Development of clinical pharmacy in Belgian hospitals through pilot projects funded by the government

Abstract

Objectives The goal is to develop clinical pharmacy in the Belgian hospitals to improve drug efficacy and to reduce drug-related problems. Methods From 2007 to 2014, financial support was provided by the Belgian federal government for the development of clinical pharmacy in Belgian hospitals. This project was guided by a national Advisory Working Group. Each funded hospital was obliged to describe yearly its clinical pharmacy activities. Results In 2007, 20 pharmacists were funded in 28 pilot hospitals; this number was doubled in 2009 to 40 pharmacists over 54 institutions, representing more than half of all acute Belgian hospitals. Most projects (72%) considered patient-related activities, whereas some projects (28%) had a hospital-wide approach. The projects targeted patients at admission (30%), during hospital stay (52%) or at discharge (18%). During hospital stay, actions were mainly focused on geriatric patients (20%), surgical patients (15%), and oncology patients (9%). Experiences, methods, and tools were shared during meetings and workshops. Structure, process, and outcome indicators were reported and strengths, weaknesses, opportunities, and threats were described. The yearly reports revealed that the hospital board was engaged in the project in 87% of the cases, and developed a vision on clinical pharmacy in 75% of the hospitals. In 2014, the pilot phase was replaced by structural financing for clinical pharmacy in all acute Belgian hospitals. Conclusion The pilot projects in clinical pharmacy funded by the federal government provided a unique opportunity to launch clinical pharmacy activities on a broad scale in Belgium. The results of the pilot projects showed clear implementation through case reports, time registrations, and indicators. Tools for clinical pharmacy activities were developed to overcome identified barriers. The engagement of hospital boards and the results of clinical pharmacy activities persuaded the government to start structural financing of clinical pharmacy.

What Happens after Hospital Discharge? Deficiencies in Medication Management Encountered by Geriatric Patients with Polypharmacy

“…However, pharmacists can provide discharge counselling and education as well [ 36 , 37 ]. Since 2007, pilot projects funded by the government have been launched in more than half of the acute Belgian hospitals to implement clinical pharmacy activities, such as medication counselling at discharge [ 37 ]. Furthermore, since 2017, patients with polypharmacy can choose a home pharmacist, i.e., a community pharmacist as a reference pharmacy.…”

Factors associated with the number of clinical pharmacy recommendations: findings from an observational study in geriatric inpatients

“…It is unclear how study findings should be implemented as the external validity of investigations might be limited [14]. For example, in Belgium, only one hospital pharmacist is budgeted per 150 beds, with limited additional governmental funding to support extra CP services (0.25 FTE per 250 beds) [15]. The aim of this study was therefore to document the output of the current CP program implemented on the acute geriatric care wards, and to determine factors associated with the number of provided recommendations at discharge.…”

Physician’s feedback on a clinical pharmacy program on geriatric wards

“…These pilot projects generated positive results and the federal government subsequently converted the pilot funding into structural funding from 2014 on. This governmental funding supports a 0.125 full time equivalent (FTE) clinical pharmacists per 100 beds [19].…”