Kumar Sanjeev, Bhoi Purnima, Gharat Manjiri Sandeep, Mohanta Guru Prasad
Health Systems Transformation Platform, New Delhi, India.
KIIT School of Public Health, Bhubaneswar, India.
PLoS One. 2025 Mar 10;20(3):e0316646. doi: 10.1371/journal.pone.0316646. eCollection 2025.
Competency frameworks in the pharmacy profession define the necessary practice standards and establish benchmarks for work accountability and career progression. Pharmacists are integral to primary healthcare, and assessing their competencies is essential for improving the performance of primary healthcare services. Although several countries have developed competency frameworks for pharmacists in primary healthcare, such frameworks are currently lacking in India.
This study aimed to develop a competency assessment framework for in-service pharmacists in Indian public primary healthcare settings. For which, a five-stage consultative process was followed. In the first stage, the systematic literature review was conducted to identify pharmacist competencies in the primary healthcare setting. After that, an expert consultation was organized to develop consensus among experts on competencies and its behaviours. Competency assessment tools were then developed based on the literature and later finalized through experts' agreements during consultation. Finally, the tools were tested in one of the public primary healthcare facilities.
In stage one, the systematic literature review identified 20 competencies and 175 associated behaviors distributed across four domains: Pharmaceutical Health, Pharmaceutical Care, Organization and Management, and Professional/Personal. Expert consultations resulted in the consensus on 11 roles as domains of pharmacists in Indian primary healthcare settings during stage 2. During the expert consultation, each one of 11 pharmacist's role and competencies and behaviours was discussed and consensus was arrived on 26 competencies and 107 behaviours. For which, under the role of pharmacy management, one of the critical competency for primary health care pharmacist is the knowledge about the layout and infrastructure of the pharmacy/store and how to adapt it to optimize pharmacy services. For this competency, one of the behaviour is assessment of the existing infrastructure and identifying gaps and opportunities for improvement. After that in stage 3, a competency assessment tool was developed, and consensus was made on it in stage 4 during expert consultation. The developed tool contains instruments such as a questionnaire to assess knowledge and attitude, and observational checklist, mini-clinical exercises for specific conditions, and simulation exercises to assess skills.
This study successfully developed a competency assessment framework for in-service pharmacists in Indian public primary healthcare settings. The framework encompasses 24 competencies and associated behaviors, covering 11 roles of pharmacists in Indian primary healthcare settings. For example, under the pharmacy management role, some of the competencies include planning and procurement, inventory management, storage conditions, digital literacy to handle supply chain-led IT Systems, NSQ Medical Products Management, etc. The developed competency assessment tool assessing knowledge, attitude and skills provides a comprehensive framework for assessing pharmacist competencies and identifying competency gaps. The framework can be used to capacitate pharmacists and improve their performance. It improves their performance in primary healthcare settings, and enhance the delivery of healthcare services in India. Additionally, it fills a critical gap in the existing literature and can serve as a valuable resource for policymakers, educators, and healthcare professionals involved in pharmacy practice in primary care settings.
药学专业的能力框架定义了必要的实践标准，并为工作问责制和职业发展确立了基准。药剂师是初级医疗保健不可或缺的一部分，评估他们的能力对于提高初级医疗保健服务的绩效至关重要。尽管有几个国家已经为初级医疗保健中的药剂师制定了能力框架，但印度目前还缺乏这样的框架。
本研究旨在为印度公共初级医疗保健机构在职药剂师制定能力评估框架。为此，遵循了一个五阶段的协商过程。在第一阶段，进行了系统的文献综述，以确定初级医疗保健环境中药剂师的能力。之后，组织了一次专家咨询，以就能力及其行为在专家之间达成共识。然后根据文献开发能力评估工具，并在咨询期间通过专家共识最终确定。最后，在一家公共初级医疗保健机构对这些工具进行了测试。
在第一阶段，系统的文献综述确定了20项能力和175项相关行为，分布在四个领域：药学健康、药学服务、组织与管理以及专业/个人。专家咨询在第二阶段就印度初级医疗保健环境中药剂师的11个角色领域达成了共识。在专家咨询期间，对11个药剂师角色中的每一个以及能力和行为进行了讨论，并就26项能力和107项行为达成了共识。为此，在药房管理角色下，初级医疗保健药剂师的一项关键能力是了解药房/商店的布局和基础设施以及如何对其进行调整以优化药房服务。对于这项能力，其中一项行为是评估现有基础设施并识别改进的差距和机会。之后在第三阶段，开发了一个能力评估工具，并在第四阶段专家咨询期间就其达成了共识。所开发的工具包含诸如用于评估知识和态度的问卷、观察清单、针对特定情况的小型临床练习以及用于评估技能的模拟练习等工具。
本研究成功为印度公共初级医疗保健机构在职药剂师开发了一个能力评估框架。该框架涵盖24项能力和相关行为，涵盖了印度初级医疗保健环境中药剂师的11个角色。例如，在药房管理角色下，一些能力包括规划与采购、库存管理、储存条件、处理供应链主导的信息技术系统的数字素养、国家药品质量控制医疗产品管理等。所开发的评估知识、态度和技能的能力评估工具为评估药剂师能力和识别能力差距提供了一个全面的框架。该框架可用于提升药剂师的能力并提高他们的绩效。它提高了他们在初级医疗保健环境中的绩效，并加强了印度医疗服务的提供。此外，它填补了现有文献中的一个关键空白，并可作为参与初级保健环境中药房实践的政策制定者、教育工作者和医疗专业人员的宝贵资源。
