The Pharmaceutical Journal
Vol 268 No 7198 p694-696
18 May 2002

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European Society of Clinical Pharmacy summary

More communication between pharmacists needed

A shift from inpatient based to out-patient based treatment means that the hospital-primary care interface is becoming increasingly important, said Dr MARCEL BOUVY, SIR Institute for Pharmacy Practice Research, Leiden, the Netherlands. Pharmaceutical care takes place in hospitals with interaction between the hospital doctor and pharmacist, and also in the community with interaction between the general practitioner and community pharmacist. However, little interaction occurs between the settings. "I think a lot of problems are caused by this lack of interaction," he said.

One system being piloted in the Netherlands involves technicians from community pharmacies having a small "pharmacy" in the hospital. Patients are able to take their prescription there and the technician faxes it to the community pharmacy. Any problems can be identified and corrected before the patient leaves hospital. The system also works the other way around: when patients are admitted, the community pharmacy can fax details of the patients' medicine to the technician in the hospital.

In some hospitals, the community and hospital pharmacy are paying for the technician working in the hospital together. "This is an example of a successful initiative between community and hospital pharmacists," said Dr Bouvy. However, he cautioned that this system only works in areas where all community pharmacies share access to one database or else the patient's record would be incomplete. This was not the case in some European countries.

Dr Bouvy reported results from a study that demonstrated that community pharmacists could identify numerous drug-related problems by using simple questionnaires. It investigated drug-related problems in 277 patients in six countries and showed that problems are common. Community pharmacists asked patients about medicines using a questionnaire and found 451 drug-related problems. The most common were: uncertainty or lack of knowledge about the aim or function of a drug (29.5 per cent); concerns over side effects (23.3 per cent); problems with the drug's use, eg, under- or over-use, duplications of dosage and interactions (17.5 per cent); and practical problems with using the drug (12.4 per cent). Patients who have a number of changes to their medicines while in hospital need the most attention, he said.