A delegate commented that both projects were very interesting. The credibility
of the data might be different. He asked the presenters which approach would
be the best to present to the Ministry of Health.
Professor Tromp replied that the choice was really up to the delegate.
Mrs Jane Nicholson (Great Britain) asked why the project group had not taken
a randomised controlled trial approach.
Professor Hartzema agreed that there was no randomised controlled trial to show
pharmacists were cost-effective. It would be difficult to discuss the effects
on small numbers in a controlled trial.
A DELEGATE (South Africa) asked if more countries, especially from the developing
regions, could possibly be involved in the project.
Professor Tromp said that the pilot phase was logistically restricted and some
countries were excluded due to lack of activities in certain domains. However,
the next phases would include more countries.
A delegate (France) commented that the subject was very important and would
become the key to pharmacy’s future. “We need to base our studies
not on surveys or questionnaires but on strong scientific principles. We are
losing the quality of research if deviating away from precise scales of data
evaluation.”
Professor Hartzema agreed that research should be based on scientific principles.
Professor Tromp doubted that a randomised controlled trial would provide the
answer. The project had been based on good scientific principles from a social
science perspective.
A delegate (Zimbabwe) commented that the studies were both introspective. “We
need to prove to others how we work, therefore we need to involve other audiences.”
Professor Hartzema replied that the nature of the studies had been a policy
decision of the funding board.
Professor Tromp said that involving others was unfeasible when modelling. The
same problems would have occurred with regard to definitions and understanding.
The only difference would be that the audience would shift from inside to outside.
A DELEGATE (United States) stated that pharmacy was made up of two elements:
product and knowledge. If there was no product then there was no need for knowledge.
Drug distribution was still a major problem. He asked: “Do the pharmacists
have time to do this? The biggest barrier is time. Could it be structured to
see how much time the pharmacist has to undertake pharmaceutical care?”
Professor Tromp said the project group was collecting data on the amount of
time available in a pharmacy but they did not have the final figures yet. “The
pharmacist should be driven to do this. Pharmaceutical care is a hot issue.
Delegation costs money but then you have time.”
A delegate (Sweden) commented: “Questionnaires, questionnaires, questionnaires!
We need to know what consumers want from us. What is public opinion of us?”
Professor Hartzema suggested that performance indicators could be used for this
purpose.
A delegate (Switzerland) stated that pharmacists had to be paid for services.
There was a need to establish pharmaceutical care as a service. Politicians
did not understand what pharmaceutical care was about. Dissemination of the
results had to be directed outside of the profession towards politicians.
Professor Tromp replied that the report would be prepared for the FIP, and it
was for the FIP then to decide how to use the report politically.