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World congress tackles effective use of medicines
What’s in store at this year’s World Congress of Pharmacy and Pharmaceutical
Sciences? The International Pharmaceutical Federation gave a hospital pharmacist a
preview of the programme. Here’s what she thought.
The World Health Organization estimates that each year some 16 million people die
prematurely — before the age of 70 — from non-communicable diseases (NCDs).
These include heart and lung diseases, stroke, cancer and diabetes. The effective
use of medicines figures prominently among the “best-buy” options to reduce the
death toll. This is a thread that links many of the sessions at the International
Pharmaceutical Federation’s 75th world pharmacy congress and is a topic of
particular interest to hospital pharmacists.
Building blocks
Evidence-based practice and medication review are two of the building blocks of
effective medicines use and a number of speakers will address different aspects of
these topics. One session is devoted to reviewing the definition and relevance of
evidence-based practice, the gaps between current practice and evidence-based use
of medicines, and the limits. Medication reviews are undertaken in all areas of clinical
practice and, in recent years, guidelines and algorithms have been developed to help
pharmacists deliver consistent, high-quality reviews. Best practice examples from all
over the world will demonstrate different methods for medication review, software
solutions and documentation together with the evidence for effectiveness. A related
session will show how “information mastery” is essential for the delivery of evidencebased practice. Speakers will explain how this differs from critical appraisal skills and
provide a hands-on demonstration of the use of high quality information mastery
resources.
Revolutionary developments
Another aspect of effective medicines use is personalised dosing — something that
is critical for high-potency drugs and vulnerable groups such as paediatric or geriatric
patients. Speakers will describe how, for some drugs, doses can be matched to the
patient’s unique genetic make-up — an approach that is predicted to increase the
safety and efficacy of drug treatment. But this is not the only revolutionary
development in drug treatment. The way we give medicines is advancing far beyond
the tablet and the injection and participants will hear about new formulation concepts.
Experts will describe how individualised oral therapy can be given using a solid
dosage pen and how printing technology can be used to produce personalised
dosage forms.
Intergrated safety
Safety is now seen as an integral aspect of medicines use. In a session devoted to
pharmacy in Germany, Dr Torsten Hoppe-Tichy, chief pharmacist, University Hospital
of Heidelberg, will describe how pharmacists are playing a key role in the
development of the medication safety system in German hospitals. “There are many
good examples where pharmacists have taken the lead, for example, in tackling
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vincristine and methotrexate dosing errors and look-alike, sound-alike drug names.
As a result there is now a national plan for patient safety,” he says.
Human impacts
In what promises to be a thought-provoking session on human impacts on medicines
use speakers will explore a variety of important issues. Yolanda Robles, executive
vice president of the Philippine Pharmacy Association, explains: “It is in the hospital
setting where admissions and negative consequences related to non-adherence by
patients to medication regimens are encountered. In addressing this problem, more focus
has been given by health professionals to motivating patients through standard patient
education and counselling (based on disease and drug information), and the use of
compliance aids. While these methods have their documented benefits, there is less
knowledge and understanding of medication adherence relating to human beliefs,
including religiosity and spirituality.” Professor Robles has studied the relationship
between medication and the depth of belief in Christian religious doctrines in the
Philippines, for example. “The data from the study may be helpful in designing
counselling interventions for patients with religious belief-related health adherence
problems,” she says. Participants will also hear how the study has provided data on
religious and spiritual beliefs that patients may not openly discuss with health
professionals during their hospital stay.
In the same session Dr Pernille Dam, an R&D consultant at Pharmakon, Denmark,
will talk about new technologies for tracking compliance and administration. The
impact of pharmacogenomics and the balance between patient autonomy and acting
in the patient’s best interests will also be discussed during the session.
Workforce evolution
The changing role of the hospital pharmacist and rapid developments in
pharmaceutical technology raise many issues for workforce training and
development. How the FIP Global Competency Framework supports the FIP Basel
statements — a set of 75 consensus statements developed by an international
group, which describe the preferred vision for hospital pharmacy — is also on the
agenda. Speakers will use practical examples and case studies to show a variety of
approaches that are being used to develop competency and advanced practice. For
instance, Catherine Duggan, director of professional development and support, Royal
Pharmaceutical Society, will describe how the UK is developing a “royal college”
approach to professional recognition, following the medical model. “Health care
providers now need to provide evidence that their staff have the qualifications,
competence, skills and experience to safely provide patient care,” Dr Duggan explains.
Participants can also hear about an e-learning project for French-speaking, lowincome countries. Started in 2013, it aims to foster the development of local experts
in hospital pharmacy. Pascal Bonnabry, chief pharmacist at the University Hospital
of Geneva, explains: “In many low-income countries access to affordable high-quality
drugs is a problem and so is [ensuring] safe and appropriate use of drugs. There are
significant gaps both in the training of professionals in this specialised area and in the
organisation of hospital pharmaceutical services — and patient care suffers as a
result.” His hospital has had a long-standing collaboration with the Faculty of
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Medicine, Pharmacy and Dentistry at the University of Bamako, Mali, providing
valuable insights into the problems and possible solutions. “The e-learning platform
that we have developed provides free, internet-based training at undergraduate and
postgraduate levels”, Professor Bonnabry says.
Remuneration
Remuneration is a critical element of any job and can be an important incentive.
Around the world there is a wide diversity of models for the payment of hospital and
community pharmacy services, some based on margins, while others are fees for
services or capitation. FIP has conducted an international survey on remuneration in
both community and hospital pharmacy and Dr Jacqueline Surugue, immediate past
president of FIP’s Hospital Pharmacy Section, will describe the findings related to
hospital pharmacy.
When and where
The World Congress of Pharmacy and Pharmaceutical Sciences will take place from
29 September to 3 October in Düsseldorf, Germany. It offers 230 hours of sessions
given by 220 experts from 40 different countries and includes many leading hospital
pharmacists, clearly demonstrating the breadth and depth of innovative hospital
pharmacy services worldwide. Make this a date for your diary.