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How to teach patient-oriented pharmacy
Lilian M. Azzopardi
Department of Pharmacy, Faculty of Medicine and Surgery
University of Malta
President, European Association of Faculties of Pharmacy
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• Protection of public safety
• Social accountability
• Mutual recognition for mobility of
professionals
Quality in Pharmacy Education
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3
robust
practical
Maintain
professional
discretion
Validation of Professional
Pharmacy Services
Quality and
safety of
patient care
Azzopardi LM, Salek S, Serracino Inglott A, Zarb Adami M, Buhagiar A.
Validating tools for the monitoring of community pharmacy services. Pharm.
J. 2001; 267: 303-305.
Community Pharmacy
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Hospital Pharmacy
Wirth F, Azzopardi LM, Serracino-Inglott A. Quality management system for clinical
pharmacy services. Scholars’ Press: Germany. 2013.
Quality System for
Clinical Pharmacy
Activities
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Fungal meningitis
outbreak in September
2012 in the US among
patients who received
preservative-free
methylprednisolone
injections prepared from
a compounding centre
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Industrial and Regulatory Perspective
Centers for Disease Control and Prevention. Multistate outbreak of fungal meningitis and other infections. October 2013
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Teaching
method
Team workersMake students
feel curious
Science-
practice
curriculum
EAFP Helsinki 2017 stakeholders discussion
Outline
Evolvement of clinical pharmacy
Patient-centred curriculum
Education leading professional developments
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One of the most dramatic changes in
pharmacy education
pharmacy practice
Gloria N. Francke, 1969
Concept of Clinical Pharmacy
Francke GN. Evolvement of “clinical pharmacy”. Drug Intell Clin Pharm 1969; 3 (12): 348-53.
Gloria N Francke
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Developments in pharmaceutical
sciences
Pharmacokinetics
Biopharmaceutics
Enabling factors for Clinical Pharmacy
Elenbaas RM, Worthen DB. Clinical pharmacy in the United States: Transformation of a
profession. USA: ACCP, 2009. 10
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Pharmaceutical
education
Pharmaceutical
practice
Pharmaceutical Care
Hepler C.D. The third wave in pharmaceutical education. Journal of Pharmaceutical Education
1987; 51: 369-385.
Clinical Pharmacy and Education
Doug Hepler
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Curricular changes
• Addition of courses in pharmacokinetics and
pharmacodynamics, biopharmaceutics
• Pharmacotherapy-related courses
• Experientials in community pharmacies, hospital
pharmacy ward-based
• Problem-based learning
Changes in Pharmacy Education
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“The advancement of the
function of pharmacists in the
quality and efficiency of
medicines use will require
schools of pharmacy to respond
with appropriate shifts in the
education of the pharmacist as
a clinical practitioner.”Steve Hudson
Hudson SA, McAnaw JJ, Johnson BJ. The changing roles of pharmacists in society.
IeJSME 2007; 1(1): 22-34.
Where should we go in Pharmacy Education?
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PATIENT-CENTRED
CURRICULUM
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Pharmacy Education in Malta
Bachelor of Science in Pharmaceutical Science
Master of Pharmacy
Total 5.5 years Pharmacist
Master of Science in Pharmacy
Doctorate in Pharmacy
Doctor of Philosophy
Co
llab
ora
tive
mo
de
lExperientials
Practice Research
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Patient-focus
Patient first
Proactive
Partnership
Leufkens H, Hekster Y, Hudson S. Scenario analysis of the future of clinical pharmacy.
Pharm World Sci 1997; 19(4): 182-185.16
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Provide pharmacy education that prepares
graduates who can function within a diverse
and complex pharmaceutical setting
Pharmacy Education: Target
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Mobilize knowledgeMerge science and practice
think
apply
communicate
Pharmacy Education: Outcome
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Emphasise active
engagement of
students in the
learning models
Foster scientific inquiry
and innovation
Immerse students in
practice early
Case-based learning
Pharmacy Practice
Research Projects
Experientials: 1525 hours
Starting from 1st -5th year
Pharmacy Education: Outcome
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The curriculum with the highest mean percentage
of clinical sciences was that of the United States
at 16.7% followed by Malta at 12.3%
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Patient-focused curriculum
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Pharmacy
PracticeAcademic-led
placements
Experientials: Community Pharmacy services
• 1 community pharmacy/ 2300 population (N=213)
• Pharmacy Practice sessions within the curriculum
(3 hour/week in first year to 6 months in fifth year)
• Teacher-practitioner sessions to lead academic
development
• Continuous method of assessment
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Objectives of Experiential Learning
Utilise the principles of experiential education and
engagement of students in “real-life” activities.
Describe the importance of workplace skills
Instill the importance of competence through lifelong
learning habits
Provide basic understanding and utility of continuous
professional development
Provide appropriate leadership skills through example
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Reflecting on your strengths and what
you want to learn and improve
Identify 3 SMART learning objectives:
specific
measurable
achievable
relevant
timed
Student Portfolio
Complete reflection
form at the start and
midpoint
Daily record sheet
Evaluation sheet at
the start (t0),
midpoint (t7) and the
end
Active learning during experientials
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• Development of critical thinking and problem-
solving skills
• Transition from dependent to active, self-directed
lifelong learners
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Pharmacy Education: Outcome
Pharmacy Practice Projects
• Inter-disciplinary learning
• Research skills: writing a proposal, literature review, fieldwork,
analysis of data, report writing, dissemination
• Longitudinal experience (second year – fifth year)
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Pharmacy Practice Projects Examples
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Pharmacist intervention in pain management
in heart surgery
Proposing a framework for INR testing and
anticoagulation management in
community pharmacies
Dissemination of treatment protocols in
gastrointestinal disorders
EAHP Best
student paper
award 2014
Oral presentation
at the ESCP
Annual Conference
2013
Runner up Best
Poster Award
Community
Pharmacy
Section, FIP 2012
EDUCATION LEADING
PROFESSIONAL DEVELOPMENTS
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Postgraduate doctorate
A post-graduate degree in
clinical pharmacy that is at
the same qualification
level of a PhD
Collaboration with College
of Pharmacy, University of
Illinois, Chicago
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Postgraduate doctorate
Interprofessional learning at the professional
sites with consultant physicians, nurses and other
healthcare professionals
International dimension to support interactive
learning group dynamics
Journal clubs, case presentations, scenario analysis,
reflective portfolios, presentations and discussions
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Patient-Centred Monitoring in Chronic Disease
Management in the Community Pharmacy
Martina Muscat
• Action plan
• Follow-up after 4 months
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Blood Glucose (n=28)
Fasting Glucose HbA1c
8.0 mmol/L
6.3 mmol/L
7.5 %
7.0 %
P < 0.001 P < 0.001
T = 0
T = 4 months
PHARMACOTHERAPY IN THE
TREATMENT OF Clostridium difficile:
IMPACT ON CLINICAL PRACTICE
Noelia Holgado Sánchez
10/11/2017
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IMPACT OF THE STUDY■ Innovative study: risk factors for active and carrier patient
status
■ Chronic kidney disease identified as a predictor to acquire
the active infection
■ Higher prevalence in female population: signal for further
investigation
■ Adherence to management algorithm needs to be improved:
delivery of educational programs
Glucagon Use in
Paediatric Type 1
Diabetic Patients: An
innovative approach
to improve outcomes
DANIKA AGIUS DECELIS
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Methodology: Phase 1
Visits to
paediatric
outpatients clinicIdentified
gaps
Development of
Glucagon Tool
Kit and
questionnaires
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Discussion
Developed the Glucagon Tool Kit which is now implemented for service provision-used by nurses in this area of practice, patients and by community pharmacist
Contributes to increased patient safety in managing hypogylceamia in paediatric T1DM
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Outcome
Empower pharmacists
Advanced clinical pharmacy skills
Perspective on patient safety in developing
and use of innovative drugs
Leadership and advocacy
Drive policies and developments
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Postgraduate Doctorate in Pharmacy, University of Malta, July 2017
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