Student: Amber-Jane Wood
Supervisors: Prof Les Toop and Kelly Robertson [Pegasus]
Topic: Understanding the learning needs of Community Pharmacists
Sponsor: Partnership Health Canterbury

Lay Report

The Pharmacy Council of New Zealand is currently reviewing the reaccreditation procedures for Pharmacists. With Community Pharmacy poised to become more integrated into primary health care teams, it is important that their continuing professional education (CPE) is aligned with that of other primary health care team members.

In 1993 Pegasus Health established a small group education programme (S.G.E.P) for GPs which was extended to Practice Nurses in 1998. Community Pharmacists joined in 2010 as a natural progression towards promoting interdisciplinary teamwork. The Pegasus Health's S.G.E.P is a peer-led, evidence based/best practice programme involving a multidisciplinary approach to the preparation of each educational topic, combining input from a Community Pharmacist, GP and Practice Nurse. This approach ensures that whilst all professional groups receive the same educational messages, the content for each individual programme is tailored to meet the specific needs of each professional group. The programme provides the opportunity to share ideas and experiences within a supportive peer environment with the quality and content of the programme partly being determined by the active involvement and contribution of participants.

Community Pharmacists are required by the Pharmacy Council of New Zealand to undertake CPE in order to maintain their annual practising certificate but limited information is available on their preferred learning modes and whether their learning needs are being met. This research project explores these areas and will be used to inform the further development of the Pegasus Programme.

The purpose of this study was to specifically investigate what the most effective modes for delivering ongoing education to Community Pharmacists are and whether attendance at the S.G.E.P is meeting the identified learning needs of this group. The study also aimed to explore whether collegial working, communication, interdisciplinary relationships and overall health outcomes for patients have improved since inclusion of Community Pharmacists in the programme.

An initial literature review into the learning needs and educational requirements of Community Pharmacists revealed that this group must participate in a recertification programme accredited by the Pharmacy Council of New Zealand. ENHANCE, a recertification programme offered by Pharmaceutical Society of NZ Inc, appears to be the only national accredited program at present. Informed by this review, a questionnaire was designed and sent out to 244 participants; 204 Community Pharmacists enrolled in the S.G.E.P and 40 non enrolled Pharmacists taken from the Canterbury Community Pharmacy Group (CCPG) members contact list. The responses from these questionnaires were analysed and a focus group drawn from volunteer respondents was held to explore issues raised in this survey. The focus group transcription was analysed for common themes.

We had a 45% response rate from the questionnaire with 68% of respondents identifying that the Pegasus Health S.G.E.P was the most popular mode for delivering ongoing education to Community Pharmacists. This demonstrated that the integration of Community Pharmacists into the S.G.E.P had indeed been well received. There was a range of other educational delivery formats requested which included: written material, online courses and workshops, however the
popularity of these formats was substantially lower. The popularity of the S.G.E.P was reinforced in the focus group discussions and there was a strong desire for the programme to gain Pharmacy Council accreditation, thus becoming an alternative accredited provider to ENHANCE. Key elements of the S.G.E.P's popularity, which came out of the focus group discussion, were the variety and depth of Pharmacist experience in the interactive small groups, the supporting evidence summaries and a sense of being valued as a professional group. The peer-led style of the programme was also seen to be key to the programmes effectiveness.

90% of respondents rated the S.G.E.P as largely meeting their learning needs, thus confirming appropriate alignment of the programme content with this group's educational requirements. Participants of both the survey and focus group discussion did suggest some improvements to greater meet the Pharmacists' learning needs. These included giving more feedback on the outcomes of GP's meetings, incorporating a practical side into the programme, providing copies of key research papers identified in the supportive written evidence summary materials and perhaps exploring a combined GP/Pharmacist small group.

The majority of participants felt that the S.G.E.P improved collegiality and communication amongst the health disciplines. Accordingly, there appeared to be a positive influence on health outcomes for patients, with 81% of participants indicating this. The scope of the summer project precluded directly measuring changes in patient outcomes. The perceived improvement in these areas was suggested to be attributed in part to the three disciplines all receiving the same messages concurrently. This has translated into enhanced mutual confidence and trust amongst the disciplines. This most likely reflects a common understanding of the evidence and allows consistent messages to be delivered to patients. Focus group discussions identified opportunities to expand the programme, such as combining the different professional groups in a mixed S.G.E.P meeting to further improve these multidisciplinary relationships.

Community Pharmacists play a very important role in the provision of care to patients and within the primary health care team, so it is important that they receive high quality CPE that is consistent with and complementary to that received by the other primary health care disciplines. Participants felt that the Pegasus Health S.G.E.P aligned well with their learning needs and that since inclusion of Pharmacists into the programme collegiality and communication amongst the health disciplines has improved. As a result of these enhanced interdisciplinary relationships, Community Pharmacists felt that their patients are receiving better health care leading to improved outcomes. Community Pharmacists are very keen for the S.G.E.P to gain Pharmacy Council accreditation. Accreditation would mean that the programme could be extended to other areas and that as a result more patients could gain the benefit of being cared for by more integrated primary health teams.

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