World congress canvasses effective use of medicines
In this insightful article, the International Pharmaceutical Federation (FIP) gives hospital pharmacists a preview of what to expect at this year’s World Congress of Pharmacy and Pharmaceutical Sciences.
The World Health Organisation 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.
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 evidence-based 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.
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.
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 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.
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 healthprofessionals 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 PernilleDam, 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.
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.“Healthcare 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, low-income 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 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 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 in your diary.