Successful implementation of Pharmaceutical care in daily practice Charlotte Rossing, MSc pharm, PhD Director of Research and Professional Development Pharmakon, Danish College of Pharmacy Practice Vice-chair FIP SIG Pharmacy Practice Research @CharRossing @Charlotte Rossing © Pharmakon Pharmaceutical care Hepler & Strand 1990 1995 2000 2005 2010 2015 FIP community pharmacy section CPD Implemen- Pharmaceutical care for tation PCNE-funded the elderly Topics Pharmaceutical Care Self-management Patient satisfaction/health Academy Network Europe Good pharmacy practice Health economics master class FIP Tokyo 1993 (research) Patient effects Designing interventions “Pharmaceutical Guidelines and manuals Barriers and facilitators care in From evidence to practice Individualised interventions community Change management Implementation of new practice practice” PCNE working implementations Change management conferences Remuneration for Indicators to measure progress Every second year community pharmacy Theory and practice services Building capacity for change © Pharmakon © Pharmakon 1 Compliance Medication review technologies Clinical pharmacy Safe and effective use of in residential Counselling Dose dispensing medicines facilities at the 2004 pharmacy 2015 - and homecare Self- PCNE Municipality PCNE management Better use of Asthma TOM pharmacy OMA project medicines in project nursing homes collaboration 1990 1995 2000 2005 2010 2015 © Pharmakon Compliance Medication review technologies Clinical pharmacy Safe and effective use of in residential Counselling Dose dispensing medicines facilities at the 2004 pharmacy 2015 - and homecare Self- Municipality PCNE PCNE management Better use of pharmacy Asthma TOM OMA project medicines in collaboration project nursing homes 1990 1995 2000 2005 2010 2015 FIP community pharmacy section CPD Implemen- Pharmaceutical care for tation PCNE-funded Topics the elderly Pharmaceutical Care Patient satisfaction/health Self-management Academy Network Europe Health economics Good pharmacy practice FIP Tokyo 1993 master class (research) Designing interventions Patient effects “Pharmaceutical Barriers and facilitators Guidelines and manuals care in Individualised interventions From evidence to practice community Implementation of new practice Change management practice” PCNE working Change management implementations conferences Indicators to measure progress Remuneration for Every second year Theory and practice community pharmacy Building capacity for change services © Pharmakon © Pharmakon 2 From research to pharmacy practice in Denmark Guidelines and Development Research tools for Postgraduate Sector-specific of pharmacy project implementation courses certification services of service © Pharmakon How to develop a community pharmacy service Year 1 Year 2 Year 3-4 Year 4-7 Year 8-9 Year ? Year ? Identifying a Designing Obtain Test and Finalising the Negotiating for Reimbursement need for a and piloting a funding for evaluation service for reimbursement obtained service service testing and practice evaluating a service E-conomic Implementation of Patients? C-linical Manuals and new practice in guidelines pharmacy Medicines? H-umanistic Population? O-utcomes © Pharmakon © Pharmakon 3 Sources of remuneration in Denmark • Negotiated centrally • By Ministry of Health and the Association of Danish Pharmacies National • Negotiated decentrally • By regions, municipalities and pharmacy owners, and supported by the Local Association of Danish Pharmacies • Offered by a private company • Negotiated at each pharmacy Private • Direct sales to consumer • Negotiated/sold at the pharmacy • By pharmacy, to the individual patient Individual © Pharmakon Invite for counselling Pharmaceutical Basic care services counselling Patient classification Patient needs Focused assessment counselling © Pharmakon © Pharmakon 4 Remunerated service in Denmark •Re-prescribing •Inhaler • Selected technique •New medicine •Compliance medications assessment service follow-up • Dose dispensing service with remuneration © Pharmakon Community pharmacy services in Denmark Medication reviews Brown back review Patients Health checks Nursing homes and Smoking cessation residential Blood facilities pressure Vaccination Cholesterol © Pharmakon © Pharmakon 5 Community pharmacy services in Denmark Quality assurance of medication Competence development Nursing homes Home care Nursing homes Residential facilities Home care Residential facilities © Pharmakon Pharmaceutical care services available in Danish community pharmacies | SpringerLink © Pharmakon © Pharmakon 6 The main research areas at Pharmakon, the Danish College of Pharmacy Practice Delivery Services Mapping practice Counselling Pharmacy-specific tasks Developing services Developing and testing pharmacy services The future of pharmacy The future counselling and distribution of drugs The future medicine user practice The profession Pharmacy technicians Their tasks at the pharmacy Data collection by students © Pharmakon Community pharmacies and Results researchers meet Network for Community Pharmacy Practice Research and Publication Development Ideas Discussion and Quality collaboration © Pharmakon © Pharmakon 7 Selected publications • Garcia-Cardenas V, Rossing C, Llimos-Fernances F, Schultz M, Tsuyaki R, Bognon O, Tonin FS, Benrimoy S. Pharmacy Practice Research – A call for action. RSAP 2020 nov • El-souri M, Hansen RN, Raagaard AM, Soendergaard B, Rossing C. Pharmacy Technicians’ Contribution to Counselling at Community Pharmacies in Denmark. Pharmacy 2020 March • Abrahamsen B, Burghle AH, Rossing C. Pharmaceutical care services available in Danish community Pharmacies. Int J Clin Pharm. 2020 feb • Desselle SP, Hoh R, Rossing C, Holmes ER, Gill A, Zamora L. The caring behaviours of Danish pharmaconomists: insight for pharmacy technician practice around the world. Int J Pharm Pract, april, 2019 Apr;27(2):157-165 • Desselle SP, Hoh R, Rossing C, Holmes ER, Gill A, Zamora L. Work Preferences and General Abilities Among US Pharmacy Technicians and Danish Pharmaconomists. Int J Pharm Pract, august 2018 Aug 9:897190018792369 • Mygind A, El-Souri M, Rossing C, Thomsen LA “Development and perceived effects of an educational programme on quality and safety in medication handling in residential facilities”. Int J Pharm Pract. 2018 April • Mygind A, El-Souri M, Pultz K, Rossing C, Thomsen LA “Community pharmacists as educators in Danish residential facilities: a qualitative study”; Int J Pharm Pract. 2016 Sep • Kaae S, Dam P, Rossing C. “Evaluation of a pharmacy service helping patients to get a good start in taking their new medications for chronic diseases”; Res Social Adm Pharm. 2016 May-Jun;12(3):486-95. • ”Safe and Effective Use of Medicines for Ethnic Minorities - A Pharmacist-Delivered Counselling Program That Improves Adherence” Pernille Dam*, Mira El-Souri, Hanne Herborg, Lotte Stig Nørgaard, Charlotte Rossing, Morten Sodemann and Linda Aagaard Thomsen; J Pharma Care Health Sys 2015, 2:1 • Kjeldsen LJ, Bjerrum L, Dam P, Larsen BO, Rossing C, Søndergaard B, Herborg H. “Safe and effective use of medicines for patients with type 2 diabetes - A randomized controlled trial of two interventions delivered by local pharmacies”; RSAP 2015 Jan-Feb;11(1):47-6 • Kjeldsen LJ, Bjerrum L, Herborg H, Knudsen P, Rossing C, Søndergaard B.“Development of new concepts of non-adherence measurements among users of antihypertensives medicines”; Int J Clin Pharm. 2011 Jun;33 (3):565-72. © Pharmakon © Pharmakon 8.