The healthcare services in community pharmacies, currently insignificant, must undergo reforms to meet the changing needs of modern medicines users. The pharmacist's role in patient care is expected to grow as professional and educational standards develop. Although pharmacists' contributions to health care are not yet recognized, there is every reason to be optimistic toward making patient care in community pharmacy setting a success. For this, the educational system for pharmacists has to be adapted.
This article discusses the concept of pharmaceutical care especially from the European perspective. It tries to clarify the current status of pharmaceutical care research and implementation, and if and how it can be part of the practice of pharmacy. Pharmaceutical care basically means improving the medication use process in order to improve outcomes, including the patients' quality of life, and that involves a focus change for pharmacy from product to patient. This change in focus also implies that the pharmacy curriculum should be adapted, in order for the pharmacist to be able to acquire new knowledge and skills. In most countries this change currently is taking place but not in very deliberate or structured manner. Some basic decisions have to be made, in order to guarantee that every patient receives pharmaceutical care when needed.
Clinical and technical DRPs are frequently observed in primary care as well as in hospital discharge prescriptions. The modified PCNE classification system, especially the amendment with a technical DRP category, proved to be useful and allowed the classification of all DRPs. Neither the setting (hospital discharge vs. primary care) nor the quality of electronically printed prescriptions, but only the number of prescribed drugs influenced the occurrence of clinical or technical DRPs.
The application of the updated Beers criteria lead to higher rates of potentially inappropriate medication, and especially those responsible for more severe adverse outcomes. The results suggest that there is a need for interventions to improve instructions for safe drug use in the elderly patients and to decrease the number of medications whenever it is possible. This study suggests a high prevalence of potentially inappropriate drug use by the elderly patients of Lisbon region, Portugal.
Objective — To establish the perceived barriers to the implementation of pharmaceutical care into community pharmacy practice in different European countries and the relative importance of these barriers.
Method — Structured interviews with representatives from national pharmacists' organisations or pharmaceutical care researchers from 11 European countries known to be actively attempting to implement pharmaceutical care. Respondents were asked to consider a list of 25 potential barriers to pharmaceutical care and to score the relative importance of each for their own country. Data were analysed to produce a European overview of barriers as well as inter‐country comparisons.
Key findings — Lack of time and lack of money are major barriers for the implementation of pharmaceutical care in European countries. Many other barriers were identified, but their impact on the implementation of pharmaceutical care seems to differ markedly over Europe. No correlation was found between money and time as barriers. Some clusters of countries were identified with similar barrier patterns.
Conclusion — Time and money are perceived to be major both in absolute and relative rankings. The European pharmaceutical associations need to pay attention to remuneration issues before attempting to implement pharmaceutical care in their countries. The results also show that pharmaceutical organisations need to work continuously to change attitudes among pharmacists. Important barriers have also been identified in the educational domain and changes in the European curriculae for pharmacy are therefore needed. Co‐operation between some countries on these issues would appear to be useful.
The shift in emphasis of healthcare from dealing only with disease and death to also managing illness, meant that healthcare providers started to realise the importance of assessing the quality of the patient's life as a new therapeutic outcome. This is equally true in the evolving concept of pharmaceutical care, the ultimate target of which is improving the patient's quality of life (QoL) through a cooperative alliance between the pharmacist and the patient. This article discusses the place of QoL assessment in today's healthcare environment, with special emphasis on its use in the practice of pharmaceutical care.
One very effective strategy to achieve good blood pressure (BP) control in primary care is the use of physician/pharmacist collaborative management. Interventions by pharmacists in both community pharmacies and primary care clinics have been shown to significantly reduce BP by both improving medication adherence and intensifying medications. This review will evaluate the strengths and weaknesses of various health services' research study designs that assess various pharmacy interventions to improve BP control. We will also evaluate strategies to measure medication adherence used in research studies, and in some cases, clinical practice. Although poor medication adherence is a major cause of inadequate BP control, suboptimal medication regimens are often more common reasons for poor BP control in typical primary care practice. This review proposes strategies to implement stronger interventions and more robust study designs in comparative effectiveness trials that evaluate team-based care for improving BP control.
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