RESUMO
Background: Drugs with fiscalized substances without a correct prescription may lead to undesirable side effects. Pharmacy staff needs to improve their competencies (knowledge, skills, and attitudes) to contribute to providing ambulatory pharmacy services and minimizing medication errors. Continuing education programs (CEP) could favor access to relevant and quality information on health promotion, disease prevention, and the rational use of drugs. Objective: To evaluate the effectiveness of a continuing education program to improve pharmacy staff competencies to enhance the use of drugs with fiscalized substances. Methods: A multicenter, prospective, parallel-group, cluster-randomized, controlled clinical trial was conducted in drugstores and pharmacies in Colombia (ambulatory retail establishments). The intervention group (IG) received a CEP: a web-based social networking site, a virtual course, a dispensing information system, and face-to-face training. The control group (CG) received general written material on the correct use of drugs. We measured pharmacy staff's skills, attitudes, and knowledge self-reported scores, and the simulated patient technique was used to assess the participant skills and attitudes in real practice. We used a questionnaire designed for this study, which was evaluated by a group of experts and piloted and showed a Cronbach's alpha of 0.96. Results: Three hundred five drugstores and pharmacies were enrolled in two groups: IG (n = 153) and CG (n = 152). Out of the 750 potential participants, 88% (n=659) agreed to participate. The pharmacy staff's skills, attitudes, and knowledge self-reported scores post-intervention were higher than baseline in both groups; however, the IG had statistically significantly higher scores than the CG. Post-intervention, the self-efficacy skills and attitudes in the IG improved by 88% (22 of 25) and in six of the seven assessed knowledge components (p<0.001). However, the dispensing criteria evaluated with simulated patient methodology showed no statistically significant differences between groups in the pharmacy staff's skills and attitudes in real practice. Conclusions: Providing a continuing education program using different educational strategies improved the pharmacy staff's competencies (assessed knowledge and self-reported skills and attitudes) to enhance the use of drugs with fiscalized substances. However, there were no improvements in skills and attitudes in real practice. These findings could show that pharmacy staff needs additional and continuous training/sustainability.
RESUMO
Resumen Introducción: La medición y evaluación de las competencias laborales, en el personal farmacéutico ambulatorio, debe combinar aspectos relacionados con los conocimientos (que sabe), habilidades (como lo hace) y actitudes (de que modo lo hace). Objetivo: Identificar y seleccionar las directrices y recomendaciones sobre las competencias laborales que requiere el personal farmacéutico ambulatorio, y construir un instrumento para su medición. Métodos: Se realizó una revisión estructurada en dos fases: a) se revisaron y seleccionaron las funciones/dominios, los criterios de desempeño (habilidades y actitudes), los conocimientos, los marcos de competencias establecidas a nivel internacional, y los instrumentos de medición reportados en la literatura; y b) se identificaron las competencias laborales necesarias de acuerdo con la normatividad colombiana y con los procesos de los Establecimientos Farmacéuticos ambulatorios (droguerías y farmacias-droguerías). Finalmente, se construyó el instrumento de medición por un panel de expertos. Resultados: Se identificaron las competencias laborales establecidas por las organizaciones de regulación internacional. Se revisaron 993 artículos que reportaban la medición y evaluación de las competencias, seleccionándose y analizándose 9 referencias. Se analizaron los marcos de competencias de diferentes países. Se analizaron las regulaciones en Colombia sobre el tema. El instrumento construido contiene 101 competencias distribuidas en los siguientes componentes: a) suministro de cuidados al paciente; b) personales; c) solución de problemas; y d) gestión y organización. Conclusión: Directrices y recomendaciones internacionales, además, la normatividad colombiana para identificar las competencias laborales que requiere el personal farmacéutico para el correcto funcionamiento de los Establecimientos Farmacéuticos ambulatorios, y partir de esto, se construye un instrumento de medición para evaluarlas.
Abstract Introduction: The measurement and evaluation of labor competencies, in outpatient pharmacy staff, must combine aspects related to knowledge (who knows), skills (as it does) and attitudes (in what way it does). Objective: Identify and select the guidelines and recommendations on labor competencies required by outpatient pharmacy staff and build an instrument for their measurement. Methodology: A structured review was carried out in two phases: a) the functions/ domains, performance criteria (skills and attitudes), knowledge, competency frameworks established internationally, and measurement instruments reported were reviewed and selected in the literature; and b) the necessary labor competencies were identified in accordance with Colombian regulations and with the processes of the outpatient Pharmaceutical Establishments (drugstores and pharmacies-drugstores). Finally, the measuring instrument was built by a panel of experts. Results: Labor competencies established by international regulation organizations. were identified. A total of 993 articles were reviewed that reported the measurement and evaluation of competencies, selecting and analyzing 9 references. Competency frameworks from different countries were analyzed. The regulations in Colombia on the subject were analyzed. The constructed instrument contains 101 competencies distributed in the following components: a) provision of patient care; b) personal; c) troubleshooting; and d) management and organization. Conclusion: The international guidelines and recommendations were reviewed and analyzed, in addition, the Colombian regulations to identify the labor competencies required by the pharmacy staff for the correct functioning of the outpatient Pharmaceutical Establishments, and from this, an instrument was built of measurement to evaluate them.