09-04-2014 The EuroPharm Forum The European Forum of National - PDF document

09-04-2014 The EuroPharm Forum • The European Forum of National Pharmaceutical Recent developments in Associations in Europe pharmaceutical care: Europe and • A joint network of national pharmaceutical associations Hungary • Collaborates with the World Health Organization, Regional Balázs Hankó Office for Europe Vice-president Associate professor, chief pharmacist • The first of the Regional Forums of FIP, covering the WHO Europe Region EuroPharm Forum Semmelweis University, University Pharmacy Department of Pharmacy Administration • Founded in January 1992 45th EQUIP ASSEMBLY MEETING AND OPEN CONFERENCE "INTERPROFESSIONAL MANAGEMENT OF PATIENTS IN FAMILY PRACTICE„ MAY 8-10th, 2014 Ljubljana, Slovenia 1.1. Society needs Content - primary prevention - Risk factors Total DALY % Total DALY % 1. Society needs and challenges High income middle income countries countries 2. Why should pharmacists be involved? Tobacco use 10.7 5.4 3. Pharmaceutical care Alcohol use 6.7 7,6 Overweight and obesity 6.5 3.6 4. Evidence – pharmacists interventions High blood pressure 6.1 5.4 5. Hungarian examples High blood glucose 4.9 3.4 Physical inactivity 4.1 2.7 6. Need for better collaboration High cholesterol 3.4 2.5 Total 42.4 30.6 7 leading risk factor causes of DALYs , GLOBAL HEALTH RISKSMortality and burden of disease attributable to selected major risks WHO, 2009 (DALY: Disability adjusted life years) 1.3.1. Society needs 1.2. Society needs Drug-related problems Undiagnosed chronic diseases – secondary prevention • Increasing OTC consumption, but! • – Inadequate use - overdose Three European cities (Abruzzo, • Irish example - Prevalence of OTC overdoses at ER departments (40 % partly, Italy; Limburg, Belgium; South- 24 % total caused by OTCs - 2002 ) 1 west London, UK) 24.4 % of the – Interactions participants’ blood pressure was • USA study shows that 50 % of the interactions are caused by OTCs 2 higher than 140/90 1 , • Elderly population – 56 % of them were newly • Polypharmacy in the elderly diagnosed • Odds of being hospitalized by ADR are 4 times higher than for younger 3 – (16.6 % vs. 4.1 %). • Use of over-the-counter (OTC) medications by elderly patients is often not • The ratio of undiagnosed diabetic identified (78 % of admitted patients use OTCs) 4 patients is around 50 % 2 • – The average prevalence of Low health literacy • diabetes is 7-8 % in adults Strongest predictor of an individual’s health status 5 • Low literacy was significantly associated with misunderstanding 6 – 34.7 % could demonstrate the number of pills to be taken daily 1. M. Wazaif y , S. Kennedy , C. M. Hughes, J. C. McElnay . Prev alence of ov er-the-counter drug-related ov erdoses at Accident and Emergency departments in Northern Ireland – a retrospectiv e ev aluation Journal of Clinical Pharmacy and Therapeutics; 2005 30:39-44 2. D. M. Qato, G. C. Alexander, R. M. Conti, M. Johnson, P et al. Use of Prescription and Ov er-the-counter Medications and Dietary Supplements Among Older Adults in the 1. J.-M. Ekoé, Paul Zimmet, Dav id Robert Rhy s Williams. The Epidemiology of Diabetes Mellitus: An International Perspectiv e. John Wiley and Sons, 2001. ISBN 047197448X, 9780471974482. United States. JAMA. 2008;300(24):2867-2878. 3. Hospitalizations caused by adv erse drug reactions: a meta analy sis of observ ational studies. Pharm World Sci 2002; 24(2):46-54.4. Gwenno M Batty et al. The use of ov er- 2. S. Costanzoa, A. D. Castelnuov oa, F. Zitoa et al. Prev alence, awareness, treatment and control of hy pertension in healthy unrelated male–f emale pairs of European regions: the dietary habit prof ile in European the-counter medication by elderly medical in-patients. Postgrad Med J. 1997; 73:720-722. 5. www.askme3.org 6. Terry C. Dav is, Ruth Parker. To Err Really is Human: Misunderstanding Medication Labels. communities with dif f erent risk of my ocardial inf arction – the impact of migration as a model of gene–env ironment interaction project. Journal of Hy pertension 2008, 26:2303–2311. http://www.iom.edu/Object.File/Master/47/271/Dav is.pdf 3. H.J.M. Beijer et al. 1

09-04-2014 1.3.2. S ociety needs 1.4. Difference between efficacy and effectiveness Drug-related problems - Quality gap - • Pharmaggedon 1 – Non-adherence • Yearly 194,500 patients die in the EU • Can pharmacists take part in interprofessional collaboration by • Yearly 1.25 billion € lost – UK bridging these gaps, solving these problems? • Estimated medication costs for England due to non-adherence (2004) € 12 million; • • Will society and other professionals Wastage of medicines accounted for 2.3 % of total medication costs – Portugal studies accept this? • proportion of medicines wasted ~ 16 %. • average wastage cost per medicine dispensed was € 4.44, • Will society and other professionals • Harm survey in the Netherland 2 respect this? • The Hospital Admission Related to Medication is 41,000/year • Will society and other professionals • 5.6 % of the unplanned hospital admissions were medication-related, almost half (46.5 %) of these admissions were potentially preventable reward this? • Will pharmacists accept the challenge? 1. PGEU policy statement. Targeting Adherence. Outcomes in Europe through community Pharmacists’ intervention. http://www.pgeu.org/Portals/6/documents/2008/Publications/08.05.13E%20Targeting%20adherence.pdf2. Anne J. Leendertse et al.Frequency of and Risk Factors for Preventable Medication-Related Hospital Admissions in the Netherlands. ARCH INTERN MED/VOL 168 (NO. 17), SEP 22, 2008 8 ~1300 2014 2. Why should Content pharmacists be involved? 1. Society needs and challenges • 400,000 Community 2. Why should pharmacists be involved? Pharmacists in Europe 3. Pharmaceutical care • 160,000 Community 4. Evidences – pharmacists interventions Pharmacies in Europe 5. Hungarian examples 6. Need for better collaboration • 46 million citizens visit a pharmacy every day 2. Why should pharmacists be involved? Content • Community pharmacists in Europe are committed to making a major contribution to 1. Society needs and challenges improving public health by: 2. Why should pharmacists be involved? – seeking to ensure that people derive a maximum 3. Pharmaceutical care therapeutic benefit from prescribed medication dispensed in pharmacies 4. Evidences – pharmacists interventions – providing high-quality advice to ensure safe and 5. Hungarian examples responsible self-care including, where appropriate, self-medication 6. Need for better collaboration – encouraging healthy lifestyles through effective health promotion and health education strategies Lisbon, 11 Nov 2009 2

09-04-2014 3. The pharmacists’ answer is pharmaceutical care 3. The pharmacists’ answer is pharmaceutical care - development in terminology - - development in terminology - • “ is the responsible provision of drug therapy for • EuroPharm Forum - WHO the purpose of achieving definite outcomes that – Holistic approach, including: improve a patient’s quality of life ”. (Hepler & • Primary and secundary prevention Strand, Am J Hosp Pharm. 1990) • Improving prescribing and rational drug use • Country definitions 1 • “….. pharmacy practice ….. to promote health, to – Differences prevent disease , and to assess, monitor, initiate, • Drug therapy focus – holistic approach and modify medication use …. within realistic – Hungarian definition economic expenditures .” (APhA) • „The responsible, documented activity of the pharmacist in collaboration with the doctor , which aims to improve the effectiveness, and efficiency of the drug therapy, and to promote healthy lifestyle, • ”responsible provision of pharmacotherapy and the right medication use, improve the adherence, and quality of life under quality controlled ……collaborative process that aims to prevent or circumstances” ( Act of Medicine) identify and solve medicinal product and health related problems …” (FIP) 1. J . W. Foppe van Mil, PhD, Martin Schulz . A Review of Pharmaceutical Care in Community Pharmacy in Europe Harvard Health Policy Review. Vol. 7, No. 1, Spring 2006 1 3. The pharmacists’ answer is pharmaceutical care 3. The pharmacists’ answer is pharmaceutical care - development in terminology - - development in terminology - Pharmaceutical care is • the pharmacist’s contribution… – multidisciplinary approach is to be desired • … to the care of individuals… – targeting individuals • …in order to optimise medicine use… – should include patient-centered elements • and improve health outcomes 4. A guide to evidence Content 1. Society needs and challenges 2. Why should pharmacists be involved? 3. Pharmaceutical care 4. Evidences – pharmacists’ interventions 5. Hungarian examples 6. Need for better collaboration 11/05/2014 C ore V alues, EuroPharm Forum 18 3