Evaluating the role of intern pharmacists in pharmaceutical care in hospitals in Uganda

ABSTRACT

Background:

In Uganda, there is limited adoption of pharmaceutical care in hospitals due to pharmacist shortages and limited collaboration among healthcare professionals. Intern pharmacists are deployed annually to assist in patient care to address pharmacist shortages.

Objectives:

Evaluate intern pharmacist’s extent of involvement in pharmaceutical care activities, assess facilitators and barriers, and explore healthcare professionals’ perceptions, attitudes, and opinions on implementation of pharmaceutical care.

Methods:

A mixed-method concurrent study was carried out for four months. We conducted an online survey among 107 intern pharmacists from 26 hospitals, including National Referral, Regional Referral, Private Not-For-Profit, and General hospitals; predictors of extent of involvement were identified using linear regression models, using STATA 14. 24 key informants (nurses, prescribers, pharmacists) from five hospitals were interviewed; themes were developed using a deductive thematic analysis approach.

Results:

Intern pharmacists had a median (Interquartile range[IQR]) age of 25 years (25-27) and 74.7% were male. About half (54.1%) of key informants were female and had a median (IQR) of 10 years (4.0-15.5) of professional experience. Interns focused on patient counseling, lacked documentation, and showed positive attitudes, and knowledge. Key informants supported implementation, but prescribers expressed dissatisfaction with interns’ performance.

Conclusion:

Enhancing pharmacy internship and training through developing policies and guidelines on pharmaceutical care practice, improving working conditions, and mentorship can address gaps impeding pharmaceutical care implementation by intern pharmacists.

KEYWORDS:

• Pharmaceutical care practices
• intern pharmacists
• Interprofessional collaboration
• Pharmacum Care Uganda‌
• Patient care

Acknowledgement

The authors would like to thank the Pharmaceutical Society of Uganda for funding the study and the study participants, both the intern pharmacists and key informants for participating in the study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical approval

The Mulago Hospital Research Ethics Committee approved this study (MHREC 1925 17/12/20). The Pharmaceutical Society of Uganda provided administrative clearance for the study. Additional clearance was provided by the administrative units of the respective internship sites.

Author contributions

The study conception and design was carried out by Agaba Robert, Ndinawe Johnmark, Keren Ebong and Kalidi Rajab. Material preparation and data collection was carried out by other authors excluding Segawa Ivan, Keren Ebong and Kalidi Rajab. Qualitative data analysis (thematic analysis) of interviews was carried out by Agaba Robert, Ndinawe Johnmark, Kabera Makuza Radiana and Kiiza Haulat while Quantitative data analysis was carried out by Segawa Ivan. The first draft of the manuscript was written by Agaba Robert and Kabera Makuza Radiana, all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Data availability

The datasets generated during and/or analysed during the study have been stored on the Pharmacum Care Uganda Google Drive and thematic analysis sheets in physical folder. All are only available from the corresponding author upon request. The study documents were securely kept, and the de-identified database was password-protected.

Consent to participate

A consent form was attached to the online survey, and respondents were required to click the consent button before responding to the questionnaire. Interviewees also consented by signing the consent forms before data collection.

Additional information

Funding

This study was sponsored by the Pharmaceutical Society of Uganda; however, it was not involved in study design, collection, analysis, and interpretation of data, report writing or submission of the paper for publication.

Notes on contributors

Agaba Robert

Agaba Robert, a registered pharmacist from Uganda, is the managing director at Champions Pharmacy Ltd. Passionate about clinical pharmacy and project management, he is pursuing a postgraduate diploma in project planning and management at Uganda Management Institute. He is the project manager of Pharmacum Care Uganda, a project that aims to improve quality of pharmaceutical services, particularly training of pharmacy professionals to improve patients' wellbeing.

Ndinawe Johnmark

Ndinawe Johnmark is a registered pharmacist currently working with EMERGENCY ONG ONLUS, Children's Surgical Hospital in Entebbe, Uganda. He is extremely passionate about global pharmacy and direct patient care. He is the project coordinator of Pharmacum Care Uganda, a project that aims to improve quality of pharmaceutical services, particularly training of pharmacy professionals to improve patients' wellbeing. His mantra is to ensure every patient is respected, valued, and cared for fairly.

Kabera Makuza Radiana

Kabera Makuza Radiana is a registered hospital pharmacist currently working at Nakasero Hospital. She is passionate about clinical pharmacy and she is pursuing her masters degree in clinical pharmacy at Mbarara University. She is the project finance manager of Pharmacum Care Uganda, a project that aims to improve quality of pharmaceutical services, particularly training of pharmacy professionals to improve patients' wellbeing.

Kiiza Haulat

Kiiza Haulat is a licensed pharmacist from Uganda working with Ecopharm pharmaceuticals and Medical Supplies Ltd. She is currently pursuing her masters degree in clinical epidemiology and biostatistics at Makerere University. She is the project quality assurance manager of Pharmacum Care Uganda, a project that aims to improve quality of pharmaceutical services, particularly training of pharmacy professionals to improve patients' wellbeing.

Segawa Ivan

Segawa Ivan is an early career pharmacist-researcher committed to the prevention and treatment of infectious diseases, especially HIV. Has extensive experience in clinical trials and implementation science research.

Kalidi Rajab

Kalidi Rajab is an academic pharmacist serving as a lecturer of clinical pharmacy at the school of pharmacy, Makerere University. He is passionate about pharmaceutical care practice and training.

Keren Ebong

Keren Ebong is an experienced principal pharmacist who is currently working at Mulago National Referral Hospital. She is passionate about improving pharmacy workforce capacity in Uganda. She is the project advisor of Pharmacum Care Uganda, a project that aims to improve quality of pharmaceutical services, particularly training of pharmacy professionals to improve patients' wellbeing.