Clinical pharmacy services in Germany: a national survey

Abstract

ObjectivesClinical pharmacy services in German hospitals appear to be underdeveloped compared with other European countries. However, recent developments have increased the interest in expanding these services. Detailed data about the current state of clinical pharmacy services in Germany are lacking. This survey establishes the current level of pharmacy services in Germany and the barriers to implementation.MethodsAn online survey conducted in 2017 was distributed to directors of all 389 German hospital pharmacies. The survey contained 26 questions addressing hospital and pharmacy characteristics, clinical pharmacy services provided, the number of clinical pharmacists and the frequency as well as the quality assurance of these services.ResultsThere were 133 responses (34%). Of these, 84 (63%) pharmacies provided some form of clinical pharmacy services. Based on the 389 contacted pharmacies, a clinical pharmacy service is available in at least 22% of hospital pharmacies in Germany. On average there are 2.4 full-time equivalent (FTE) clinical pharmacists per hospital employed, although there is a wide variation in numbers (0.3–22 FTE) and service provision between hospitals. Clinical pharmacy services are generally provided on a daily or weekly basis, with a principal focus on general surgery, critical care and general medicine wards.ConclusionsThis is the first survey providing a detailed picture of clinical pharmacy services in Germany. There is wide variation in clinical service provision among hospitals, with some hospitals having developed a comprehensive range of clinical services. Compared with other countries, particularly the UK where the focus has shifted to provision of 7-day clinical services, the gap in clinical pharmacy services remains large. The focus should be turned to refining clinical pharmacy services in hospital admissions and discharge planning while also improving Health IT, the opportunities for specialisation and aligning education in accordance with the EAHP common training framework.

Clinical pharmacists’ interventions across German hospitals: results from a repetitive cross-sectional study

“…Thus, we are confident, that our data represent a cross section of routine CPS in Germany. The fact that the majority of participants work in university hospitals reflects the general situation in German hospitals regarding the staffing levels of clinical pharmacists in different types of hospitals, with a median of 2.7 full-time equivalents per hospital for university hospitals and 1.0 for maximum care and general hospitals, respectively [10]. Furthermore, the willingness to participate in scientific studies might be slightly higher for employees from university hospitals.…”

“…During the last years, the topic of CPS and medication management has gained a greater focus of attention in Germany. According to a recent national survey, at least 22% of hospital pharmacies in Germany provide some form of CPS with a wide variation between hospitals [10].…”

Clinical Pharmacy Activities in Swiss Hospitals: How Have They Evolved from 2013 to 2017?

“…The spectrum of clinical pharmacy activities offered by Swiss hospitals is comparable to other European countries [13]. In German hospitals that offer clinical pharmacy services, 44 of 84 hospitals provide medication reconciliation at admission [14]. This trend is not seen for pharmacists in Swiss hospitals; fewer of them indicated that they were involved in this activity in 2017 than in 2013.…”

Arzneimitteltherapiesicherheit gefördert durch die interprofessionelle Zusammenarbeit von Arzt und Apotheker auf Intensivstationen in Deutschland

“…Eine intensivmedizinische Visite mit Apothekern findet in Deutschland noch vorwiegend wöchentlich (62,1 %) statt. Dies ist konform zur aktuellen Empfehlung der DIVI [11] und wird auch von einer deutschen Untersuchung aus dem Jahr 2017 bestätigt [24]. Nur 5,2 % (3/58) berichten über eine tägliche Visite, die in den USA und Großbritannien als "essenzielle" Tätigkeit fest etabliert ist [6,19].…”

“…Direkte und proaktive pharmazeutische Dienstleistungen tragen zur Erhöhung der Patienten-und Arzneimitteltherapiesicherheit sowie zur Reduktion von Liegedauer und Mortalität bei [15,17,30]. Diese Dienstleistungen finden in Deutschland nicht nur auf Intensivstationen sondern auch auf Nicht-Intensivstationen statt [24].…”