Burnout among clinical pharmacists: causes, interventions, and a call to action

Burnout among clinical pharmacists: causes, interventions, and a call to action
Brianna Ferrell, Pharm.D., Essentia Health

Background: Burnout among health-care professionals can be related to a multidimensional framework consisting of emotional exhaustion, depersonalization, and reduced personal accomplishment. Recent evidence suggests the rate among clinical pharmacists is as high as 66%. Based on the evidence reviewed in this article, causes of burnout can be divided into individual factors, organizational factors, or a mix of the two called situational factors. Examples of individual factors include demographics, personality traits, and age. Organizational factors are mainly work overload and increasing job demands relative to job resources. Clinical pharmacists have unique stressors that can contribute to burnout, such as working in high-stress environments with little to no margin for error. The consequences of burnout may include reduced job satisfaction and increased rates of various mental health diagnoses. Increased levels of stress and exhaustion may also lead to adverse patient events, such as medication errors, patient dissatisfaction, and even mortality. This article details the available evidence related to the assessment of burnout in health care professionals and how to prevent or combat it from occurring in clinical pharmacists.

Discussion: In order to assess burnout among healthcare professionals, a number of validated tools have been used. The American Pharmacists Association recently began offering pharmacists the ability to take the Well-Being Index, which is a tool developed by Mayo Clinic to assess and track well-being. Additionally, there is evidence to suggest that the main driver of burnout is the degree of motivational mismatch between a person and their work, leading to decreased engagement. An article by Leiter and Maslach published in 1999 describes this concept by outlining a framework with six different areas of work life that has been discussed in the literature. This includes workload, control, reward, community, fairness, and values. For example, a mismatch in workload can occur because pharmacists are often involved in tasks outside of providing direct patient care, such as teaching, precepting, research, and administrative duties.

Practice Impact: Research has shown that ways to combat burnout can be divided into two categories: individual-focused and organization-focused interventions. Most research regarding burnout is centered on individual strategies, such as mindfulness techniques, stress-management training, and physical modalities such as exercise and sleep. Organization-focused interventions include alterations in workload, improvements in work-life integration, and changes in the organization’s values and culture. Additionally, redesigning workflow can be impactful in reducing burnout. The knowledge and skills of pharmacy technicians can be utilized to improve the workload balance for clinical pharmacists, similar to how pharmacists sharing clinical duties with physicians can decrease rates of physician burnout.

One proposed strategy in the literature to combat burnout is to clearly state the job responsibilities and expectations of the position when hiring. Additionally, strong support from leaders in the organization is necessary to ensure that the demands placed on employees are consistent with their expectations and resources. A third strategy is to provide career guidance to residents and students to increase the likelihood these individuals will pursue jobs that they will be satisfied in. Similarly, it is important for preceptors to residents and students to model ways to promote well-being and engagement in their careers. Finally, continuous career guidance should be available for pharmacist clinicians to ensure their role is aligning with their personal and professional values. Overall, the authors concluded that the available evidence indicates there is a lack of research on what aspects of burnout are unique to clinical pharmacists. In order to properly address these issues, there needs to be a shift to more research devoted specifically to pharmacist burnout and ways to fight it.

Reference:

  1. Hagemann TM, Reed BN, Bradley BA, et al. Burnout among clinical pharmacists: causes, interventions, and a call to action. J Am Coll Clin Pharm. 2020; 3(4): 832-842. doi 10.1002/jac5.1256.