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Consultation opens on European Professional Card for pharmacists

20 May, 14 | by ltempler

The European Commission has opened a short consultation (deadline 2nd June) on technical matters related to the prospective introduction of a European Professional Card for pharmacists.

The system, which emerges immediately from the recently revised Professional Qualifications Directive (January 2014), has the aim of speeding up the time it takes for an individual seeking to work in another EU country to have their qualifications recognized in another country.

The European Professional Card will not come in the form of a physical card, but rather will be an online portal system. An individual will upload relevant identity and qualification documents for recognition by their home ‘competent authority’ (e.g. a professional qualification regulator, such as a chamber of pharmacy). This will then enable them to have an immediately accessible repository of their qualification documentation, verified at their home level, for a competent authority in another country to recognize. It will prevent lengthy exchanges of documentation that can take place at the present time, blamed for some very slow recognition times.

Pharmacy, alongside the medical profession, nursing profession, engineering profession and others, is one of the professional groups the European Commission are minded to give early support to in creating the system.

Although the current consultation is aimed at professional organisations and authorities within EU countries, all interested parties are invited to take part.

The European Association of Hospital Pharmacists intend to make a short response to the consultation offering measured support for the introduction of the European Professional Card for the pharmacy profession, highlighting the need for mechanisms for individuals to be able to include advanced and specialized qualifications, and for the system to be cogniscant of the possibility that individuals could hold qualifications gained from more than one country, throwing up potential definition issues regarding the “home authority” in charge of verifying.

EAHP Members are welcome to review the consultation and consider their own responses.

This information was originally published on the EAHP website. More detail can be found here

Patients and professionals agree the future vision for hospital pharmacy in Europe

16 May, 14 | by ltempler

A robust set of hospital pharmacy practice standards for Europe has been agreed at an international Summit in Brussels. These standards should be met across European health systems to ensure safe, effective and optimal use of medicines in collaboration with multi-disciplinary teams. The standards, comprising 44 statements of practice, were agreed at the European Hospital Pharmacy Summit which concluded on Thursday 15th May, and was attended by more than 100 persons.

The statements were subject to open Delphi consultation with national hospital pharmacy associations, European patient groups, doctors and nursing organisations. The organisations then gave their final joint approval to each statement individually by a weighted voting method at the Summit event. The European Statements of Hospital Pharmacy include:

  • All hospitals should have access to a hospital pharmacist who has overall responsibility for the safe, effective and optimal use of medicines.
  • Hospital pharmacists should be involved in all patient care settings to prospectively influence collaborative, multidisciplinary therapeutic decision-making.
  • All prescriptions should be reviewed and validated as soon as possible by a hospital pharmacist.
  • Hospital pharmacists should play a full part in decision making including advising, implementing and monitoring medication changes in full partnership with patients, carers and other health care professionals
  • Hospital pharmacists should have access to the patients’ health record. Their clinical interventions should be documented in the patients’ health record and analysed to inform quality improvement interventions.
  • Clinical pharmacy services should continuously evolve to optimise patients’ outcomes.

The 44 European Statements of Hospital Pharmacy are available here.

Dr Roberto Frontini, President of the European Association of Hospital Pharmacists (EAHP) said:

“Through the new European Statements of Hospital Pharmacy, patients, hospital pharmacists and our sister healthcare professionals have set out a clear vision for what hospital pharmacy should be achieving in every European country. The task now turns immediately to implementation. EAHP will roll out a series of tools and initiatives to support the achievement of the statements, but a major onus now falls on health systems to prepare the way for improvement as well. The positive support from patient organisations and other healthcare professionals assures us that the statements are a shared aspiration and provide a route towards continuously improving patient care within hospitals in every European country.”



This information was taken from the EAHP website, more details can be found here.

Four reports of eHealth Stakeholder Group published

15 Apr, 14 | by ltempler

On 11 April 2014, the European Commission published a series of reports by the eHealth Stakeholder Group (eHSG), an advisory group of which EAHP was an active member.

The reports related to:

  • eHealth interoperability
  • patient’s access to Electronic Health Records
  • eHealth inequalities
  • Telemedicine deployment (Key Action 13 of Digital Agenda)

The report on eHealth interoperability is connected to the European Commission’s operational objective, set out in itseHealth Action Plan 2012-2020, to achieve wider interoperability of ehealth services by the end of 2015. The principal recommendations from the stakeholder group to the Commission included:

  • focus on priority use cases which have been widely adopted and for which mature specifications exist;
  • clarify privacy and data protection requirements; and,
  • foster the use of international standards.

On patient access to the electronic health records, the stakeholders recommended that:

  • patients should be in charge of their own medical file, and be able to ‘log in’ and inspect it. Amongst the reasoning given was that: “The option to access one”s own information is a fundamental right that is embodied in the EU Data Protection legislation”;
  • access to patients” health records should only be permitted to the health professionals directly involved with the patient”s condition on a need to know basis;
  • patients should be given the possibility to know who accessed their EHR and restrict access if they wish so and are informed about the risks of doing so.

The report on ehealth inequalities looked at the concern that the rise of ehealth applications may have an unintended consequence of increasing health inequalities. Stakeholders believed that the speed of change, the costs involved in accessing and upgrading the required hardware/software and devices and various barriers related to insufficient knowledge, skills and literacy, lack of user-friendliness and doubts over the meaningfulness of information can all present the possibility of new health inequalities.

However, if directed appropriately, ehealth could also address inequalities. Sweden is held up in the report as a good case study, with its national strategy on eHealth including provisions on ‘’eServices for accessibility and empowerment’’. Another good case study identified is the practice in Danish hospitals of providing interpretation services via video conferencing, which is particularly useful for migrants unfamiliar with Danish medical culture and treatments.

The report recommends:

  • various categories of end users have to be an integral part of the design, evaluation and follow-up during the whole lifecycle of technologies so that particular challenges experienced by specific user groups can be understood and rectified;
  • when implementing large-scale eHealth systems, adequate consideration should be given to the needs of vulnerable groups such as children, migrants or people with mental and other disabilities;
  • the creation of sufficient incentives for industry to come up with solutions for underserved patients and communities; and,
  • some financial subsidies be made available for the purchase of eHealth equipment/ICT access for patients from disadvantaged backgrounds.

The report on telemedicine, advised the Commission to clearly differentiate two types of telemedicine services:

  • medical Act type telemedicine services, implying that registered medical doctors perform an existing medical practice over a distance; and,
  • telemonitoring type services, services provide multi-professional care teams with physiological parameters of the patient, with the support of remote monitoring technologies

The latter is seen as the more disruptive technology of two, challenging health care organization, professional roles and reimbursement rules. The report’s recommendations include:

  • digital literacy and training in using eHealth tools should become part of the educational curricula of all Health Professionals; and,
  • benefit and added value of telemedicine services should be systematically monitored and evaluated.

More information and the original post can be found on the EAHP website here

19th Congress of the EAHP looks to the future hospital pharmacist in 2020

3 Apr, 14 | by ltempler

A major talking point of last week’s Congress of the EAHP in Barcelona was the future roles and competencies for hospital pharmacists in the year 2020 and beyond.  Drawing from the keynote speech of Dr. Roberto Frontini on Thursday 27th March, attendees debated the extent to which the future hospital pharmacist must more thoroughly adopt ‘social competencies’ in order to effectively communicate with increasingly health literate patients.

On Wednesday 26th March, Prof. Daan Crommelin explored with Congress attendees the social drivers of innovation. He urged hospital pharmacists to understand the essential need for any profession to adopt innovation in order to survive, as well as the importance of maintaining open minds about adopting new technologies from other sectors. On the final day of Congress, Dr. Graham Walton investigated the problem of knowledge management in times of information overload. Whilst the problem is driven to a large degree by new technologies, coping strategies are available by putting in place effective working practices.

With the exception of the main auditorium, it was standing room only for many sessions, including the Synergy Satellite event on novel anticoagulants, and the topical seminar on drug shortages. The Synergy event, supported by an educational grant from Bayer Pharmaceuticals, examined how choices about oral anticoagulants can best be made. Synergy speaker Duncan McRobbie of Guy’s and St. Thomas hospitals (London) also took attendees through some of the primary patient compliance considerations in the area of anticoagulation treatment.

At the drug shortages seminar, Dr Thomas Langebner reflected on the changes within the pharmaceutical sector that could be driving the growing problem. This included the expiry of major patents, increasing complexity of global medicines supply chains, failure of quality management, and the unintended consequences of cost containment measures. He made a personal call for the European Union to understand the urgency of the problem and to take steps to re-establish sustainable supply systems.

Attendees also packed the session room for the new Congress programme feature, ‘Good Practice Initiatives’(GPIs). A full house heard about noteworthy examples of practice improvements from the change-makers themselves, with opportunities provided to draw inspiration for the attendees’ return to their hospital setting.

Speaking at the end of the week’s events, Congress organiser and EAHP Chief Operating Officer Jennie De Greef said:

“The hot topics covered, unique networking opportunities, and ever-growing programme of events continues to see the EAHP Congress broaden its international reach and attendance.  We depart Barcelona with a spring in our step and real momentum to reach new heights again in Hamburg in 2015. Finally, I want to express gratitude to all of EAHP’s sponsors and especially, Platinum partners Amgen and Bayer, and Corporate Partner Pfizer, for making the year-on-year realisation of our educational ambitions possible.”

Rationing of chemotherapy drugs in Europe a possibility

1 Apr, 14 | by ltempler

News from an EAHP congress seminar has shown that rationing of chemotherapy in Europe is a possibility if the shortages problem is not resolved.

This startling news was revealed by Wolf-Dieter Ludwig, medical director and head of haematology, oncology, and tumour immunology at the Robert Rössle Clinic, Helios Hospital Berlin-Buch, Germany. He followed this statement with the insistence that pharmaceutical companies should be penalised if they fail to register drug shortages six months in advance.

His comments echoed remarks made by Thomas Langebner, chief pharmacist at the Hospital of the Sisters of Mercy in Linz, Austria, that pharmaceutical companies are unwilling to produce generic medicines if they do not make a profit which then leads to shortages.

Dr Langebner said that medicines have a “product life cycle”, going from development, introduction, growth and maturity to eventual decline, at which point companies often develop an exit strategy. He then explained that excessively high prices of new medicines and low prices of mature medicines after their patent expires discourage production of established drugs. However he also explained that these mature drugs are not useless and it is just as essential to secure a supply of these as it is to generate innovative medicines.

Dr Ludwig went further, saying that he believes the supply of older medicines is more important than that of new drugs. This is because many mature cancer medicines cannot be replaced, he explained. He suggested that pharmaceutical companies should be offered financial incentives to keep older medicines on the market. Dr Langebner argued that the price curve needs to be “flattened”, so that there is not such a sharp difference in price once a medicine loses its patent, which would encourage companies to keep producing it.

Read more and answer the medicine shortages survey here

World TB day

26 Mar, 14 | by ltempler

Speaking on World Tuberculosis Day on the 24th March, Dr Roberto Frontini, President of the European Association of Hospital Pharmacists (EAHP), called for better patient counselling, antimicrobial stewardship and new antibiotic development in order to successfully eliminate the disease as a public health concern in Europe by 2050.

With recent data published by the European Centre for Disease Control and Prevention (ECDC) showing European health systems still facing problems in treating multidrug-resistant TB successfully, Dr Frontini reiterated the need to utilise the role of hospital pharmacists in providing both counselling about medication use and antimicrobial stewardship services, and for European Governments to work together in incentivising and facilitating the development of new antibiotics.

Dr Frontini said:

“A major factor in the development of multidrug-resistant tuberculosis (TB) has been non-adherence to treatment. Yet with TB being an infectious and contagious disease, adherence takes on that extra importance. Hospital pharmacists have a pivotal role to play both in improving adherence through patient counselling, but also in improving prescribing and treatment through multidisciplinary collaboration. I urge policy makers overseeing national responses to the TB challenge in Europe to grasp the opportunities before them by advancing the pharmacist role in these areas.

Further to this, many countries have now instituted policy measures to ensure hospital pharmacists have prominent roles in antimicrobial stewardship. This occurs to me as the right policy response given the gravity of the antimicrobial resistance problem and I encourage other countries to give such measures serious consideration.

Finally, alongside reducing inappropriate use of antibiotics, there is a clear need to scale up the search for new agents. European Governments must accept the urgency of this challenge and work together to create an improved environment for discovery. Whilst this includes the EU’s Horizon 2020 research programme and the Innovative Medicines Initiative, the new Commission scheduled for late 2014 should review what further improvements can be made.”

EAHP Congress

26 Mar, 14 | by ltempler

The 19th Congress of EAHP began today with a key note speech from Professor Daan Crommelin,  scientific director of the Dutch Top Institute Pharma in Leiden also Professor at the Department of Pharmaceutics at Utrecht University. However before the speech began the delegates were treated to a performance from a local flamenco troupe to immerse everyone in the culture of this years host city, Barcelona.

Flamenco at the EAHP congress

Professor Crommelin will be summarising his speech and expanding on a few of the key points in a podcast for the journal which will be published on the homepage soon.

EAHP and UZ Leuven to host meeting on reducing medication error in hospitals

22 Aug, 13 | by ltempler

On the 16th August the European Association of Hospital Pharmacists (EAHP) announced it will be conducting a high-level meeting on how to reduce medication errors in the hospital sector. This meeting will take place at the University Hospitals Leuven (UZ Leuven) on the 14th October and will focus more specifically on how scanning medicines at the time of administration can  increase patient safety and how this can become a widespread reality.

This technology is regularly used in some countries like the USA, and has demonstrated how rates of medication error can be reduced by as much as 40%.  As this practice is not common in Europe the event will focus on why this is the case and what can be done to overcome the implementation obstacles.

The event will also include:

• guided visits to hospital wards to see the technology in operation;
• presentations on the industrial, regulatory and international contexts to the issue; and,
• workshops to gain the perspectives and considered opinions of a variety of impacted stakeholders.

Further information about the event can be found here or by contacting the EAHP directly

UKCPA Chair Mark Borthwick discusses the future of hospital pharmacy

23 Jul, 13 | by kuppell

In an interview with EJHP Mark Borthwick, Chair of the United Kingdom Clinical Pharmacy Association (UKCPA) and Consultant Pharmacist in Critical Care, John Radcliffe Hospital, Oxford talks about his views on the future of hospital pharmacy and clinical pharmacy services.

Q1) What are the challenges facing clinical pharmacy today?

A1) There are many: developing and spreading innovative practice, combating silo working, obtaining and retaining recognition for the work we already do, establishing and utilising research networks, keeping abreast of the flow of information to stay up-to-date. All of these require resource and commitment from pharmacists, no one else will do it for us.

Q2) What would you say to hospital pharmacists, especially in Europe, who don’t see the need for clinical pharmacy services?

A2) Clinical pharmacy services improve patient outcomes. Mortality and morbidity rates are improved, and costs are reduced or managed. This has been shown in numerous studies. Pharmacy provision is as much about information and using the product in its most effective way as it is about the actual product itself. As experts in medicines, we are well placed to know the nuances of why drug A gives a different outcome to drug B, we can balance the risks to give a recommendation based on our knowledge. If we have the confidence in our own abilities, then of course we should prescribe and take full responsibility for our decisions through our actions.

Q3) How can the level of research into clinical pharmacy services be increased? Who should be doing this research?

A3) We can improve the level of research by raising the expectation on pharmacists to do it. This can be done at undergraduate level and so build a workforce with the skills and belief that this is something they should do. That could take some time to feed through into tangible results. For those already working as pharmacists now, we can do something as simple as audit or start to group together to build networks. I find that groups of pharmacists are quite capable of coming up with ideas and working out how to do projects even with limited funds. Such groups naturally become more ambitious with time, building on successes and learning as they go along. They don’t have to meet physically either, they can be virtual groups linked by electronic communication lines. Research should just be part of the job, so that means pharmacists should do it, wherever they work.

Q4) Do you think European wide hospital pharmacy standards can work in reality?

A4) Such things have the feel of a self-fulfilling prophecy about them. If we all believe they will work, then they will work.  If we think ‘that’s too hard, it will never work’, then it won’t work.  I think the reality is it’s hard, but completely possible.

Q5) What would you say to those contemplating joining the hospital pharmacy profession?

A5) Hospital pharmacy is a rewarding career that requires every bit of your attention, intelligence and patience to do well. It is entirely possible to be half hearted, but then you will find it is not rewarding.  If you like to learn and like to make a difference, then there are ample opportunities to do so. I came from several years in community practice and found that my thinking was radically altered by working in hospital, in a good way. By working in the same space as doctors I realised they did not know it all, that they made mistakes and that I could stop them from doing so. More than that, I realised that my knowledge complemented theirs; together we made decisions that were more beneficial to patients and made care plans that took account of a wider variety of factors than if the plan was created by just one of the professions.

Q6) What do you think needs to be done to increase collaboration with other healthcare professionals?

A6) This links back to my previous answer; share the same space.  At undergraduate level subjects such as physiology, pharmacology, biochemistry subjects could all be taught across multiple professional groups.  After qualifying, there should be no need to separate all continuous professional development activities, some of these can continue to be shared.  Pharmacists must not be shy to approach working parties and invite themselves along to relevant initiatives (journal clubs, stakeholder meetings, guideline development groups, etc).  Pharmacists are quite capable of making their own professional treatment guidelines and disseminating to other professions.  Such activity thrusts home to other professionals just what they are missing out on when pharmacists are excluded from projects that are being set up.  In my experience such exclusion is never malicious, it’s just an oversight that is easily rectified with a bit of noise.  Set up your own working party and invite other professions to join, lead by example.

Q7) Where do you see the profession in 5 and 10years time?

A7) Difficult question, when I think back 10 years ago, we did not have competency frameworks, we did not have consultant pharmacists, we did not have prescribing pharmacists.  So much has changed radically in the UK that I may be in danger of not speculating wildly enough when looking forward.

In 5 years time we will definitely have a formal system of recognition of the different levels of pharmacy practice in the UK.  Pharmacists will be developing themselves in a more structured way to meet the needs of patients and the health service.  This will be across the profession, from pharmacies on the high street to consultant level practice in hospitals. Patients will benefit as a result, and many of the clinical skills hospital pharmacists have will be transferring to the community pharmacy setting.

In 10 years time clinical pharmacy will be the norm in the high street, just as it is in UK hospitals at the moment.  Pharmacists will be working on solid research questions and improving the health of the nation.  Community pharmacists will be offering a range of services to complement that of community based doctors.  This may well include the use of in-pharmacy diagnostic tests as the age of personalised medicine arrives and the population begins to use medicines that are most effective for their genetics and lifestyle, etc.

No advantage in double dose oseltamivir in treatment of severe influenza

23 Jul, 13 | by kuppell

A study investigating the validity of recommendations in treatment guidelines to use higher than approved doses of oseltamivir in patients with severe influenza has found that there were no virological or clinical advantages with double dose compared with standard dose.

The double-blind randomised control trial was conducted in 13 hospitals in Indonesia, Singapore, Thailand and Vietnam. The study included 326 patients, of which 246 were children (<15 years), and 165 and 161 patients were randomised to receive double (150mg twice daily or paediatric equivalent) or standard (75mg twice daily or paediatric equivalent) oseltamivir, respectively. A total of 260 patients (79.8%) were infected with influenza virus A, 53 (16.2%) with influenza virus B and 13 (3.9%) were found to be false positive by rapid antigen test.

The primary endpoint was the viral status according to reverse transcriptase PCR for influenza RNA in a combined nasal and throat swab on day 5 after oseltamivir treatment. Secondary clinical endpoints included mortality, mechanical ventilation, admission to intensive care, symptoms and resumption of activity. The researchers say: ‘We found that double dose oseltamivir was well tolerated but did not confer additional virological or clinical benefits over standard dose treatment in South East Asia. There were no differences between the treatment arms in detection of viral RNA or infectious virus on day 5.’ They do, however, point out that as all patients were randomised to an active treatment the study was not designed to evaluate the efficacy of oseltamivir in H5N1 infections. BMJ 2013;346:f3039.

Latest from European Journal of Hospital Pharmacy

Latest from European Journal of Hospital Pharmacy