Provision of pharmaceutical care by community pharmacists: a comparison across Europe

Hughes, Carmel; Hawwa, Ahmed F.; Scullin, Claire; Anderson, Claire; Bernsten, Cecilia; Björnsdóttir, Ingunn; Cordina, Maria; Costa, Filipa Alves da; Wulf, Isabelle De; Eichenberger, Patrick M.; Foulon, Veerle; Henman, Martin; Hersberger, Kurt E.; Schaefer, Marion; Søndergaard, Birthe; Tully, Mary P.; Westerlund, Tommy

doi:10.1007/s11096-010-9393-x

Cited by 87 publications

(92 citation statements)

References 17 publications

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“…Although there are several definitions of this concept, most agree that a pharmacist's commitment to the patient is to attain the patient's health objectives. This concept has become widely used in North America, particularly in Quebec, but it has received less recognition in Europe [10], with the exception of the United Kingdom and the Netherlands [8]. The pharmacists' practices considered in the present study are integrated into the concept of pharmaceutical care that is defined by the Ordre des Pharmaciens du Québec (The College of Pharmacists in Quebec) as: "all the acts and services that the pharmacist is required to provide to patients, in order to improve the quality of their lives by attaining the pharmacotherapeutic objectives of prevention, cure or the provision of palliative care."…”

Section: Discussionmentioning

confidence: 99%

The future of pharmaceutical care in France: a survey of final-year pharmacy students' opinions

et al. 2011

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BackgroundIn the last decades, the provision of pharmaceutical care by community pharmacists has developed in OECD countries. These developments involved significant changes in professional practices and organization of primary care. In France, they have recently been encouraged by a new legal framework and favored by an increasing demand for health care (increase in the number of patients with chronic diseases) and reductions in services being offered (reduction in the number of general practitioners and huge regional disparities).Objectives: This study aimed to investigate final-year pharmacy students' opinions on 1/expanding the scope of pharmacists' practices and 2/the potential barriers for the implementation of pharmaceutical care. We discussed these in the light of the experiences of pharmacists in Quebec, and other countries in Europe (United Kingdom and the Netherlands).MethodsAll final-year students in pharmaceutical studies, preparing to become community pharmacists, at the University Paris-Descartes in Paris during 2010 (n = 146) were recruited. All of them were interviewed by means of a questionnaire describing nine "professional" practices by pharmacists, arranged in four dimensions: (1) screening and chronic disease management, (2) medication surveillance, (3) pharmacy-prescribed medication and (4) participation in health care networks. Respondents were asked (1) how positively they view the extension of their current practices, using a 5 point Likert scale and (2) their perception of potential professional, technical, organizational and/or financial obstacles to developing these practices.Results143 (97.9%) students completed the questionnaire. Most of practices studied received a greater than 80% approval rating, although only a third of respondents were in favor of the sales of over-the-counter (OTC) drugs. The most significant perceived barriers were working time, remuneration and organizational problems, specifically the need to create a physical location for consultations to respect patients' privacy within a pharmacy.ConclusionsDespite remaining barriers to cross, this study showed that future French pharmacists were keen to develop their role in patient care, beyond the traditional role of dispensing. However, the willingness of doctors and patients to consent should be investigated and also rigorous studies to support or refute the positive impact of pharmaceutical care on the quality of care should be carried out.

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Section: Discussionmentioning

confidence: 99%

The future of pharmaceutical care in France: a survey of final-year pharmacy students' opinions

et al. 2011

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“…Additionally, as the study was to be undertaken over a very short period of time (1 month), one could not expect a high participation rate neither a high recruitment rate from each of the participating pharmacies. The pharmacy participation rate was assumed to be 15 % based on previous studies [30,31], indicating 99 pharmacies would participate. As such, to achieve the estimated sample size each pharmacy would have to recruit 3.78 patients.…”

Section: Methodsmentioning

confidence: 99%

Primary non-adherence in Portugal: findings and implications

Costa

Pedro²,

Teixeira

et al. 2015

Int J Clin Pharm

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Background Portugal is currently facing a serious economic and financial crisis, which is dictating some important changes in the health care sector. Some of these measures may potentially influence patients' access to medication and consequently adherence, which will ultimately impact on health status, especially in chronic patients. Aims This study aimed at providing a snapshot of adherence in patients with chronic conditions in Portugal between March and April 2012. Setting Community pharmacy in Portugal. Method A cross-sectional pilot study was undertaken, where patients were recruited via community pharmacies to a questionnaire study evaluating the number of prescribed and purchased drugs and, when these figures were inconsistent, the reasons for this. Main outcome measures Primary and secondary adherence measures. Failing to purchase prescription items was categorized as primary nonadherence. Secondary nonadherence was attributed to purchasing prescription items, but not taking medicines as prescribed. Results Data were collected from 375 patients. Primary nonadherence was identified in 22.8 % of patients. Regardless of the underlying condition, the most commonly reported reason for primary non-adherence was having spare medicines at home (''leftovers''), followed by financial problems. The latter appeared to be related to the class of medicines prescribed. Primary nonadherence was associated with low income (\475 €/month; p = 0.026). Secondary non-adherence, assessed by the 7-MMAS was detected in over 50 % of all patients, where unintentional nonadherence was higher than intentional nonadherence across all disease conditions. Conclusion This study revealed that more than one fifth of chronic medication users report primary nonadherence (22.8 %)A very short-version of this work was included in the Annual Report 2012 of the Portuguese Observatory of Health Systems. and more than 50 % report secondary nonadherence. Data indicates that the existence of spare medicines and financial constraints occurred were the two most frequent reasons cited for nonadherence (47, 6-64, 8 and 19-45.5 %, depending on the major underlying condition, respectively). Electronic supplementary material

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“…For instance, Urban and colleagues found that the potential of community pharmacists to improve patient safety after discharge from hospital is not being used in England [9]. Across Europe pharmacists are infrequently involved in patient-centred professional activities such as monitoring plans [10]. The situation in the US differs to some extent as the implementation of collaborative working relationships between community pharmacists and physicians aims at fostering interprofessional collaboration.…”

Section: Introductionmentioning

confidence: 99%

Perceptions of interprofessional collaboration of general practitioners and community pharmacists - a qualitative study

Löffler

Koudmani

Böhmer

et al. 2017

BMC Health Serv Res

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BackgroundDespite numerous evidences for the positive effect of community pharmacists on health care, interprofessional collaboration of pharmacists and general practitioners is very often limited. Though highly trained, pharmacists remain an underutilised resource in primary health care in most western countries. This qualitative study aims at investigating pharmacists’ and general practitioners’ views on barriers to interprofessional collaboration in the German health care system.MethodsA total of 13 narrative in-depth interviews, and two focus group discussions with 12 pharmacists and general practitioners in Mecklenburg-Western Pomerania, a predominantly rural region of North-Eastern Germany, were conducted. The interviews aimed at exploring general practitioners’ and pharmacists’ attitudes, views and experiences of interprofessional collaboration. At a second stage, two focus group discussions were performed. Fieldwork was carried out by a multi-professional team. All interviews and focus group discussions were audio taped and transcribed verbatim. The constant comparative method of analysis from grounded theory was applied to the data.ResultsThere are three main findings: First, mutual trust and appreciation appear to be important factors influencing the quality of interprofessional collaboration. Second, in light of negative personal experiences, pharmacists call for a predefined, clear and straightforward way to communicate with physicians. Third, given the increasing challenge to treat a rising number of elderly patients with chronic conditions, general practitioners desire competent support of experienced pharmacists.ConclusionsOn the ground of methodological triangulation the findings of this study go beyond previous investigations and are able to provide specific recommendations for future interprofessional collaboration. First, interventions and initiatives should focus on increasing trust, e.g. by implementing multi-professional local quality circles. Second, governments and health authorities in most countries have been and still are reluctant in advancing political initiatives that bring together physicians and pharmacists. Proactive lobbying and empowerment of pharmacists are extremely important in this context. In addition, future physician and pharmaceutical training curricula should focus on comprehensive pharmacist-physician interaction at early stages within both professional educations and careers. Developing and fostering a culture of continued professional exchange and appreciation is one major challenge of future policy and research.

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Provision of pharmaceutical care by community pharmacists: a comparison across Europe

Cited by 87 publications

References 17 publications

The future of pharmaceutical care in France: a survey of final-year pharmacy students' opinions

The future of pharmaceutical care in France: a survey of final-year pharmacy students' opinions

Primary non-adherence in Portugal: findings and implications

Perceptions of interprofessional collaboration of general practitioners and community pharmacists - a qualitative study

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