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

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European Society of Clinical Pharmacy summary

How transferable are disease management programmes?

The concept of disease management differs between countries and is less well developed in Europe than it is in the United States, said Dr FRANCESCA VENTURINI, Pharmacy Interna, Verona, Italy.

How transferable are disease management programmes, she asked. Dr Venturini investigated the differences between health care systems across Europe by interviewing ESCP members in 13 countries. In nine countries, disease management programmes are implemented to some degree but none is in place in four. Of those countries with programmes, they are only experimental in Switzerland, are not available in primary care in the Netherlands and are not in place consistently in the United Kingdom and Italy.

In the majority of the countries, disease management programmes are promoted by government despite the fact that not all countries have government-funded health care systems (many are either entirely or partly funded by private medical insurance).

The need for disease management programmes does not depend on the type of health care system in place, she said. "Regardless of who is the major provider of health care, there is a need for continuity of care between hospital and primary care," she added. However, the survey suggested that continuity of care is a problem. Seven out of the 13 countries said that there is no interaction to discuss patient care between hospital and community pharmacists.

Although disease management programmes are needed, the implementation of such programmes would depend on the structure of the health care system. Some parts of another country's system might be adopted but "one fits all" would not be useful for disease management programmes, she said.

Dr Venturini added that a specific problem with disease management programmes was that for people with co-morbidities, their management could fall into several programmes. "The patient does not have a clear point of reference for overall management," she said. In addition, in some cases, pharmaceutical companies are involved in disease management programmes and this might suggest a conflict of interest.