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Pharmacy Practice (Granada)

versão On-line ISSN 1886-3655versão impressa ISSN 1885-642X

Pharmacy Pract (Granada) vol.18 no.1 Redondela Jan./Mar. 2020  Epub 27-Abr-2020

https://dx.doi.org/10.18549/pharmpract.2020.1.1878 

Editorial

An international series on the integration of community pharmacy in primary health care

Shalom I Benrimoj (orcid: 0000-0001-9768-7838)1  , Fernando Fernandez-Llimos (orcid: 0000-0002-8529-9595)2 

1PhD. Editorial Board member, Pharmacy Practice. Emeritus Professor University of Sydney. Sydney (Australia). shalom.benrimoj@gmail.com

2PhD, MPharm, MBA. Editor-in-chief, Pharmacy Practice. Laboratory of Pharmacology, Department of Drug Sciences, College of Pharmacy, University of Porto. Porto (Portugal).fllimos@ff.up.pt

Abstract

The interrelationship between governmental policies and objectives in primary health care and community pharmacy/pharmacists’ strategic plans are of the outmost importance, having significant professional, economic and practical consequences for the future of the pharmacy profession, research, education and health care. Sharing information of the potential and real impact on current and future practice of community pharmacy/pharmacists, be it in product or service, in primary care would benefit many stakeholders. In order to create and focus professional and scientific debate the journal has commissioned key experts to contribute a series of country case studies. The aim of the series is to promulgate and disseminate country-based information on primary health care and community pharmacy/pharmacist.

Keywords: Pharmacies; Primary Health Care; Delivery of Health Care Integrated; Ambulatory Care; Community Health Services; Pharmacists; Community Pharmacy Services

In recent times many governments have launched policies and strategic plans for the development of primary care in their health care systems. Alongside this development other health care organisations such as private health insurers and other third-party payers will have a major influence on primary health care. The emphasis and drive towards prioritising primary care comes, as excellently summarised by the World Health Organization (WHO), due to the fact that "Primary health care is well-positioned to respond to rapid economic, technological, and demographic changes, all of which impact health and well-being".1 Primary health care is seen to be the "cornerstone of health care coverage".2 In many countries government policy is encouraging people to access health care at an appropriate level and entry point for their needs. For example, in the case of minor ailments to seek advice at community pharmacies rather than emergency departments or general medical practice.3

The term ‘primary care’ is in its broadest terms is defined by WHO as: "At its heart, primary health care is about caring for people, rather than simply treating specific diseases or conditions. Primary health care is made up of three main areas: empowered people and communities; multisectoral policy and action; and primary care and essential public health functions as the core of integrated health services. This includes a spectrum of services from prevention (e.g., vaccinations and family planning) to management of chronic health conditions and palliative care".

Concurrently many pharmacy organisations, including the International Pharmaceutical Federation (FIP), and several national pharmacy organisations are in the process or have developed vision statements and strategic plans about the future of pharmacy and the role of pharmacists.4 These documents describe the current and future philosophical direction and plans for community pharmacy and pharmacists. In general, there is a consensus that the future of community pharmacy and pharmacist, whilst maintaining the dispensing and supply of all types of medications, is in the implementation of remunerated professional services. Community pharmacies are positioned as "health care hubs" and "primary health care destinations" for patients and consumers. Community pharmacists are positioned as essential primary health care professionals. In many cases community pharmacy is cited as the most accessible, most visited and pharmacists quoted as a cost-effective primary health care professional.5 Community pharmacy professional services are being defined broadly to encompass many types of services.6 These services range from minor ailments services in Scotland, immunisations and vaccinations in Canada, Australia and some European countries, disease screening in the United Kingdom, medication reviews and medication management of many types in Canada, England, United States of America and Australia, and more recently disaster and outbreak response in many countries.7,8

The interrelationship between governmental policies and objectives in primary health care and community pharmacy/pharmacists’ strategic plans are of the outmost importance, having significant professional, economic and practical consequences for the future of the pharmacy profession, research, education and health care. In many countries there is call by the profession for the integration of community pharmacy into the health care system rather than just be seen since as a supplier of medications. There is also a shift of remuneration from being based on medicine cost and mark up to a fixed professional fee for dispensing and fees for professional services. These moves are complicated by many factors associated with community pharmacy such as ownership laws and, retailing and commercial aspects.9 The move for retailer to health care providers is complex and transformative with many challenges.

Sharing information of the potential and real impact on current and future practice of community pharmacy/pharmacists, be it in product or service, would benefit many stakeholders. In order to create and focus professional and scientific debate the journal has commissioned key experts to contribute a series of country case studies. The aim of the series is to promulgate and disseminate country-based information on primary health care and community pharmacy/pharmacist.

The series has a number of specific objectives:

  1. To describe primary health care policies strategies and developments in individual countries and the key changes envisaged.

  2. To describe how they include/exclude pharmacy particularly community pharmacy and the role of community pharmacy /pharmacists.

  3. To describe and analyse the strategic plans/vision/mission statements of community pharmacy organisations

  4. To discuss the challenges and the opportunities community pharmacy/pharmacist face.

Each paper will include country specific data on size of population and health expenditure with a brief description of the health care systems, the main changes envisaged in the primary care and the influences behind those changes. Governmental objectives with resource allocation for primary health care will be reported. Importantly, the papers will review the inclusion of community pharmacy and the roles of community pharmacy/pharmacists. The specific primary health care services which are being currently being delivered and those that are being planned to be delivered by community pharmacies and pharmacist will be documented.

From the perspective of community pharmacy, we will attempt to provide a brief overview of community pharmacy for example in terms of numbers of pharmacies and pharmacist etc. We will extract key strategies and elements being considered and if possible and available review critical elements of the implementation plans. The invited expert will provide their assessment and views of the integration of community in to the primary health care system covering the main challenges and opportunities for community pharmacy in their country and critical issues in health and their effect on policy for community pharmacy. Not all papers will cover all these issues since their relative importance, applicability and availability of data will be different for individual countries

As series editors we are hoping that these articles, from a diverse number of countries, will act as a catalyst for debate and disseminate critical knowledge that will inform and affect the pharmacy profession.

REFERENCES

1. World Health Organization. Primary health care. Available at: https://www.who.int/news-room/fact-sheets/detail/primary-health-care (accessed Mar 10, 2020). [ Links ]

2. Binagwaho A, Adhanom Ghebreyesus T. Primary healthcare is cornerstone of universal health coverage. BMJ. 2019;365:l2391. https://doi.org/10.1136/bmj.l2391 [ Links ]

3. Scottish Government. The NHS Minor Ailment Service at your local pharmacy. Available at: https://www.gov.scot/publications/nhs-minor-ailment-service-local-pharmacy-2/ (accessed Mar 10, 2020). [ Links ]

4. International Pharmaceutical Federation. Vision and mission. Available at: https://www.fip.org/vision-mission (accessed Mar 10, 2020). [ Links ]

5. Pharmacies in Profile. RxImpact 2013;(March):6. [ Links ]

6. Moullin JC, Sabater-Hernández D, Fernandez-Llimos F, Benrimoj SI. Defining professional pharmacy services in community pharmacy. Res Social Adm Pharm. 2013;9(6):989-995. https://doi.org/10.1016/j.sapharm.2013.02.005 [ Links ]

7. Durham MJ, Goad JA, Neinstein LS, Lou M. A comparison of pharmacist travel-health specialists' versus primary care providers' recommendations for travel-related medications, vaccinations, and patient compliance in a college health setting. J Travel Med. 2011;18(1):20-25. https://doi.org/10.1111/j.1708-8305.2010.00470.x [ Links ]

8. Yuan C, Ding Y, Zhou K, Huang Y, Xi X. Clinical outcomes of community pharmacy services: A systematic review and meta-analysis. Health Soc Care Community. 2019;27(5):e567-e587. https://doi.org/10.1111/hsc.12794 [ Links ]

9. Mossialos E, Courtin E, Naci H, Benrimoj SI, Bouvy M, Farris KB, Noyce P, Sketris I. From "retailers" to health care providers: Transforming the role of community pharmacists in chronic disease management. Health Policy. 2015;119(5):628-39. https://doi.org/10.1016/j.healthpol.2015.02.007 [ Links ]

pub: March 13, 2020

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