title: Preparing pharmacists to deliver a targeted service in hypertension management: evaluation of an interprofessional training program.
abstract: BACKGROUND
  Non-adherence to medicines by patients and suboptimal prescribing by clinicians underpin poor blood pressure (BP) control in hypertension. In this study, a training program was designed to enable community pharmacists to deliver a service in hypertension management targeting therapeutic adjustments and medication adherence. A comprehensive evaluation of the training program was undertaken.
  
  
  METHODS
  Tailored training comprising a self-directed pre-work manual, practical workshop (using real patients), and practice scenarios, was developed and delivered by an inter-professional team (pharmacists, GPs). Supported by practical and written assessment, the training focused on the principles of BP management, BP measurement skills, and adherence strategies. Pharmacists' experience of the training (expectations, content, format, relevance) was evaluated quantitatively and qualitatively. Immediate feedback was obtained via a questionnaire comprising Likert scales (1 = "very well" to 7 = "poor") and open-ended questions. Further in-depth qualitative evaluation was undertaken via semi-structured interviews several months post-training (and post service implementation).
  
  
  RESULTS
  Seventeen pharmacists were recruited, trained and assessed as competent. All were highly satisfied with the training; other than the 'amount of information provided' (median score = 5, "just right"), all aspects of training attained the most positive score of '1'. Pharmacists most valued the integrated team-based approach, GP involvement, and inclusion of real patients, as well as the pre-reading manual, BP measurement workshop, and case studies (simulation). Post-implementation the interviews highlighted that comprehensive training increased pharmacists' confidence in providing the service, however, training of other pharmacy staff and patient recruitment strategies were highlighted as a need in future.
  
  
  CONCLUSIONS
  Structured, multi-modal training involving simulated and inter-professional learning is effective in preparing selected community pharmacists for the implementation of new services in the context of hypertension management. This training could be further enhanced to prepare pharmacists for the challenges encountered in implementing and evaluating services in practice.
authors.affiliation: Graduate School of Health, University of Technology Sydney (UTS), Sydney, Australia. Beata.Bajorek@uts.edu.au.
authors.forename: Beata V
authors.initials: BV
authors.lastname: Bajorek
authors.affiliation: Woolcock Institute of Medical Research, University of Sydney (USyd), Sydney, Australia. Kate.Lemay@sydney.edu.au.
authors.forename: Kate S
authors.initials: KS
authors.lastname: Lemay
authors.affiliation: Discipline of General Practice, University of Newcastle (UNewc), Newcastle, Australia. Parker.Magin@newcastle.edu.au.
authors.forename: Parker J
authors.initials: PJ
authors.lastname: Magin
authors.affiliation: Sydney Medical School - Northern, Hornsby Ku-ring-Gai Hospital, Sydney, Australia. Christopher.Roberts@sydney.edu.au.
authors.forename: Christopher
authors.initials: C
authors.lastname: Roberts
authors.affiliation: Faculty of Pharmacy, University of Sydney (USyd), Sydney, Australia. Ines.Krass@sydney.edu.au.
authors.forename: Ines
authors.initials: I
authors.lastname: Krass
authors.affiliation: Woolcock Institute of Medical Research, University of Sydney (USyd), Sydney, Australia. Carol.Armour@sydney.edu.au.
authors.forename: Carol L
authors.initials: CL
authors.lastname: Armour
mesh_terms: D004513:Education, Pharmacy, Continuing / Q000379:methods*; D000068156:Formative Feedback; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007400:Interprofessional Relations; D055118:Medication Adherence; D010348:Patient Care Team; D010595:Pharmacists; D024382:Professional Role; D015397:Program Evaluation; D000066908:Simulation Training