Development, implementation and evaluation of the instruments for pharmacists' competency assessment in community pharmacies in Serbia

Zdravstvene profesije kao što je farmaceutska, zbog moralnih načela kojima se rukovode i zbog odgovornosti za ljudsko zdravlje i život, posebno su posvećene kvalitetu i visokim standardima u svom radu. Obezebeđivanje kvaliteta usluge i visoki standardi profesionalnog odnosa prema pacijentu, zajednički su interes stručanjaka, pacijenata, kao i regulatornih stručnih tela. Za obezbeđenje kvaliteta zdravstvene zaštite i postizanje odgovarajućih standarda, jedan od neophodnih faktora je korpus znanja, veština i stavova koji će omogućiti donošenje odgovarajućih odluka u interesu pacijenata. U uslovima stalnih promena, koje su bile najintenzivnije u drugoj polovini dvadesetog veka, vezanih za nove zdravstvene potrebe, pojavu novih zdravstvenih tehnologija, zahteve opšte i stručne javnosti, razvoja i primene informacionih tehnologija, stručnjaci iz oblasti zdravstva i obrazovanja tragali su za modelima koji će omogućiti ispunjavanje potreba svih relevantnih činilaca. Tradicionalni sistem obrazovanja farmaceuta nije dao očekivane rezulatate. Neprilagođeni obrazovni sadržaji, neodgovarajuća praksa i loši rezultati, izazivali su nezadovoljstvo i brigu stručne i šire javnosti, što je rezultovalo zaokretom u vidu reforme, kada je nastao sistem obrazovanja zasnovan na kompetencijama. Pored toga, krajem dvadesetog veka oblikovan je i novi koncept farmaceutske prakse, u kojoj farmaceut odgovorno pruža sigurnu i racionalnu terapiju pacijentu, u čijem se fokusu nalazi pacijent, odnosno, njegove potrebe: farmaceutska zdravstvena zaštita (farmaceutska nega). Prema Hepleru i Strandu, reč je o profesionalnoj delatnosti u kojoj farmaceut preuzima odgovornost za pozitivan ishod terapije. Stoga je od izuzetne važnosti da farmaceuti poseduju znanja, veštine i sposobnosti za pružanje odgovarajućih usluga, kao i stavove za njihovo usvajanje u svakodnevnom radu. Dinamički okvir koji obuhvata ove činioce, nazivamo okvir kompetencija farmaceuta. U poslednjoj deceniji XX veka, kompetencije farmaceuta predstavljaju centralnu temu zdravstvenih organizacija i asocijacija (FIP, WHO, UNESCO), koje sinergistički rade na generisanju modela i instrumenata za razvoj i procenu kompetencija...Health professions, such as pharmaceutics, are especially dedicated to quality and high standards in their work due to moral principles that serve as a guide, and responsibility towards human health and life. Providing quality service and high standards in professional relations towards the patients are a common interest of experts and patients, as well as regulatory bodies. In order to provide quality healthcare and achieve adequate standards, one of the necessary factors is knowledge, skills and attitude corpus, which would lead to making adequate decisions in patients' best interest. In the conditions of constant changes, which were most intensive in the second half of the twentieth century, regarding recent healthcare needs, appearance of new healthcare technologies, general and expert public demands, development and implementation of information technologies, the experts from the fields of healthcare and education have been searching for models which will provide fulfilment of needs of all relevant factors. Traditional pharmaceutical education system did not yield expected results. Maladjusted education content, unsuitable practice and poor results have caused dissatisfaction and concern among expert and general public, which resulted in change through reform, leading to an education system based on competency. Aside from this, a new concept in pharmaceutical practice was formed in the late twentieth century, in which a pharmacist responsibly provides safe and rational therapy for the patient. The focus of the therapy is the patient, i.e. his/her needs: pharmaceutical healthcare (pharmaceutical care). According to Hepler and Strand, the point in question is professional service in which a pharmacist takes responsibility for the positive outcome of the therapy. For this reason, it is exceptionally important that pharmacists possess knowledge, skills and abilities to provide adequate services, as well as willingness to implement them into everyday practice. Dynamic framework that encompasses all of these factors is called pharmacists' competency framework..

Ocena i samoocena kompetencija farmaceuta u Srbiji korišćenjem globalnog okvira kompetencija

Background/Aim. Pharmacists' competence represents a dynamic framework of knowledge, skills and abilities to carry out tasks, and it reflects on improving the quality of life and on patients' health. One of the documents for the Evaluation and Competency Development of Pharmacists is the Global Competency Framework (GbCF). The aim of this study was to implement the GBCF document into Serbian pharmacies, to perform assessment and self assessment of the competencies. Methods. The assessment and self-assessment of pharmacists' competencies were performed during the period 2012-13 year in eight community pharmacy chains, in seven cities in Serbia. For assessment and self-assessment of pharmacists competencies the GbCF model was applied, which was adjusted to pharmaceutical practice and legislation in Serbia. External assessment was conducted by teams of pharmacists using the structured observation of the work of pharmacists during regular working hours. Evaluated pharmacists filled out the questionnaire about demographic indicators about the pharmacist and the pharmacy where they work. Results. A total of 123 pharmacists were evaluated. Pharmacists' Professional Competency Cluster (KK1) had the lowest score (average value 2.98), while the cluster Management and Organizational Competency (KK2) had the highest score (average value 3.15). The competence Recognition of the Diagnosis and Patient Counseling (K8), which belonged to the cluster KK1, had the lowest score (average value for assessment and self-assessment were 2.09, and 2.34, respectively) among the all evaluated competencies. Conclusion. GbCF might be considered as an instrument for the competencies' evaluation/self-evaluation and their improvement, accordingly.Uvod/Cilj. Kompetencije farmaceuta predstavljaju dinamični okvir i obuhvataju znanja, veštine i sposobnosti da se izvrše zadaci sa ciljem unapređenja kvaliteta života i zdravlja bolesnika. Jedan od dokumenata za ocenu i razvoj kompetencija farmaceuta je globalni okvir stručnosti - Global Competence Framework (GbCF). Cilj ovog rada bio je primena GbCF u apotekama u Srbiji i ocena i samoocena kompetencije farmaceuta. Metode. U periodu 2012-2013. godine izvršena je ocena i samoocena kompetencije farmaceuta u osam apotekarskih lanaca iz sedam gradova u Srbiji. Za ocenu i samoocenu stručnosti farmaceuta primenjen je model GbCF, prilagođen praksi i zakonodavstvu u Srbiji. Eksternu ocenu izvršili su timovi farmaceuta kroz strukturiranu opservaciju (upotrebom GbCF dokumenta) kompetencija farmaceuta tokom radnog vremena. Ocenjivani farmaceuti su popunili i upitnik o demografskim pokazateljima koji su se odnosili na podatke o samom farmaceutu i apoteci u kojoj radi. Rezultati. Ocenjena su ukupno 123 farmaceuta. Najviša ocena kompetencija farmaceuta zabeležena je za skup 'Upravljanje i organizacija' (KK2) (srednja vrednost 3,15), dok je skup 'Stručno znanje' (KK1) (srednja vrednost 2,98) ocenjen najnižom ocenom. Kompetencija K8 - 'Prepoznavanje dijagnoze i savetovanje bolesnika', koje pripadaju skupu KK1, imale su najniži skor (srednja vrednost u proceni i samoproceni iznosila je 2,09 i 2,34, respektivno) posmatrajući sve, kompetencije. Zaključak. Dokument za ocenu i razvoj kompetencija farmaceuta GbCF može služiti kao instrument za ocenu/samoocenu kompetencije, a samim tim i za njihovo poboljšanje

Continuing professional development - challenge for professional organization

Professions, as one of key sectors of social systems, bear a leading role in the existing social work organization. Free professions take up a special place and significance, all the way from Roman artes liberales to our times. Pharmaceutical profession, as one of the oldest, led by ethical principles, is regulated by postulates accepted by the profession members, and in modern times established through legislations. Typical determinants of the regulated professions, which also refer to pharmacists, as chamber members, are as follows: following ethical principles, specific skills and knowledge, professional development, autonomy at work, continuing improvement, competencies development, professional associations, licensing

Analiza, adaptacija i validacija dokumenta za procenu kompetencija farmaceuta

The competency of a pharmacist is one of the fundamental preconditions for high quality pharmaceutical care provision. The General Lever Framework (GLF), which was developed by a group of British experts (Competency Development and Evaluation Group - CoDEG), represents a tool that allows definition, measurement and professional competences development of the pharmacist during pharmaceutical care provision. Community Pharmacy Subotica organized an expert panel in order to analyze, adapt and validate the GLF document, which would be relevant to pharmacy practice in Serbia. The aim of the paper is to present the adaptation process of the GLF document that could be used in community pharmacies in Serbia. Validation of the document was performed using the expert panel methodology. The document was analyzed in terms of relevance, comprehension, compliance with national regulation, and applicability in practice, through anonymous evaluation and discussion of the expert panel participants. Titles and descriptions of each competence (26 in total) were validated. The document for the competence assessment was adapted in accordance with the pharmacy practice and regulations in Serbia. All the competencies of the original document were accepted, with minor modifications in order to accommodate pharmaceutical practices and regulations in Serbia. GLF document, have shown satisfactory properties to be used in the pharmacy practice in Serbia, based on the adaptation carried out by the expert panel.Kompetentnost farmaceuta jedan je od osnovnih preduslova za obezbeđivanje farmaceutske zaštite visokog kvaliteta. Okvir opšteg nivoa (eng. General Level Framework - GLF) koji je razvila grupa britanskih stručnjaka (eng. Competency Development and Evaluation Group - CoDEG) obuhvata odgovarajući upitnik i metode koje omogućavaju definisanje, procenu i razvoj stručne osposobljenosti farmaceuta u pružanju farmaceutske zdravstvene zaštite. U okviru Apoteke Subotica je iniciran i organizovan panel eksperata radi analize, adaptacije i validacije GLF dokumenta za primenu u javnim apotekama u Srbiji. U radu je dat prikaz adaptacije GLF dokumenta za primenu u javnim apotekama u Srbiji. Dokument je analiziran sa aspekta relevantnosti, razumljivosti, nacionalne regulative i primenljivosti u praksi putem anonimnih ocena i diskusije učesnika panela eksperata. Validirani su nazivi i opisi 26 kompetencija farmaceuta identifikovanih u hrvatskoj verziji originalnog dokumenta. Dokument za procenu kompetencija farmaceuta prilagođen je farmaceutskoj praksi i regulativi u Srbiji, pri čemu su, uz odgovarajuće, manje, izmene s ciljem prilagođavanja farmaceutskoj praksi i regulativi u Srbiji, prihvaćene sve kompetencije iz originalnog dokumenta. GLF dokument je, na osnovu adaptacije sprovedene od strane panela eksperata, pokazao zadovoljavajuće karakteristike za primenu u farmaceutskoj praksi u Srbiji

Uticaj pandemije Covid -19 na transformaciju obrazovanja u zdravstvu

Pandemija COVID-19 dovela je do istorijskog preokreta u svim segmentima društva ne ostavljajući po strani obrazovanje. Iako je potreba za celoživotnim obrazovanjem zdravstvenih profesionalaca deo globalnog i trajnog konsenzusa opšte i stručne javnosti, izazovi koje je COVID-19 postavio, proširili su se u organizacijskom, sadržajnom i profesionalnom smislu, postavljajući vremensku dimenziju u prvi plan: suačavanje sa dosada nepoznatim virusom zahteva hitnu reakciju potkrepljenu znanjem i iskustvom. Pandemija je uticala da se primena informacionih tehnologija putem on line nastave pozicionira kao summum bonum za obezbeđivanje kontinuiteta u obrazovanju. Primena digitalnih tehnologija u zdravstvu sa telemedicine i telehealtha proširila se i na obrazovanje zdravstvenih radnika. Digitalno obrazovanje se pokazalo kao dobro privremeno rešenje, a brza i neupitna promena kao prilika da se procene prednosti i mane brojnih modela koje digitalno obrazovanje pruža i razvija. Ključne reči: COVID 19, obrazovanje u zdravstvu, virtuelno obrazovanje, telemedicin

Cultural Adaptation and Examination of Metric Characteristics Shirom-Melamed Burnout Questionnaire (SMBQ) On a Sample of Pharmacists in Serbia

Introduction: Due to the nature of work in pharmacies pharmacists may occur job burnout, which can affect the quality of health services. It is necessary to use validated instruments to test the burnout. One type of instrument is Shirom-Melamed Burnout Questionnaire (SMBQ). Objective: The primary objectives of this work are: cultural adaptation and assessment metric characteristics of SMBQ in a population of pharmacists in Serbia. Alternative objective is evaluate the degree of burnout in the pharmacist population. Methods: For comparison Maslach Burnout Inventory (MBI) was used. All licensed pharmacists have received an email by the Pharmaceutical Chamber of Serbia, with a link for accessing the questionnaires. The questionnaires were completed by 514 pharmacists. Results and Discussion: Professional translators carried out the translation using translation steps like forward translation and backward translation. Were calculated following metric characteristics: alpha - reliability coefficient Cronbach and associates; beta - the reliability of the first principal component; psi 1 - representativeness; h1 - the homogeneity (the average correlation of scale items), extent of curvature, horizontal (Skewness) and vertical (Kurtosis). Correlations between subscales are examined. Latent structure SMBQ (maximumlikelihud extraction) is examined. To select a number of factors, the method of parallel analysis was used. For calculation number of latent factors the Hull method was applied. Concurrent validity was examined by correlating the results of the questionnaire SMBQ and MBI. To confirm a one factor solution of the scale, factor analysis was used. Conclusion: All methods show that it is best to keep only one factor. SMBQ satisfies theoretical statistical criteria of reliability and validity and can be used to estimate job burnout at pharmacist population

Potentially Inappropriate Prescribing in Older Primary Care Patients

Objectives: The aim of the study was to determine the rate of Potentially Inappropriate Medicines (PIM) and Potential Prescription Omissions (PPO) according to Screening Tool of Older Person's potentially inappropriate Prescriptions/Screening Tool to Alert doctors to the Right Treatment (STOPP/START) criteria. Study Design: A cross-sectional survey in community pharmacy. Method: A prospective cross-sectional study was performed, during March-May 2012, in five community pharmacies. Patients aged >= 65 years, who collected one or more prescribed medications, were asked to participate in the study, and an interview was scheduled. Patients were asked to provide their complete medical and biochemical record from their general practitioner. Results: 509 patients, mean age 74.8 +/- 6.5 years, 57.4% female, participated in the study. 164 PIM were identified in 139 patients (27.3%). The most common were: long-term use of long-acting benzodiazepines (20.7%), use of non-steroidal antiinflammatory drugs (NSAID) in patients with moderate-severe hypertension (20.1%), use of theophylline as monotherapy for chronic obstructive pulmonary disease (COPD, 15.9%) and use of aspirin without appropriate indication (15.2%). Patients with more than four prescpritions had a higher risk for PIM (OR 2.85, 95% CI 1.97-4.14, p lt 0.001). There were 439 PPO, identified in 257, (50.5%) patients. Predictors for PPO were older age, presence of diabetes, myocardial infarction, osteoporosis, stroke, COPD and/or angina pectoris. Conclusion: STOPP/START criteria may be useful in identifying inappropriate prescribing and improving the current prescribing practices. Pharmacists should focus more on patients with more than four medications and/or patients with gout or pain accompanied with arterial hypertension because those patient may be at higher risk of PIM. Additionlly, patients older than 74 years with diabetes, osteoporosis, myocardial infarction, stroke, angina pectoris and/or COPD may have an increased risk of PPO

Zašto nam je potrebna baza farmaceuta i podsećanje na opis poslova magistra farmacije?

Exact number of masters of pharmacy, level of their education, and jobs they are engaged in is not known in Serbia. The number of pharmacists employed in health institutions in Serbia is known (data is regularly updated by Pharmaceutical Chamber of Serbia (FCC) because pharmacists must be licensed and registered). According to the FCC, in Serbia, there are 6,814 Masters of Pharmacy licensed to work in healthcare institutions (1). However, their arrangement and number by pharmacy, type and level of services are unknown. Although all health institutions are now obliged to register through Business Registers Agency (2), actual number of pharmacies and number of responsible pharmacists per pharmacy remained invisible. The big question is whether all masters of pharmacy are aware of their legal obligations, responsibilities, and professional opportunities. The number of masters of pharmacy employed in other sectors is completely unknown. There is no register of colleagues with completed health and academic specializations, master and doctoral studies. The legal opportunity to acquire title of subspecialist in pharmacy should be used and enable further training and recognition of work to colleagues who deal with narrowly specialized pharmaceutical jobs. Funds for creating database of pharmacists (who they are, what positions they hold, and what their level of education is) are minimal. It is only necessary to recognize the importance of such database and connect key stakeholders. The intersection of current situation would enable development and improvement of pharmaceutical profession and would be step forward towards modernization of Serbian health care system.U Srbiji nije poznat precizan broj magistara farmacije, stepen njihovog poslediplomskog obrazovanja i radna mesta na kojima su angažovani. Broj farmaceuta zaposlenih u zdravstvenim ustanovama u Srbiji je poznat (podatke redovno ažurira Farmaceutska komora Srbije (FKS), jer farmaceuti moraju imati licencu i moraju biti upisani u FKS). Prema podacima FKS u Srbiji 6.814 magistara farmacije poseduje licencu za rad u zdravstvenim ustanovama (1). Ipak, njihov raspored i broj po apotekama, vrsta i nivoi njihovih usluga su nepoznati. Nakon promene zakonske regulative, sada sve zdavstvene ustanove imaju obavezu da se registruju preko Agencije za privredne registre (2), i dalje je ostao nevidljiv stvaran broj apoteka i odgovornih farmaceuta po svakoj apoteci. Veliko je pitanje i da li su svi magistri farmacije svesni svojih zakonskih obaveza, odgovornosti i profesionalnih mogućnosti. Broj magistara farmacije zaposlenih u ostalim sektorima je potpuno nepoznat. Ne postoji ni registar kolega sa završenim zdravstvenim i akademskim specijalizacijama, magistarskim i doktorskim studijama. Zakonsku mogućnost za sticanje zvanja subspecijalista u farmaciji treba iskoristiti i omogućiti dalje usavršavanje i priznavanje rada kolegama koji se bave uskostručnim farmaceutskim poslovima (npr. onkološka farmacija). Sredstva za izradu baze farmaceuta (ko su, na kojim pozicijama rade i kog su nivoa obrazovanja) su minimalna, a ljudski resursi već postoje. Potrebno je samo prepoznati važnost ovakve baze i povezati ključne zainteresovane strane (FKS, Privrednu komoru Srbije, akademiju, Savez farmaceutskih udruženja Srbije, farmaceutsku industriju). Presek zatečenog stanja putem baze farmaceuta bi omogućio dalji razvoj i unapređenje farmaceutske struke, i bio bi korak napred ka modernizaciji zdravstvenog sistema Srbije.VIII Kongres farmaceuta Srbije sa međunarodnim učešćem, 12-15.10.2022. Beogra

Razvoj apotekarske delatnosti u srbiji‐ šta nam je potrebno?

This paper presents a set of recommendations that can contribute to the improvement of the pharmacy business. They resulted from a series of professional meetings and a collection of opinions from masters of pharmacy employed in various health care institutions in the Republic of Serbia. The general recommendation would imply strict compliance with existing laws (Law on Medicines and Medical Devices (1), Law on Health Care (2)), but also the adoption of the Law on Pharmacy, following the example of countries with developed pharmacy practice. Individual key provisions that would bring improvement of pharmacy and quality pharmaceutical services to patients in the short term are the mandatory presence of at least one licensed pharmacist during the entire working hours in each pharmacy, as well as compliance and control of prescription and over-the-counter medicines. In the long term, strengthening national regulatory bodies in the field of medicines and medical devices is important for improving the quality, safety, and efficacy of medicines and the issuance and application of therapy. According to all standards, these jobs should be entrusted exclusively to masters of pharmacy, and in certain cases to appropriate pharmacy specialists. Development of specific clinical skills and introduction of additional services, such as vaccination and disposal of pharmaceutical waste, would significantly contribute to resource savings and contribute to the health system.Ovaj rad predstavlja skup preporuka koje mogu doprineti poboljšanju apotekarske delatnosti, a koje su proistekle iz niza stručnih sastanaka i prikupljanja mišljenja od magistara farmacije zaposlenih u različitim zdravstvenim ustanovama u Republici Srbiji. Opšta preporuka bi podrazumevala strogo poštovanje postojećih zakona (Zakona o lekovima i medicinskim sredstavima (1), Zakon o zdravstvenoj zaštiti (2)), ali i donošenje Zakona o apotekarskoj delatnosti, po ugledu na države sa razvijenom apotekarskom praksom. Pojedinačne ključne odredbe koje bi u kratkom vremenskom roku donele unapređenje apotekarske delatnosti i kvalitetne farmaceutske usluge ka pacijentima su obavezno prisustvo najmanje jednog diplomiranog farmaceuta sa licencom tokom celokupnog radnog vremena u svakoj apoteci, kao i poštovanje i kontrola režima izdavanja lekova na recept i lekova bez recepta. Na dugi rok, jačanje nacionalnih regulatornih tela u oblasti lekova i medicinskih sredstava je značajno radi poboljšanja kvaliteta, bezbednosti i efikasnosti lekova i izdavanja i primene terapije. Ovi poslovi bi prema svim standardima morali biti povereni isključivo magistrima farmacije, a u određenim slučajevima i odgovarajućim specijalistima farmacije. Razvoj specifičnih kliničkih veština i uvođenje dodatnih usluga, kao što su npr. vakcinacija i zbrinjavanje farmaceutskog otpada, bi značajno doprineli uštedama resursa i doprineli zdravstvenom sistemu u celini.VIII Kongres farmaceuta Srbije sa međunarodnim učešćem, 12-15.10.2022. Beogra

Pharmaceutical care for people with depression: experiences and challenges

One of the most significant health issues are the disorders of mood because they have a significant effect on the quality of life of the patients, their families, their working and wider social surroundings. According to the World Health Organization (WHO, 1992; WHO, 2001), mood disorders are the fourth cause of morbidity and mortality with a tendency to move to the second place by the 2020. The prediction that there is going to be an increase in the number of ill in the future comes from the facts that the factors of risk, like stress, are in constant rise, that the demographic image (ageing of the population) is changing which has an effect on the rise of comorbidity of these illnesses with the chronic illnesses of the elderly population and that the incidence of genetically predisposed depressions increases etc