A survey to assess the availability, implementation rate and remuneration of pharmacist-led cognitive services throughout Europe

Soares, Inês Branco; Imfeld-Isenegger, Tamara L.; Makovec, Urska Nabergoj; Horvat, Nejc; Kos, Mitja; Arnet, Isabelle; Hersberger, Kurt E.; Costa, Filipa Alves da

doi:10.1016/j.sapharm.2019.02.002

Cited by 29 publications

(13 citation statements)

References 22 publications

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“…The proposal for clinical services provided by community pharmacists in the EU is unavoidably affected by the potential remuneration for private pharmacies. Although European community pharmacists are among the most easily accessible and highly visible healthcare professionals in primary care, most of them still work in small-to-medium shops that must ensure (high) returns on their investments [33]. This becomes paramount in countries (such as France, Italy, and Spain), where the 'one pharmacist-one pharmacy' rule still largely holds.…”

Section: Future Prospectsmentioning

confidence: 99%

Do European pharmacists really have to trespass on medicine?

2020

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Section: Future Prospectsmentioning

confidence: 99%

Do European pharmacists really have to trespass on medicine?

2020

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“…However, the proposals for clinical services provided by community pharmacists, like that recently approved by the Italian Government on the detection of risk factors (e.g., glycaemia and cholesterolemia assays), are inevitably affected by the crucial issue of their potential remuneration. Many European community pharmacists still work in small to medium shops, which must ensure returns on their investments [ 19 ], as the sky-high prices of face masks during the very first wave of COVID-19 pandemic in Italy has recently shown. The major marketing advantage of pharmacies is attracting extra customers for other health products and services owing to their monopoly on reimbursable drugs.…”

Section: Policy Implicationsmentioning

confidence: 99%

Community and hospital pharmacists in Europe: encroaching on medicine?

2020

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Pharmacy has been historically regarded as a discipline between health and chemistry devoted to drug development, production, and compounding. These tasks have been almost lost with the industrial manufacturing, and dispensing remains the main activity of pharmacists. Hospital pharmacists are usually employees in their workplace, while the professional framework of community pharmacists is very different, being pharmacies predominantly private shops in almost all European countries. In the last years pharmacists have strongly advocated that the focus of their services should switch from ‘product’ to ‘patient’. Clinical pharmacy and pharmaceutical care are the two most cited concepts to support this shift. Clinical pharmacy was originally defined as the area of pharmacy concerned with the science and practice of rational medication use, pharmaceutical care as the responsible provision of drug therapies to achieve definite outcomes. The practice of clinical pharmacy should embrace the philosophy of pharmaceutical care. The new wave of pharmacists’ patient-centered care in Europe still seems to be a reaction against the loss of their traditional professional role after the drug manufacturing revolution. To depict a realistic scenario for progress, it is worth differentiating between hospital and community. Hospital pharmacists should strengthen their pivotal role of medication gatekeepers to improve among clinicians the appropriateness of drug prescriptions and generate savings in expenditures. Any proposal for clinical services provided by community pharmacists is inevitably affected by the issue of their potential remuneration, especially in countries where the remuneration for reimbursable drugs is still a proportion of the retail price.

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“…Medication review (MR) services are recognized cognitive pharmaceutical services that aim to optimize medicines use and improve health outcomes [1,2]. Pharmaceutical Care Network Europe (PCNE) defined different types of MR, among them intermediate MR (type 2), commonly known as medicines use review.…”

Section: Introductionmentioning

confidence: 99%

“…Literature shows, medicines use review services can improve adherence [9][10][11][12][13][14][15][16][17], since factors that influence safe and effective medicines use are discussed between pharmacist and patient, and tailored interventions to resolve identified drug related problems (DRPs) are performed [16][17][18]. According to the PRACTISE study [1,2], medicines use review services are offered in 14 European countries, among them in Slovenia. Almost 300 Slovenian community pharmacists throughout the country (data from 2020) are certified to provide a standardized Medicines Use Review (MUR) service; however, provision rates vary and service is not remunerated [19,20].…”

Section: Introductionmentioning

confidence: 99%

Improved adherence with Medicines Use Review service in Slovenia: a randomized controlled trial

Makovec

Locatelli

Kos

2021

BMC Health Serv Res

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Background Based on several existing patient-oriented activities, Medicines Use Review (MUR) service was standardized and officially adopted in Slovenia in 2015. Service aims to provide adherence support and ensure safe and effective medicines use. Therefore, the aim of the study was to evaluate the benefits of MUR in Slovenia, primarily the impact on medication adherence. Methods A randomised controlled trial was performed in community pharmacies to compare MUR with standard care. Patients were randomised into either the test (patients received MUR by a certified MUR provider at visit 1), or control group. The study primary outcome was self-reported adherence to multiple medications, assessed by electronic ©Morisky Widget MMAS-8 Software at the first visit (V1) and after 12 weeks (V2). A sub-analysis of intentional and unintentional non-adherence was performed. MUR impact was defined as the relative difference in ©MMAS-8 score after 12 weeks between the test and control group. A multiple linear regression model was used to predict MUR impact based on baseline adherence (low versus medium and high). Several secondary outcomes (e.g. evaluation of drug-related problems (DRPs)) were also assessed. Results Data from 153 (V1) and 140 (V2) patients were analysed. Baseline adherence was low, moderate and high in 17.6, 48.4 and 34.0% patients, respectively. In the low adherence subpopulation, test group patients showed a 1.20 point (95% CI = 0.16–2.25) increase in total ©MMAS-8 score (p = 0.025) compared to control group patients. A 0.84 point (95% CI = 0.05–1.63) increase was due to intentional non-adherence (p = 0.038), and a 0.36 point (95% CI = − 0.23-0.95) was due to unintentional non-adherence (p = 0.226). Additionally, statistically significant decrease in the proportion of patients with manifested DRPs (p < 0.001) and concerns regarding chronic medicines use (p = 0.029) were revealed. Conclusion MUR service in Slovenia improves low medication adherence and is effective in addressing DRPs and concerns regarding chronic medicines use. Trial registration ClinicalTrials.gov - NCT04417400; 4th June 2020; retrospectively registered.

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A survey to assess the availability, implementation rate and remuneration of pharmacist-led cognitive services throughout Europe

Cited by 29 publications

References 22 publications

Do European pharmacists really have to trespass on medicine?

Do European pharmacists really have to trespass on medicine?

Community and hospital pharmacists in Europe: encroaching on medicine?

Improved adherence with Medicines Use Review service in Slovenia: a randomized controlled trial

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