DEVELOPMENT OF QUALITY INDICATORS FOR PHARMACEUTICAL CARE PERFORMANCE ASSESSMENT IN NIGERIAN COMMUNITY PHARMACIES: A DELPHI PANEL
Objective: This study aimed to develop quality indicators for assessing pharmaceutical care performance in the Nigerian community pharmacies.
Methods: We searched for existing quality indicators through an extensive literature review. The identified quality indicators consisted of thirty-four items in 10 core components. The Delphi method was used to arrive at a consensus on quality indicators for assessing pharmaceutical care performance in the Nigerian community pharmacies by surveying a panel of experts. There were 3 rounds of the Delphi panel conducted by consulting a panel of 10 experts in pharmaceutical care practice. A mean score>3.5, median>3.5, an absolute value between the median and mode<1.00 was used to establish consensus on the quality indicators for assessing pharmaceutical care performance in the Nigerian community pharmacies.
Results: Ten studies met the inclusion criteria. A list of 33 quality indicators comprising of 10 core components emerged from the extensive literature review. They included quality management, documentation of care, communication with the patient, management of clinical risk in pharmacy, compounding, dispensing and patient care, follow-up of pharmacotherapy counselling, drug inventory and stocking, training of pharmaceutical staff. At the end of the round three votings, 24 statements of the quality indicator reached consensus in nine core components: quality management (5), continuity of care (1), communication with patients (3), clinical risk management (5), dispensing (1), follow-up of pharmacotherapy (3), counselling (1), logistics (3), training of pharmacy staff (2).
Conclusion: This study developed a set of 24 quality indicators for assessing pharmaceutical care performance in community pharmacies in Nigeria.
2. Foppe Van Mil JW, Schulz M, Tromp TH, FJ Dick. Pharmaceutical care, Europian developments in concepts, implementation, teaching, and research: a review. Pharm World Sci 2004;26:303-11.
3. Petkova V, Georgiev ST, Dinitrov ZI, Radivoeva M. Implementation of pharmaceutical care knowledge in Bulgarian community pharmacy. Pharm Education 2006;6:107-10.
4. Penna RP. Pharmaceutical care: Pharmacy’s mission for the 1990s. Am J Hosp Pharm 1889;47:545–7.
5. Vantamay N. Using the Delphi technique to develop effectiveness indicators for soci marketing communication to reduce health-risk behavior among youth. Southeast Asian J Trop Med Public Health 2015;46:949-57.
6. Barzekar G, Aziz A, Mariapan M, Ismail MH, Hosseni SM. Delphi technique for generat¬ing criteria and indicators in monitoring ecotourism sustainability in northern forests of Iran: case study on Dohezar and Sehezar Watersheds. Folia Forest Pol 2011;53:130-41.
7. Rowe G, Wright G. The delphi technique as a forecasting tool: issues and analysis. Int J Forecast 1999;15:353-75.
8. Chartrand M, Guenette L, Brouillete D, Cote S, Huot R, Landry J, et al. Development of quality indicators to assess oral anticoagulant management in community pharmacy for patients with atrial fibrillation. J Manag Care Spec Pharm 2018;24:357-65.
9. Fujita K, Moles RJ, Timothy F Chen. Quality indicators for the responsible use of medicines: a systematic review. Br Med J 2018;8:e020437.
10. Sagarananda G, Parbati D, Gulam MK. Assessment of patient-care, facility care and complementary drug use indicators among elderly patients in a tertiary care hospital of Western Nepal. Asian J Pharm Clin Res 2020;13:83-6.
11. Arkaravichien W, Wongpratat A, Lertsinerdom S. Quality indicators to compare accredited independent pharmacies and accredited chain pharmacies in Thailand. Int J Clin Pharm 2016;38:899-909.
12. Teichet M, Schoenmakers T, Kylstra N, Mosk B, Bouvy ML, van de Vaart F, et al. Quality Indicators for pharmaceutical care: A comprehensive set with national scores for dutch community pharmacies. Int J Clin Pharm 2016;38:870–9.
13. Grey E, Harris M, Rodham K, Wenss MC. Characteristics of good quality pharmaceutical services common to community pharmacies and dispensing general practices. Int J Pharm Pract 2016;24:811-8.
14. Bie DJ, Kijlstra NB, Daemen BJG, Bouvy ML. The development of quality indicators for community pharmacy care. Br Med J 2015;20:666-71.
15. Schoenmakers TW, Teichert M, Braspenning J, Vanderink L, De Smet PA, Wensing M. Evaluation of quality indicators for dutch community pharmacies using a comprehensive assessment framework. J Manag Care Spec Pharm 2015;21:144-52.
16. Halsall D, Noyce RR, Ashcroft DM. Characterizing healthcare quality in the community pharmacy setting: insights from a focus group study. Res Soc Adm Pharm 2012;3:360-70.
17. Winslade N, Taylor L, Shi S, Schuwairth L, Vander Vieuten C, Tomblem R. Monitoring community pharmacists quality of care: a feasibility study of using pharmacy claims data to assess performance. BMC Health Serv Res 2011;11:12.
18. Trap B, Hansen EH, Trap R, Kahsay A, Simoyi T, Oteba MO, et al. A new indicator-based tool for assessing and reporting on good pharmacy practice. Southern Med Rev 2011;3:4-11.
19. Benrimoj SI, Werner JB, Raffaek C, Roberts AS, Costa FA. Monitoring quality standards in the provision of non–prescription medicines from Australian community pharmacies: results of a national progamme. Qual Saf Health care 2007;16:354-8.
20. Suwaratchai P, Sithisarankul P, Sriratanban J, Chenvidhya D, Phonburee W. Utilize the modified delphi technique to develop trauma care indicators. J Med Assoc Thai 2008;91:99-103.
21. Eubank BH, Mohtadi NG, Lafve MR, Wiley JP, Bois AJ, Borman RS, et al. Using modified clinical consensus for the diagnosis and treatment of patients with rotator cuff pathology. BMC Med Res Methodol 2016;16:56.
22. Murry JW, Hammors JO. Versatile methodology for conducting qualitative research. Rev High Educ 1995;18:423-36.
23. Dalkey NC, Helmer O. An experimental ap¬plication of the delphi method to the use of experts. Manag Sci 1963;9:458-67.
24. Hermanides HS, Hulscher MEJL, Schouten JA, Prins JM, Geerlings SE. Development of quality indicators for the antibiotic treatment of complicated urinary tract infections: a first step to measure and improve care. Clin Infect Dis 2008;46:703–11.
25. Campbell S, Cantrill J, Roberts D. Prescribing indicators for UK general practice: delphi consultation study. Br Med J 2000;321:425–8.
26. Morris C, Cantrill J, Hepler C, Noyce P. Preventing drug-related morbidity–determining valid indicators. Int J Qual Health Care 2002;14:183–98.
27. Morris C, Cantrill J. Preventing drug-related morbidity–the development of quality indicators. J Clin Pharm Ther 2003;28:295–305.
28. To T, Guttmann A, Lougheed M, Gershon A, Dell S, Stanbrook M, et al. Evidence-based performance indicators of primary care for asthma: a modified RAND appropriateness method. Int J Qual Health Care 2010;22:476–85.
29. Uphoff E, Wennekes L, Punt C, Grol R, Wollersheim H, Hermens R, et al. Development of generic quality indicators for patient-centered cancer care by using a RAND modified delphi method. Cancer Nurs 2012;35:29–37.
30. Caughey GE, Ellett LMK, Wong TY. Development of evidence-based Australian medication-related indicators of potentially preventable hospitalizations: a modified RAND appropriateness method. Br Med J 2014;4:e004625.
31. Martirosyan L, Braspenning J, Denig P, de Grauw W, Bouma M, Storms F, et al. Prescribing quality indicators of type 2 diabetes mellitus ambulatory care. Qual Saf Health Care 2008;17:318–23.
32. Yoon D, Park I, Schuemie M, Park M, Kim J, Park R. A quantitative method for assessment of prescribing patterns using electronic health records. PLoS One 2013;10:e75214.
33. Zinn J, Zalokowski A. The use of delphi panel for consensus development on an indicator of lab performance. CLM 1999;13:425-8.
34. Boulkedid R, Abdoul H, Loustan M, Sibony O, Alberti Care. Using and reporting the delphi method for selecting healthcare quality indicators: a systematic review. PLOS ONE 2011;6:e20476.
35. Roland M, Holden J, Campbell S. Quality assessment for general practice supporting clinical governance in primary care groups. Manchester National primary care research and development centre; 1998.
36. Bettie E, Mackway Jones K. Delphi study to to identify performance indicators for emergency medicine. Emerg Med J 2004;21:47-50.
This work is licensed under a Creative Commons Attribution 4.0 International License.