Scaling up clinical pharmacy practice in Africa: Current challenges and the future

Abstract

AbstractThe potential of clinical pharmacy to improve patient health outcomes is yet to be fully realized in Africa as the practice remains scarce. In this paper, we highlight the current status, gaps, and opportunities for clinical pharmacy scale‐up in the region. Persistent gaps in clinical pharmacy practice include undergraduate and postgraduate curricula that are inadequate in producing practice‐ready clinical pharmacists. Experiential training is insufficient, and its effectiveness is limited by an inadequate number of trained clinical pharmacy preceptors at practice sites. At the institutional level, a lack of formalized job descriptions, low numbers of practicing clinical pharmacists, and lack of tools to facilitate documentation of clinical pharmacy activities and interventions pose practice challenges. Finally, there is inadequate policy and legislation to guide the increase of clinical pharmacy practice. Curriculum reform of the traditional Bachelor of Pharmacy (B.Pharm) program at the undergraduate level is needed to prepare pharmacy students for direct patient care roles. In addition, there is a need to increase Doctor of Pharmacy (Pharm.D.) programs and adopt innovative postgraduate programs for clinical pharmacist specialization, such as residencies and fellowships. Experiential training can be strengthened by making it longitudinal, and conducting it in practice sites with trained clinical pharmacy preceptors. At the level of hospital institutions, clear job descriptions need to be crafted for clinical pharmacists, and systems to facilitate documentation of their activities and interventions created. Finally, national policy and legislation on clinical pharmacy practice is needed to facilitate required training and practice reforms, and guide hospital implementation of clinical pharmacy practice.