General overviewThe DeMoPhaC project allowed us to build a stronger international network of expertise on ‘Nurse and Pharmaceutical Care’. In a partnership with representatives of 14 European countries and in collaboration with students, the role of nurses in pharmaceutical care (PC) was investigated. As a result the NuPhaC-EU framework on nurses’ role in interprofessional PC was developed. This framework shows responsibilities and tasks in PC for nurses expected by health care providers in clinical practice, the labour market. The application of the NuPhaC EU-framework is an essential step towards more competency based education. Therefore, each of these responsibilities and tasks were linked to the competences they require. In the last stage of the project, a website with a competency test was created, allowing nurse students to evaluate and benchmark their competences. Transnational project meetings facilitated the planning of the studies and activities and international discussions about the meaning and the interpretation of study results. Students were trained in intensive study programs on nurse pharmaceutical care and research methodology. Partners and students had the opportunity to learn from exchanging knowledge, experiences and ideas. Results were disseminated through open access, peer reviewed publications, the NuPhaC website, mailings to stakeholders, videos, the DeMoPhaC assessment website, ‘the NuPhaC winter conference’, a doctoral thesis, presentations at national and international conferences, contacts with professional organisations and several other initiatives. Intellectual outputA first study in 4888 nurses, 974 physicians and 857 pharmacists showed providing patient education and information (PEI), monitoring medicines adherence (MMA), monitoring adverse/therapeutic effects (ME) and prescribing medicines were considered integral to nursing practice by 77%, 85%, 81% and 23% respectively. Most respondents were convinced that quality of PC would be improved by increasing nurses' involvement in ME (95%), MMA (95%), PEI (91%) and prescribing (53%). Mean scores for the reported quality of collaboration between nurses and physicians, collaboration between nurses and pharmacists and interprofessional communication were respectively <7/10, ≤4/10, <6/10 for all four aspects of PC. In a second study, in 340 interviews, health care providers reflected on the preferential role for nurses in PC. Nurses' autonomy varied across Europe (none, limited, a few tasks, in case of emergency, a broad range of tasks and responsibilities). Respondents reported when nurses would assume more pharmaceutical care responsibilities this could have a positive effect on quality of care and patient outcomes. However, when translating the preferential role for nurses into clinical practice several contextual factors such as education, team characteristics, country-specific regulations, and types of medications for which nurses are held responsible have to be taken into account.In a third study, a scoping review was performed to corroborate the evidence and to extract the responsibilities and tasks described in literature. Seven responsibilities were identified: management of therapeutic and side effects of medications; management of medication adherence; management of patient medication self-management; management of patient education/information about medications; prescription management; management of medication safety; and care coordination. Within these seven responsibilities 26 tasks were described. The first three studies resulted in the development of the NUPHAC-EU framework. Following its' development, the framework was evaluated by 923 nurses, 240 physicians, and 199 pharmacists. No responsibilities, tasks or contextual factors had to be removed after evaluation. In a fourth study, through literature review and a Delphi procedure, competences required for nurses to take up the responsibilities and tasks of the NuPhaC-EU framework were described. The expert panel reached consensus on the relevance of 60 competences for 22 nursing tasks. In a fifth study, applying the NuPhaC-EU framework and related competences, the level of integration into nursing curricula was questioned in 1807 students. The results showed that the embedding of PC courses in nurse curricula should be extended. In a sixth study, the extent to which nurse students master PC competences was investigated in 1741 students. PC knowledge of final year students differed between nurse educational levels and was rather limited with regard to the expectations of the labour market.Finally, considering the studies performed in the DeMoPhaC project, a position paper was published on the implementation of more interprofessional, integrated, evidence-based PC with a shared focus on patient care.DOI10.1016/j.nedt.2021.10492610.3390/ijerph1815786210.1002/nop2.98410.3390/ijerph1811597310.1371/journal.pone.025198210.1136/bmjopen-2019-036269

<< Background >>The UPPSCAle strategic partnership is a powerful transnational collaboration aiming to innovate, improve and standardise Bachelor Physiotherapy pain science curricula across Europe. Pain science is a core field in a physiotherapy curriculum and physiotherapists are essential members of healthcare teams managing people with pain within a biopsychosocial framework. Chronic pain affects millions of people worldwide across the lifespan and is a global cause of disability in the developed and developing world alike. Poorly managed pain is costly not only for the affected individuals and their families (12-30% EU member states) but also for governments and taxpayers with estimated direct and indirect costs of chronic pain are between 2-3% of GDP across member states (annual cost of 441 billion euro to Europe).Pain management is the primary reason people attend physiotherapy for treatment. The International Association for the Study of Pain 2010 Declaration of Montreal states that all patients have the right to have access to the appropriate assessment and treatment of pain by adequately trained healthcare professionals. However, there is currently no standardised curriculum or common training framework for physiotherapists, with professional education about pain management repeatedly documented as inadequate worldwide. Hence the inequities in pain science knowledge across Europe results in inequitable health service delivery and costs and most importantly to significant differences in patients quality of life.Greater connectivity between higher education systems with standardised curricula will also reduce obstacles that face physiotherapists applying to practice their profession across geographical borders in EU member states. Once graduated Physiotherapists are consistently the 4th most mobile regulated profession that travels abroad to practice their profession in the EU. Under the EU Directive 2005/36/EC in principle physiotherapists are permitted freedom of movement to practice their profession across geographical borders of EU member states. However, as there is no common training framework for physiotherapists, and training requirements differ from country to country, having professional qualifications recognised can be challenging between one EU member state and another. A standardised curriculum in pain science physiotherapy could reduce challenges that graduates face and serve as a test case for physiotherapy curricula as well as other health professional Bachelor programmes. In summary, there is a need for the exchange of best practices pain science through the development of sustainable products for faculty as well as students. This project is therefore timely, with the right partners and with the right blend of expertise to develop a cadre of highly trained academics capable of addressing current and future needs.<< Objectives >>The UPPSCAle project objectives are focusing on harmonising pain science education across Europe by offering a roadmap for all academics in Bachelor programmes seeking to ensure their graduates can meet the evolving challenges of pain management. The project will take advantage of the considerable expertise of all the partners involved to achieve this through the various project activities and outputs that can be utilised by academics across EuropeUPPSCAle has three main objectives:Objective 1: Curriculum bench marking of Bachelor Physiotherapy pain science curricula against international best practice (European Pain Federation EFIC Pain Physiotherapy curriculum) to identify gaps in learning. ; Objective 2: Augmenting knowledge and skills through evidence-based professional practices;Objective 3: Enhancing and standardising Teaching and learning methodology based on dynamic Open Education Resource that addresses identified limitations to support academics with student learning across Europe and beyond.<< Implementation >>Three core project activities (PA), one building on the next will be undertaken(i)Needs Analysis: A curriculum review process mapping partners current pain science curricula against international best practice (European Pain Federation Pain Physiotherapy curriculum) will be undertaken, facilitated by experts in curriculum design in NUID UCD Teaching and Learning Centre.(ii) Capacity Building: Two week long face to face Teach-the-Teacher Pain Schools will be developed to standardise and up-skill academic partners with both theoretical and hands-on skills development sessions. Materials developed for and during the Pain Schools Outputs will be incorporated into the Open Education Resource.(iii) Addressing Limitations: An open education resource will be developed and maintained on key and emerging pain science knowledge to ensure that Bachelor Physiotherapy programme curricula content can meet the evolving challenges of pain management across Europe and beyond. Through all three core PA dissemination of progress and project results (PR) will be disseminated widely through the UPPSCAle communication strategy in partner countries and beyond to allow other institutions join in the curriculum review and enhancement process, to build a community of physiotherapy academic staff (special interest group) to further develop and enhance pain science education.<< Results >>This 24 month project results include a number of sustainable outputs that will enhance and standarise pain science education in Bachelor Physiotherapy programmes across Europe:1. Open educational ResourceThe OER will house all educational outputs from the UPPSCAle project; gaps identified through the curriculum review process can be addressed by accessing the Teach-the-Teacher Pain School Manual and the knowledge and skills content on the OER. This will augment and promote state-of-the-art pain science education that healthcare professionals, patients and health services will benefit from. The OER will be hosted by UCV and be accessible.2. Open source files accessibilityUPPSCAle Project results will all be freely available for institutions removing barrier of funding issues that arise in institutions across Europe.3. Curricula availability & comparisonsAcademics can review and augment their current pain science curricula using a pedagogically sound approach against international best practice recommendations (European Pain Federation EFIC Pain Physiotherapy curriculum). 4. Special interest group The UPPSCAle project will develop a special interest group for academic physiotherapist teaching pain science to engage with each other, sharing knowledge on the topic. It will also allow for discussion around the development of a common training framework for physiotherapy education. This would ultimately enhance patient care, reduce healthcare costs and limit obstacles faced by physiotherapists seeking to have their qualifications recognised when they wish to practice professionally across geographical borders of European Union member states. 5. InterconnectivityThis project will further enhance inter-connectively and teaching excellence between universities in Europe, increasing their capacity to operate jointly at transnational level, boosting internationalisation of their educational and research activities, and through exchanging or developing new practices and methods as well as sharing and confronting ideas.

Future sustainable mobility is not simply a transport challenge, but requires new combinations between mobility patterns, energy generation, and forms of housing. This project develops new visions with citizens and stakeholders from the transport, energy, and housing sectors as well as concrete templates on how to realize such integrated systems technically and organizationally.