Pharmaceutical care in Italy and other European countries: between care and commerce?

Do European pharmacists really have to trespass on medicine?

“…The professional framework of European pharmacists in the community is very different from those in hospitals. Community pharmacies are predominantly private shops in almost all European countries [15], mainly owned either by a single pharmacist (like in France, Italy, and Spain) or a big chain (like in The Netherlands and the United Kingdom). As a consequence, commercial considerations are inevitably crucial for profitability.…”

“…As a consequence, commercial considerations are inevitably crucial for profitability. Overall, community pharmacists have always a potential conflict of interest when employed in a private pharmacy, due to their dual role of health professionals and commercial agents [15]. The clear evidence that commercial reasoning unavoidably prevails over the obligations of the health profession is the wide range of other products sold in the vast majority of pharmacies besides drugs, including some which should in fact conflict with pharmacist's education (e.g., homeopathic products).…”

“…Although in theory, it seems realistic to expect positive results from clinical pharmacy services and pharmaceutical care philosophy [27], in practice, they are difficult to prove on the basis of clinical evidence. Many interventions are hard to standardize, hence their outcome measures in trials too [9,15]. Yet, most studies have been conducted on small samples in single facilities, probably pushed by pharmacists to demonstrate the usefulness of their local services; thus, results are hardly extendable to other hospital settings by definition.…”

From pharmacy faculty to pharmacy shop: still a logical pathway in Europe?

“…cardiology, neurology, oncology, etc.). In most countries the pharmacist's role as employee in a community pharmacy seems closer to the lower part of the range, partly because pharmacists always have a potential 'conflict of interest' when employed in a private pharmacy, on account of their dual role of health professional and commercial agent [13]. Since private pharmacies are still predominant in almost all European healthcare systems, regardless of whether they are owned by a single pharmacist or a large company, a minimum of 3 years before graduation could be a reasonable solution for a pharmacist to start working in a pharmacy shop, consistently with the 'Bologna model'.…”

“…In the light of these radical changes, it is time to reconsider their baseline education in the EU, especially for those working in community pharmacies, which, in most European countries, are still private shops where commercial considerations (obviously) prevail over public health tasks [13]. We think that a minimum of 3 years to earn a bachelor degree in pharmacy-such as exists in almost all faculties except medicine (human and veterinary) nowadays-would be a wise solution in the EU, making it easier for young pharmacists to enter their main 'labor market' with the essential knowledge to provide their basic health service of dispensing drugs professionally.…”