Mil and Schulz: a Review of PhaRMaceutical caRe
A Review of Pharmaceutical Care in Community Pharmacy in Europe
J. W. Foppe van Mil, PhD, Martin Schulz, PhD
lthough a number of articles about pharmacy practices in European countries have been published, few reviews compare pharmacy and pharmaceutical care practices throughout Europe.1,2 In 2000 the status of pharmaceutical carein Europe was discussed in a Spanish journal,3 and in 2004 two other reviews were published.4,5 A series of articles on the development of pharmaceutical care and pharmacy practice in a number of countries is now being published in the Annals of Pharmacotherapy.6 But these articles describe one country at a time, and the series will only cover a limited number of European countries.7,8,9,10 Thereare several reasons why it is difficult to get a clear picture of pharmacy and pharmaceutical care practices in Europe. Although the European Union (EU) has now existed for many years, there has yet to be any harmonization in the field of primary health care even
though a number of recommendations have been made.11 As a result, there still are major differences in health care policies andpractices among European countries. Furthermore, it is not very common to describe current practices or professional developments in pharmacy; most articles focus on commercial and professional threats to pharmacy or future challenges. It is somewhat easier to find articles describing research into small elements of pharmacy practice; but in most European countries even this research is not yet normalpractice. There are many different pharmacy journals in Europe, but they are published in over forty different languages and many are not indexed in major international databases like Medline/Pubmed. In this literature review, we aim to describe contemporary European developments regarding the implementation of and research into pharmaceutical care, focusing on the community pharmacy. We willidentify the major
J.W. Foppe van Mil, PhD, is a community pharmacist in a rural area of the Netherlands. Since 2000, he has also served as a consultant on pharmacy practice research and pharmaceutical care. In January 2000, he concluded his PhD in Social Pharmacy and Pharmacoepidemiology at the University Center of Pharmacy in Groningen. He is author or co-author of over 100 publications onpharmacy practice and pharmaceutical care. Martin Schulz, PhD, is an Adjunct Professor at Johann Wolfgang Goethe University, Department of Pharmacology, Frankfurt at Main, Germany. He is head of the Center for Drug Information and Pharmacy Practice (ZAPP) of ABDA - the Federal Union of German Associations of Pharmacists, Berlin. In addition, Dr. Schulz is Director of Pharmacy of the German Institutefor Drug Use Evaluation (DAPI). He has more than 360 publications to his name, has delivered 220 lectures and seminars, and has written books as well.
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movements in the pharmacy profession and give some indication of future developments. This review is based upon information from articles that are written in major European languages (French,German, English, Dutch and Spanish) and articles written in other languages with English abstracts. Letters to the editors are not included in the review, but commentaries are.
Definition of Pharmaceutical Care
In 1990 Hepler and Strand published the first useful definition of pharmaceutical care. They wrote, “pharmaceutical care is the responsible provision of drug therapy for the purpose ofachieving definite outcomes which improve a patient’s quality of life.” Most European countries rely on this definition in their approach to pharmaceutical care, and many have just translated Hepler and Strand’s terminology. But even the act of translation has introduced notable discrepancies, for the meaning of the word “care” differs across languages. Some Europeans have tried to clarify the...