No abstract

The present findings suggest that the provision of pharmaceutical care in community pharmacy is still limited within Europe. Pharmacists were routinely engaged in general activities such as patient record screening but were infrequently involved in patient centred professional activities such as the implementation of therapeutic objectives and monitoring plans, or in self-evaluation of performance.

The present study demonstrated a slight evolution in self-reported provision of pharmaceutical care by community pharmacists across Europe, as measured by the BPCS. The slow progress suggests a range of barriers, which are preventing pharmacists moving beyond traditional roles. Support from professional bodies and more patient-centred community pharmacy contracts, including remuneration for pharmaceutical care services, are likely to be required if quicker progress is to be made in the future.

No abstract

Objectives: To explore the opinions and experiences of a range of stakeholders on inter-professional working relationships between community pharmacists and physicians. Study design: Five qualitative studies. Setting: Primary care. Population and Methods: Thirty-one community pharmacists, eight medical and pharmacy leaders, 12 physicians and 21 patients took part in interviews and focus groups reflecting on medicines management services in Portuguese community pharmacy. Data pertaining to inter-professional work was subjected to thematic content analysis with the aid of NVIVO® software. Results: Generally, datasets offer evidence of immature inter-professional working relationships. Data analysis suggests a mismatch between the role pharmacists perceived for themselves and physicians' perceptions. A second key theme in explaining barriers to inter-professional work is its perceived benefits. Once again, a mismatch was found between physicians, who generally perceived little benefit for patients or for themselves, and pharmacists, who were keen to collaborate and anticipated benefits for patients. A third key theme was that of role encroachment. Analysis suggests that territorial behaviour was evident in both professions. More clinical roles were perceived as an invasion of physicians' professional practice both by physicians and community pharmacists, but the latter showed unwillingness to compromise on these newly extended roles. Facilitators mentioned by participants included increasing awareness of the pharmacist's role and services, adopting aspects such as joint training, and informal and formal inter-professional meetings. The use of protocols for collaboration and clinical data sharing were also identified as facilitators for inter-professional work. Conclusions: Inter-professional work between community pharmacists and physicians appears to be in an early stage of development. Multi-modal strategies combining top-down and bottom-up approaches seem necessary to advance inter-professional work to a collaboration level that can contribute to patient safety in the medication use process.

One year since the emergence of the COVID-19 pandemic, rapid response measures have been implemented internationally to mitigate the spread of the virus. Following rapid and successful pre-clinical and human trials, several vaccines have been authorised for use across Europe through the European Medicines Agency and national regulatory authorities. Clinical trials have shown promising results including important reductions in disease severity, hospitalisation and mortality. In order to maximise the public health benefit of available vaccines, there is a pressing need to vaccinate a large proportion of the population. Internationally, this has prompted coordination of existing services at enormous scale, and development and implementation of novel vaccination strategies to ensure maximum inoculation over the shortest possible timeframe. Pharmacists are being promoted as healthcare professionals that enhance roll-out of COVID-19 vaccination programmes. This paper aims to summarise current policy and practice in relation to pharmacists’ involvement in COVID-19 vaccination in 13 countries across Europe.

BackgroundCurrently, people live longer but often with poor quality of life. The decrease in healthy life-years is partly attributable to the institution of polypharmacy to treat various comorbidities.ObjectivesThe objectives of the study were to determine the prevalence and nature of drug-related problems (DRPs) in polypharmacy elderly patients residing in nursing homes and to test the acceptability of a pharmacist’s intervention.MethodsAn exposure cohort was constituted in three Portuguese nursing homes, where all polypharmacy (five or more medicines) elderly patients (≥65 years of age) were analysed and then a random stratified sample was extracted to be subject to an intervention. Clinical and therapeutic data were collected and analysed for DRPs and classified according to the II Granada Consensus, by a pharmacist-led team. The intervention was the formulation of a pharmacist’s recommendations to prescribers addressing clinically relevant DRPs, along with suggestions for therapy changes.ResultsThe initial sample included 126 elderly patients taking 1332 medicines, where 2109 DRPs were identified. The exposure cohort included 63 patients, with comparable baseline data (p > 0.005). Manifest DRPs occurred in 31.7 % of the intervention group (mainly quantitative ineffectiveness–DRP 4), whereas potential DRPs were identified in 100 % of patients (mainly non-quantitative unsafe–DRP 5). Amongst the DRPs identified, 584 (56.7 %) were reported to prescribers (all types of DRPs) and 113 (11 %) to nurses (only non-quantitative ineffectiveness–DRP 3). A total of 539 pharmacist recommendations were presented to physicians, corresponding to 62 letters sent by mail, each including an average of 8.7 recommendations to solve DRPs present in intervention group (IG) patients. There was a high non-response rate (n = 34 letters; 54.8 %; containing 367 pharmacist recommendations; 68.1 %) and amongst recommendations receiving feedback, only 8.7 % of pharmacist recommendations made were accepted (n = 15). Positive responses were significantly associated with a lower number of recommendations made, whereas a higher number of recommendations increased the odds of no response (p < 0.001).ConclusionA pharmacist-led medication review proved useful in identifying DRPs in elderly polypharmacy nursing home residents. Stronger bonds must be developed between healthcare professionals to increase patient safety in the vulnerable institutionalised elderly population.

No abstract