collected on training and medication reviews, and a postal survey, developed to measure pharmacists’ self-assessed competence, was administered. Simple regression was used to predict medication review performance and multiple regression to predict self-assessed competence. The better the pharmacists’ performance in Pharmaceutical care planning module, the better their performance in suggesting actions to solve drug related problems (DRPs) in medication reviews. In addition, the better the pharmacists’ performance in suggesting actions to solve DRPs, the poorer their self-assessed competence in “delivery of patient care” competency cluster. While the training supported the provision of medication reviews, pharmacists may need more continuous, individual support and feedback to further develop their ability to self-assess competence.
Anderson, C. (1995). A controlled study of the effect of a health promotion training scheme on pharmacists’ advice about smoking cessation. Journal of Social and Administrative Pharmacy, 12, 115–124.
Anonymous (2006). Commissioner’s corner: Medication review in Stockport—the DMART team. Pharmacy Management, 22, 10–15.
Antoniou, S., Webb, D. G., McRobbie, D., Davies, J. G., Wright, J., Quinn, J., & Bates, I. P. (2005). A controlled study of the general level framework: Results of the South of England competency study. Pharmacy Education, 5, 201–207.
Austin, Z., Marini, A., Croteau, D., & Violato, C. (2004). Assessment of pharmacists’ patient care competencies: Validity evidence from Ontario (Canada)’s quality assurance and peer review process. Pharmacy Education, 4, 23–32.
Barnsley, L., Lyon, P. M., Ralston, S. J., Hibbert, E. J., Cunning- ham, I., Gordon, F. C., & Field, M. J. (2004). Clinical skills in junior medical officers: A comparison of self-reported confi- dence and observed competence. Medical Education, 38, 358 – 367.
Benrimoj, S. I., Langford, J. H., Berry, G., Collins, D., Lauchlan, R., Stewart, K., & Ward, P. R. (2003). Clinical intervention rates in community pharmacy: A randomised trial of the effect of education and a professional allowance. International Journal of Pharmacy Practice, 11, 71–80.
Bond, C. M., Grimshaw, J., Taylor, R., & Winfield, A. J. (1998). The evaluation of clinical guidelines to ensure appropriate “over- the-counter” advice in community pharmacies. Journal of Social and Administrative Pharmacy, 15, 33–39.
Department of Health (2001a). Medicines for older people: Implementing medicines-related aspects of the NSF for older people. London: Department of Health Publications.
Department of Health (2001b). Working together–learning together. A framework for lifelong learning for the NHS. London: Department of Health Publications.
Department of Health (2001c). Learning from Bristol: The report of the public inquiry into children’s heart surgery at the Bristol Royal Infirmary 1984–1995 (Report No. CM 5207 (I)). London: HMSO.
Department of Health (2003). A vision for pharmacy in the new NHS. London: Department of Health Publications.
Department of Health (2004). The NHS knowledge and skills framework (NHS KSF) and the development review process. London: Department of Health Publications.
Department of Health (2005a). Implementing the new community pharmacy contractual framework. Information for primary care trusts. London: Department of Health Publications.
Department of Health (2005b). Agenda for change: NHS terms and conditions of service handbook. London: Department of Health Publications.
Department of Health, Pharmaceutical Services Negotiating Committee, and NHS Confederation (2005). NHS community pharmacy contractual framework, Enhanced service—medi- cation review (full clinical review). Pharmaceutical Services Negotiating Committee. Available: http://www.psnc.org.uk/ uploaded_txt/EN7%20-%20Medication%20Review.pdf (accessed 24.4.2007).
Field, A. (2000). Discovering statistics using SPSS for Windows. Trowbridge: Sage Publications.
Glajchen, M., & Bookbinder, M. (2001). Knowledge and perceived competence of home care nurse in pain management: A national survey. Journal of Pain and Symptom Management, 21, 307–316.
Hansford, D., Krska, J., & Gill, D. (2005). Supported training for community pharmacists in medication review: What does it achieve? International Journal of Pharmacy Practice, 13, R44.
Holland, R., Lenaghan, E., Harvey, I., Smith, R., Shepstone, L., Lipp, A., Christou, M., Evans, D., & Hand, C. (2005). Does home based medication review keep older people out of hospital? The HOMER randomised controlled trial. British Medical Journal, 330, 293–295.
James, D., Beaumont, S., Carter, S., & Davies, J. G. (2002). A framework for assessing the continuous professional development needs of community pharmacists. Pharmacy Education, 2, 63–68.
Jansen, J. J. M., Tan, L. H. C., van der Vleuten, C. P. M., van Luijk,
S. J., Rethans, J. J., & Grol, R. P. T. M. (1995). Assessment of competence in technical clinical skills of general practitioners. Medical Education, 29, 247–253.
Kaufman, D. M. (2003). ABC of learning and teaching in medicine: Applying educational theory in practice. British Medical Journal, 326, 213–216.
Krass, I. (1996). A comparison of clients’ experiences of counselling for prescriptions and over-the-counter medications in two types of pharmacies: Validation of a research instrument. Journal of Social and Administrative Pharmacy, 13, 206–214.
Krass, I., & Smith, C. (2000). Impact of medication regimen reviews performed by community pharmacists for ambulatory patients through liaison with general practitioners. International Journal of Pharmacy Practice, 8, 111–120.
Laaksonen, R., Mills, E. R., Duggan, C., Davies, J. G., Bates, I., & Mackie, C. A. (2007a). The effect of training and service provision on the self-assessed competence of community pharmacists. International Journal of Pharmacy Practice, 15, 141 – 147.
Laaksonen, R., Duggan, C., Bates, I., & Mackie, C. (2007b). Performance in clinical therapeutics training of community pharmacists. Pharmacy Education, 7, 167–175.
Latif, D. A., Berger, B. A., Harris, S. G., Barker, K. N., Felkey, B. G., & Pearson, R. E. (1998). The relationship between community pharmacists’ moral reasoning and components of clinical performance. Journal of Social and Administrative Pharmacy, 15, 210–224.
Mackie, C. A., Mohammed, A., Corlett, S., Laaksonen, R., Bates, I., Duggan, C., Morrow, S., Patel, H., & Krishek, B. (2005). A randomised controlled trial of medication review by accredited community pharmacists. International Journal of Pharmacy Practice, 13, R17.
Maclaren, A. G., Mackie, C. A., Lowrie, R., & Tennant, S. (2003). Medication review: Recruitment and accreditation of a cohort of community pharmacists. International Journal of Pharmacy Practice, 11, R7.
Medicines Partnership (2002). Room for review. A guide to medication review: The agenda for patients, practitioners and managers, 1st ed. London: Medicines Partnership. Performance and self-assessed competence 265
Mills, E., Laaksonen, R., Bates, I., Davies, G., & Duggan, C. (2005). Self-assessment of competence in a community pharmacy setting. Pharmacy Education, 3–4, 189–199.
National Institute for Health and Clinical Excellence (2005). Research to explore training programmes in smoking cessation for pharmacists and pharmacy assistants. London: NICE.
Pardo Merino, A. & Ruiz Díaz, M. (2002). SPSS 11 Guía para el análisis de datos. Madrid: McGraw-Hill.
RPSGB (2004). Plan and record continuing professional develop-
ment version 1.1, Royal Pharmaceutical Society of Great Britain [On-line]. Available: http://www.uptodate.org.uk/home/ PlanRecord.htm (accessed 15.6.2004)
Rethans, J. J., Sturmans, F., Drop, R., van der Vleuten, C., & Hobus, P. (1991). Does competence of general practitioners predict their performance? Comparison between examination setting and actual practice. British Medical Journal, 303, 1377 – 1380.
Santoso, B. (1996). Small group intervention vs. formal seminar for improving appropriate drug use. Social Science and Medicine, 42, 1163–1168.
Tracey, J., Arroll, B., Barham, P., & Richmond, D. (1997). The validity of general practitioners’ self assessment of knowl- edge: Cross sectional study. British Medical Journal, 315, 1426 – 1428.
Watson, M., Gunnell, D., Peters, T., Brookes, S., & Sharp, D. (2001). Guidelines and educational outreach visits from community pharmacists to improve prescribing in general practice: A randomised controlled trial. Journal of Health Services Research and Policy, 6, 207–213.
Watson, M. C., Bond, C. M., Grimshaw, J. M., Mollison, J., Ludbrook, A., & Walker, A. E. (2002). Educational strategies to promote evidence-based community pharmacy practice: A cluster randomized controlled trial. Family Practice, 19,
Witt, K., Knudsen, E., Ditlevsen, S., & Hollnagel, H. (2004). Academic detailing has no effect on prescribing of asthma medication in Danish general practice: A 3-year randomized controlled trial with 12 monthly follow-ups. Family Practice, 21, 248–253.