Continuing Professional Development of Physiotherapists - Literature review Example

? The Significance of the New Medicines Service Self-assessment Tool on the Undertaking of Relevant Continuing Professional Development by Community Pharmacists Total Number of Words: 2,527 Abstract The New Medicine Service is a free service offered by the community pharmacists to individuals who are taking medications for specific health conditions related to asthma, COPD, antiplatelet/anticoagulant therapy, hypertension, and type II diabetes. To learn more on how the community pharmacists can take advantage of the New Medicine Service self-assessment tool when offering the New Medicine Service to the public, this study conducted a literature review to explore new ways on how the New Medicines Service self-assessment tool can be utilized for the continuing professional development (CPD) of the community pharmacists. Upon analyzing the significant role of the New Medicine Service self-assessment tool over the continuous professional development of community pharmacists, this study concludes that the New Medicine Service self-assessment tool clearly serves as a useful framework which aims to guide the community pharmacists on what they should know in order to effectively deliver the New Medicine Service to the public. In the absence of the New Medicine Service self-assessment tool, it would be very difficult to point out the specific topic that each of the community pharmacists should be familiar with in order to provide the New Medicine Service to the public. Introduction Commenced on the 1st of October 2011, the New Medicine Service is considered the 4th advanced service which was added in the NHS community pharmacy contract (PSNC 2012a). PSNC reported that “between 30% and 50% of the prescribed medicines are not taken as recommended” (PSNC 2012c, d). To avoid wasting medicines, the NHS implements the provision of free service called the New Medicine Service: which will be offered by the local pharmacists to help patients understand their health condition and learn more about how they can benefit from the new medicine. By gaining access to higher health education and/or continuous training and development programmes, community pharmacists are expected to continuously improve their existing knowledge and skills. Considering the long-term goal of the New Medicine Service, this study aims to conduct literature review in order to determine the impact of the New Medicines Service self-assessment tool on the undertaking of relevant continuing professional development (CPD) among the community pharmacists. Using keywords like CPD, NHS, community pharmacy, and New Medicine Service, online database search engines such as the Cochrane Library, EMBASE, google scholar, and Pubmed were utilized in gathering related literature. Literature Review Definition and Importance of ‘Continuing Professional Development’ Alsop (2000, p. 1) defined CPD as “the term used in denoting the process of ongoing education and development of health care professionals, from initial qualifying education and duration of professional life so as to maintain competence to practice and increase professional proficiency and expertise”. In most cases, a formal curriculum is created to assist the students in developing their core competencies (Lo and Field 2009, p. 122). A formal learning takes place each time a community pharmacist enrol himself/herself in formal education courses, meetings, symposia, rounds, and/or attend professional-related conferences (Gunn and Goding 2009; Davis et al. 1999). On the other hand, informal learning takes place each time a community pharmacist open a two-way communication with other allied healthcare professionals. Regardless of whether or not a licensed community pharmacist prefer to take a formal or informal learning, the two definitions presented earlier made it clear that CPD is all about the importance of pursuing continuous learning in order to increase the professional competency of each community pharmacist. Kostrzewski, Dhillon, Goodsman et al. (2009a) mentioned that the personality traits of the hospital pharmacists had a significant impact on whether or not these professionals would keep a CPD portfolio. Even though Kostrzewski, Dhillon, Goodsman et al. (2009b) revealed that the process of developing a portfolio of CPD does not have any significant impact over the professional practice of the pharmacists within the hospital setting, several studies acknowledges a significant increase in the learning experience of community pharmacists when undergoing a continuous professional development programme (Adepu and Shariff 2010; Leikola et al. 2009). To increase the success rate of a continuous professional development programme, Tofade et al. (2010) revealed that the provision of a combined 2-hour self-study and 3-hour live interactive programme is more than enough to effectively train the professionals. Significance of the New Medicines Service Self-assessment Tool over the Professional Growth of our Local Community Pharmacists To ensure that the local community pharmacists in UK are ready to perform their duties and responsibilities when delivering the New Medicine Service, a self-assessment form was designed as a framework that can assure the pharmacists, their employer(s), and the NHS about their ability to deliver the New Medicine Service to the public (PSNC 2012b). Before delivering the New Medicine Service to the patients, the NHS does not literally require community pharmacists to undergo training. However, it is important that each one of them has sufficient knowledge and skills about this particular service (PSNC 2012d). Publicly introduced back in 2005, the Medicines Use Review (MUR) is the first advance community pharmacy service which was purposely developed to promote the importance of patient empowerment particularly among those individuals who are taking multiple medicines (van Den Berg and Donyai 2010; Latif and Boardman 2008). Even though community pharmacists are required by the NHS to provide MUR service among the patients who are currently on multiple medicines, Latif and Boardman (2008) revealed that 27% of the 167 research survey respondents did not exert an effort to perform the MURs in the past and that only 43% of the total research survey respondents had managed to conduct between 1 to 14 MURs. The provision of MUR consultation is expected to broaden the role of community pharmacists in terms of delivering valuable service to the patients. However, the implementation of MURs was a failure in terms of increasing the patients’ knowledge with regards to the proper use of their prescribed medicines (Latif, Pollock and Boardman 2011). In line with this, several studies identified time constraints due to workload and situational pressure such as the absence of suitable consultation area for MUR consultation to be common factors that could impede the ability of the community pharmacists to perform MURs (Latif, Pollock and Boardman 2011; Latif and Boardman 2008). Aside from the fact that the type of ownership of each pharmacy could affect the provision of MUR services (Bradley et al. 2008), van Den Berg and Donyai (2010) revealed that most of the community pharmacists do not have the required knowledge and skills needed to effectively promote patient empowerment. Through continuous professional development programme, the New Medicines Service self-assessment tool can be use as a template when promoting the professional growth of each community pharmacist. Since the NHS has strictly implemented the delivery of MUR services whenever a community pharmacist encounter patients who are taking multiple medications, the first question under the self-assessment tool purposely ask the question whether or not the community pharmacist is accredited to provide MUR services (PSNC 2012b). Basically, this question encourages the community pharmacists to increase their knowledge and improve necessary skills that will enable them provide outstanding MUR services to the patients. The provision of New Medicines Service focuses on specific health conditions related to asthma, COPD, antiplatelet/anticoagulant therapy, hypertension, and type II diabetes (Royal Pharmaceutical Society 2012). In case a patient has at least one of these identified health condition, community pharmacists are encouraged to interact with the patients concerning the potency and usage of each prescribed drug(s) and allows the patients to personally engage themselves when making important decision about their preferred self-management and treatment (PSNC 2012a). For this reason, the second and third question presented on the self-assessment tool purposely ask the question whether or not the community pharmacist has fully understand the main purpose and background of the service (PSNC 2012b). Quality, Innovation, Productivity, and Prevention (QIPP) is a programme under the NHS which will improve the quality of care given to the patients (NHS Employers, 2012). Basically, the main objective of implementing QIPP is to maximize the value of investment spent on the improvements in healthcare services (Department of Health, 2012). By asking the question whether or not the community pharmacist has fully understand the main purpose and background of the service (PSNC 2012b), the community pharmacists are encouraged to reflect upon their role and knowledge with regards to the existing government policies such as how to achieve the NHS’ QIPP objectives (Carroll, Hewitson and Carroll 2012). The third question aims to determine whether or not the community pharmacists fully understand the aims and intended outcomes of the service (PSNC 2012b). As mentioned earlier, the main purpose of implementing the New Medicine Service is not only focused on reducing medicine wastage but also improve adherence to medicine, increase patient engagement with their treatment, reduce the risk of hospital admissions, promote the practice of reporting the adverse effects of new medicine, maintain a positive patient assessment practices, ensure the effectiveness of the service, and develop possible outcome and quality measures for community pharmacy (PSNC 2012a; Royal Pharmaceutical Society 2012). By asking the question whether or not the community pharmacist has fully understand the aims and intended outcomes of the service (PSNC 2012b), community pharmacists are encouraged to reflect upon their knowledge concerning the main purpose and its intended outcomes. The fourth question aims to ensure that the community pharmacists have knows how to effectively deliver the service (PSNC 2012b). Aside from requiring the community pharmacists to recruit patient(s) who are qualified to receive the service, this group of professionals are also expected to know when and how to offer health teachings related to healthy lifestyle, encouraging the patients to register for the service, obtain signed patient consent before undertaking interventions such as giving information about the new medicine, conducting a telephone or one-on-one appointment between 7 to 14 days after the patient received the medicine, setting an interview schedule with regards to patients’ concern about the new medicine, arranging a follow-up appointment, giving follow-up support between 14 to 21 days after the first meeting, provide necessary referral to GPs, and submitting a quarterly report to the PCTs (PSNC 2012a, b, c). Basically, asking the question whether or not the community pharmacists fully understand the service and how to provide it is only one way of determining whether or not this group of professionals is familiar with the service specifications. To effectively provide the service, the last question which can be found in the New Medicine Service self-assessment form aims to determine whether or not the community pharmacist has gained an effective communication skill that is required when dealing with the pharmacy staff, patients, and other local healthcare providers (PSNC 2012b). To ensure that each patient is able to receive good quality educational support directly from the community pharmacists, the study of Shah and Chewning (2006) highlighted the importance of being able to develop a two-way communication process between the pharmacists and the patients. Because of the importance of establishing a two-way communication with the patients, each of the community pharmacists is required to improve their communication skills. In general, the way the community pharmacists are able to verbally express their thoughts have a significant impact over the success of the service. Aside from communicating the main purpose of the New Medicine Service to the patients, each of the community pharmacists who are representing a pharmacy contractor is required to communicate with the local GPs with regards to the cases of each patient (PSNC 2012b). By improving one’s own communication skill, each of the community pharmacists will not encounter difficulty when dealing with other healthcare professional(s) and/or in case there is a need to set an interview schedule with the patients. Conclusion and Recommendations The New Medicine Service is unique in the sense that community pharmacists are required to clearly explain the main purpose of the service and recruit patients to the accept the service. In line with this, the Centre for Pharmacy Postgraduate Education (CPPE) has published e-learning materials which include the discussion of guidelines on how to improve the knowledge and skills of each licensed pharmacist and a comprehensive review about the New Medicine Service (CPPE 2011). Using a patient-centred approach, the main purpose of publishing the e-learning materials is to enable the local pharmacists, pharmacy technicians and the pre-registration trainees learn new ways on how they can be able to effectively deliver the New Medicine Service to each patient. After analyzing the significant role of the New Medicine Service self-assessment tool over the continuous professional development of community pharmacists, this study concludes that the New Medicine Service self-assessment tool clearly serves as a useful framework which aims to guide the community pharmacists on what they should know in order to effectively deliver the New Medicine Service to the public. Regardless of whether or not the community pharmacists decided to take a formal or informal learning intervention, the main purpose of going through a CPD programme is to ensure that the knowledge and skills of each community pharmacist is constantly updated. In the absence of the New Medicine Service self-assessment tool, it would be very difficult to point out the specific topic that each of the community pharmacists should be familiar with in order to provide the New Medicine Service to the public. Even though the provision of continuous professional development programme could effectively increase the pharmacists’ knowledge and skills when providing the New Medicine Service to the patients with either one or more of the following health conditions (i.e. asthma, COPD, antiplatelet/anticoagulant therapy, hypertension, and type II diabetes), the individual point-of-views and attitude of the community pharmacists with regards to the provision of this service could significantly affect its success or failure. Given that community pharmacists is in need of a strong support and ready access to a wide-range of learning resources (Power et al. 2011), the NHS should consider the New Medicines Service self-assessment tool should be considered as the basic foundation or guideline when it comes to enhancing the professional growth and competency of our local community pharmacists. Effective communication skill is the key behind the success of the New Medicine Service. To solve problems collaboratively or develop interpersonal relationship with the patients, this study highly recommends the need to establish two-way communication between the pharmacists and the patients. Since the MUR’s requirement to deliver healthcare education overshadow the pharmacists’ intention to promote patient empowerment, this study strongly recommends the need to promote interpersonal relationship among the community pharmacists and the patients. By strengthening the interpersonal relationship between the community pharmacists and the patients, the NHS can have a better chance of eradicating the one-way communication line between these two groups. In general, barriers to a successful continuous professional development programme includes not only time constraints but also financial difficulty to gain access to formal continuing education, availability of useful resources, beliefs, attitude and interests on the importance of continuous professional development, and the facilitation and support for continuous professional development (Donyai et al. 2011). For this reason, this study strongly recommend the need to develop not only a positive attitude towards continuous professional development programme but also the need to establish a strong regulatory board that can effectively eradicate the identified barriers to a successful continuous professional development programme. References Adepu, R. and Shariff, A. (2010). Development, validation and implementation of continuous professional development programmes for community pharmacists. Indian Journal of Pharmceutical Sciences 72(5), pp. 557-563. Alsop, A. (2000). Continuing Professional Development: A Guide for Therapists. Blackwell Science. Bradley, F., Wagner, A., Elvey, R., Noyce, P. and Ashcroft, D. (2008). Determinants of the uptake of medicines use reviews (MURs) by community pharmacies in England: a multi-method study. Health Policy 88(2-3), pp. 258-268. Carroll, R., Hewitson, M. and Carroll, S. (2012). NHS North West. Bow Group Report: Delivering Enhanced Pharmacy Services in a Modern NHS: Improving Outcomes in Public Health and Long-Term Conditions. [Online] Available at: http://www.pharmacyworkforcenw.nhs.uk/?page=1362 [Accessed 12 April 2012]. CPPE (2011, September). New Medicine Service - An e-learning programme for pharmacists and pharmacy technicians. [Online] Available at: http://www.cppe.ac.uk/e-learning/newMedicineService/flash/index.asp?EL_EID=41117&EventID=41117&Test=1 [Accessed 11 April 2012]. Davis, D., O'Brien, M., Freemantle, N., Wolf, F., Mazmanian, P. and Taylor-Vaisey, A. (1999). 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The extent and characteristics of United Kingdom hospital pharmacists keeping, or not keeping, a professional development portfolio. International Journal of Pharmacy Practice 17(5), pp. 299-304. Kostrzewski, A., Dhillon, S., Goodsman, D. et al. (2009b). The influence of continuing professional development portfolio records on pharmacy practice. International Journal of Pharmacy Practice 17(2), pp. 107-113. Latif, A. and Boardman, H. (2008). Community pharmacists' attitudes towards medicines use reviews and factors affecting the numbers performed. Pharmacy World & Science 30(5), pp. 536-543. Latif, A., Pollock, K. and Boardman, H. (2011). The contribution of the Medicines Use Review (MUR) consultation to counseling practice in community pharmacies. Patient Education and Counseling 83(3), pp. 336-344. Latif, A., Pollock, K. and Boardman, H. (2011). The contribution of the Medicines Use Review (MUR) consultation to counseling practice in community pharmacies. Patient Education & Counseling 83(3), pp. 336-344. Leikola, S., Tuomainen, L., Ovaskainen, H., Peura, S., Secon-Vilkman, N., Tanskanen, P. et al. (2009). Continuing Education Course to Attain Collaborative Comprehensive Medication Review Competencies. American Journal of Pharmaceutical Education 73(6), pp. 108-116. Lo, B. and Field, M. (2009). Institute of Medicine of the National Academes. Conflict of interest in medical research, education, and practice. [Online] Available at: http://www.ncbi.nlm.nih.gov/books/NBK22942/pdf/TOC.pdf [Accessed 10 April 2012]. NHS Employers (2012). QIPP and workforce productivity. [Online] Available at: http://www.nhsemployers.org/PlanningYourWorkforce/WorkforceProductivity/Pages/QIPPandWorkforceProductivity.aspx [Accessed 12 April 2012]. Power, A., Grammatiki, A., Bates, I., McKellar, S., Johnson, B., Diack, H. et al. (2011). Factors affecting the views and attitudes of Scottish pharmacists to continuing professional development. International Journal of Pharmacy Practice 19(6), pp. 424-430. PSNC (2012a). NMS. [Online] Available at: http://www.psnc.org.uk/pages/nms.html [Accessed 10 April 2012]. PSNC (2012b). New Medicine Service - self-assessment of readiness for community pharmacists. [Online] Available at: http://www.psnc.org.uk/data/files/PharmacyContract/Contract_changes_2011/NMS_pharmacist_self-assessment_form__final_.pdf [Accessed 10 April 2012]. PSNC (2012c). New Medicine Service: helping you with your new medicine. [Online] Available at: http://www.psnc.org.uk/data/files/PharmacyContract/Contract_changes_2011/NMS_patient_leaflet_with_HoC_logo_for_website.pdf [Accessed 11 April 2012]. PSNC (2012d). NHS Community Pharmacy Contractual Framework: The New Medicine Service (NMS). [Online] Available at: http://www.psnc.org.uk/data/files/PharmacyContract/Contract_changes_2011/PSNC_NMS_presentation_Nov_2011_for_website.pdf [Accessed 11 April 2012]. Royal Pharmaceutical Society (2012). Support for New Medicine Service. [Online] Available at: http://www.rpharms.com/nhs-community-pharmacy-contract-england/new-medicine-service.asp [Accessed 10 April 2012]. Shah, B. and Chewning, B. (2006). Conceptualizing and measuring pharmacist-patient communication: a review of published studies. Research in Social & Administrative Pharmacy 2(2), pp. 153-185. Tofade, T., Foushee, L., Chou, S., Eckel, S. and Caiola, S. (2010). Evaluation of a condensed training program to introduce the process of continuing professional development. Journal of Pharmcy Practice 23(6), pp. 560-569. van Den Berg, M. and Donyai, P. (2010). How was patient empowerment portrayed in information leaflets describing the community pharmacy Medicines Use Review service in the UK? Patient Education and Counseling 80(2), pp. 274-276. Read More

 

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