Developing a National Competency Framework for Clinical Pharmacy Practice in Nigeria: A Consensus-Based Multi-Stakeholder Delphi Study

A nationally endorsed clinical pharmacy competency framework is foundational to standardizing educational outcomes, credentialing practitioners, and guiding continuing professional development in hospital and ambulatory pharmacy settings. Despite the rapid expansion of clinical pharmacy roles in Nigerian healthcare, no formally validated national competency framework exists for this specialty. This study developed a national competency framework for clinical pharmacy practice in Nigeria using a multi-round consensus-based Delphi methodology involving a diverse national expert panel. An initial competency item pool of 142 statements was generated through systematic review of international clinical pharmacy competency frameworks and qualitative consultation with 28 clinical pharmacy experts, educators, and policymakers. Three Delphi rounds were conducted with a purposively sampled expert panel of 74 stakeholders representing six geopolitical zones, encompassing hospital pharmacists, clinical pharmacy academics, Pharmacists Council of Nigeria officials, pharmaceutical society leaders, physicians, and nurses. Consensus thresholds were set at greater than 75 percent agreement for retention and less than 50 percent for exclusion. Round three yielded a final framework of 89 competency statements organized into eight domains: patient assessment and medication history, therapeutic decision support, drug information and evidence application, pharmacovigilance and medication safety, patient education and communication, collaborative interprofessional practice, clinical leadership and professional development, and digital health and informatics. Content validity index was 0.92, and inter-rater reliability was excellent. The framework provides the first consensus-validated, nationally applicable reference standard for clinical pharmacy competency in Nigeria. Keywords: clinical pharmacy competency, Delphi method, national framework, Nigeria, pharmacy education