Drug-related problems : a cornerstone for pharmaceutical care

Drug related problems are an essential term in the world of pharmaceutical care. Other terms can be used for the same concept, such as medication errors, but this term is different from drug related problems. The errors refer to the mistakes in the process that could lead to problems. Drug related problems can originate when prescribing, dispensing or taking/administering medicines. Drug use problems by the patient are probably the most frequent, but are not always noticed. There are several classifications for drug related problem, but in this article the classification of the Pharmaceutical Care Network Europe (PCNE) is used to clarify the concepts. Some of the known classifications seem difficult to be used in practice, and especially the reproducibility of the existing classifications should be researched further.peer-reviewe

The organizational framework of community pharmacies in Europe

This is the author’s version of a manuscript that was accepted for publication in International Journal of Clinical Pharmacy. The final publication is available at link.springer.co

Community pharmacist-led medication review procedures across Europe: characterization, implementation and remuneration

Background: Pharmaceutical Care Network Europe (PCNE) proposed a definition and classification system (type 1, 2a, 2b, 3) for medication review in 2016. However, to date, a description of the implementation and remuneration of such procedures across Europe is lacking. Objective: The aim of this study was to describe the medication review procedures and the level of implementation and remuneration in community pharmacies across Europe. Methods: An online survey was developed to characterize medication review procedures (PCNE classification), level of implementation (considering regional or national) and remuneration by a third party. This survey was sent to a purposive sample of three individuals per country, with a working background in community pharmacy, pharmacy practice research, or health policy to ensure reliable data. Data triangulation was used and consensus sought between the responses. Results: Data were received from 34 out of 44 targeted European countries (November 2016–October 2017) [response rate = 77%]. Overall, 55.9% of the countries provided at least one type of medication review as an implemented service or project. Type 1 medication review (based on the medication history) was provided in 13 countries, type 2a (medication history + patient interview) in 14, type 2b (medication history + clinical data) in two, and type 3 medication review (medication history + patient interview + clinical data) in four countries. Ten of the mentioned services or projects were remunerated by a third-party. Conclusion: Substantial heterogeneity was observed across Europe in various aspects, including the procedures, implementation level and remuneration obtained. Type 1 and 2a medication review services seem to be more feasible to implement in the community pharmacy than type 2b and 3. A large number of medication review projects were ongoing in community pharmacies, which suggests that new medication review services could become implemented in the coming years.info:eu-repo/semantics/publishedVersio

Barreras para la implantación de servicios cognitivos en la farmacia comunitaria española

Objetivo: Identificar y analizar los elementos que dificultan la diseminación, la implantación y la sostenibilidad de distintos servicios cognitivos orientados a los pacientes en la farmacia comunitaria española. Diseño: Estudio cualitativo en el que se han utilizado entrevistas semiestructuradas, con el fin de realizar un análisis descriptivo. Métodos: Se eligieron dos conjuntos de expertos relacionados con la farmacia comunitaria española. El primero estaba compuesto de 15 farmacéuticos comunitarios que se habían destacado por sus actividades profesionales y el segundo, por 18 estrategas de la farmacia. Resultados: La falta de orientación clínica de la formación universitaria, la falta de actitud ante el cambio y la incertidumbre sobre su futuro profesional se identificaron como barreras del farmacéutico individual. Para la farmacia como empresa, se identificaron como barreras la falta de pago por los servicios, la ausencia de mensajes claros y el reducido volumen de la farmacia española. En la categoría profesión farmacéutica, el actual sistema de remuneración, la falta de formación universitaria clínica y la falta de liderazgo de las instituciones representantes fueron las barreras encontradas. En cuanto a los otros colectivos, se encontró que la falta de apoyo real de las administraciones sanitarias, el desconocimiento de los médicos de los objetivos de los servicios cognitivos farmacéuticos, y la falta de demanda de estos servicios por los pacientes fueron las barreras identificadas. Conclusiones: Se han encontrado 12 barreras que se han agrupado en 6 categorías. Estas barreras coinciden con las comunicadas en otros países.Objective: To identify and assess barriers for dissemination, implementation, and sustainability of different cognitive services in Spanish community pharmacies. Design: Qualitative study through semistructured interviews followed by a descriptive analysis. Method: Two groups of experts related to Spanish community pharmacy were chosen. One with 15 community pharmacists with a relevant professional activity, while the other group (n=18) was related to pharmacy strategists. Results: The lack of university clinical oriented learning, lack of pharmacists’ attitude towards change and some uncertainty over their professional future were identified as barriers at the pharmacists’ level. In relation to pharmacy as an organization the lack of clear messages by their leaders and the small volume of Spanish pharmacies were identified as barriers. In the category of pharmacy profession, the current reimbursement system, the lack of university clinical education, and the lack of leadership by current representative organizations were the barriers found. The lack of real involvement by health authorities, the lack of knowledge about the objectives of pharmacy cognitive services, and the lack of demand of these services by patients where also identified as barriers. Conclusions: Finally, 12 barriers were identified and grouped into 6 categories. These barriers fit in with the barriers identified in other countries

Pharmaceutical care, the future of pharmacy : theory, research, and practice

The first chapter of this dissertation deals with issues surrounding health systems and the position and definitions of pharmaceutical care. Pharmaceutical care is a way of dealing with patients and their medication. It is a concept that deals with the way people should receive and use medication and should receive instructions for the use of medicines. It also deals with responsabilities of patients and professionals, medication surveillance, counseling and outcomes of care. In some countries the concept also deals with the way people should obtain information about disease states and lifestyle issues. In exceptional cases even purchasing medicines by a pharmacy is concidered te be part of the concept. ... Zie: Summary.