Medication review is a structured and systematic evaluation of a patient’s medicines with the aim of optimising their use and improving health outcomes. It involves the identification of actual or potential medicine-related problems and results in recommendations to optimise medicine use. Medication review is performed in parts of Europe but is an under-used health service intervention and needs to be performed in a consistent and systematic manner to realise the benefits. The potential value of medication review to patients and to health services does not seem to be appreciated, and while some countries have national guidance, there is no standardised guidance at the European level available across the Council of Europe member states at present. These guidelines aim to: a) establish a common understanding of what medication review is and how it contributes to improving the use of medicines; b) set out the process of conducting a medication review; c) illustrate the necessity for the collection and sharing of data; d) provide guidance concerning education and training; e) provide insights on how to support the development of this service and to facilitate the implementation into practice at the European level; f) provide information on existing medication review programmes. The guidelines are intended for competent national authorities and policy makers, pharmacists and healthcare professionals conducting medication review, and for health service organisations establishing medication review programmes.
The South-eastern Europe Health Network (SEEHN), a regional intergovernmental organisation, and the European Directorate for the Quality of Medicines & HealthCare (EDQM), a Directorate of the Council of Europe, are both committed to contributing to improve the health of their member states’ populations. To promote Council of Europe Resolution CM/Res(2020)3 on the implementation of pharmaceutical care for the benefit of patients and health services, a joint EDQM-SEEHN survey was conducted to map the implementation of pharmaceutical care and related services in daily practice in SEEHN member states that are also Council of Europe members and signatories of the Convention on the Elaboration of a European Pharmacopoeia. This report presents the outcomes of the EDQM-SEEHN data collection exercise. It also provides some suggestions for possible follow-up actions to ensure a wider promotion of Resolution CM/Res(2020)3 and the concept of pharmaceutical care in SEEHN member states with the ultimate goal to achieve the benefits of responsible use of medicines and encourage rational use of healthcare resources.
This document was prepared by the Committee of Experts on Quality and Safety Standards in Pharmaceutical Practices and Pharmaceutical Care (CD-P-PH/PC). The goal of the document is to provide a general framework and guiding principles for the dissemination of deliverables of the European Committee on Pharmaceuticals and Pharmaceutical Care (CD-P-PH) and its subordinate committees of experts in accordance with their terms of reference.
The ADD guidelines were developed by a working group of experts from industry, academia, pharmacy and government from across the region of the Council of Europe. These guidelines harmonise the standards and approaches to automated dose dispensing across Europe and are intended to be used by pharmacies and manufacturers involved in ADD, as well as by national authorities in countries where this service is provided. They include standards regarding the ADD sites and operations, as well as patient care activities associated with the ADD process.
Pharmaceutical care is understood as a quality concept and working method for the responsible provision of medicine therapy for definite outcomes in the interest of patients’ quality of life (Hepler and Strand’s definition - 1990). The main goal of the EDQM Pharmaceutical Care Quality Indicators Project was to develop, test and validate 4 sets of quality indicators. For each indicator set, pilot studies were carried out in different countries in Europe under real-life conditions, and in different healthcare settings. A total of 19 collaborators from 12 countries in Europe were involved in the last phase of the project. The project drew up and validated 4 basic sets of quality indicators covering 4 key areas of the pharmaceutical care process. These indicators can be used by health authorities and healthcare professionals to evaluate pharmaceutical care practices and policies, and to promote the efficient and safe use of medicines, leading to the best possible medication outcome for the patient.
Medication is the most frequent intervention in healthcare systems. However, patients do not always receive the full benefits that their treatment can provide and if they are not prescribed or taken properly, medicines can actually cause serious illness or even death. Pharmaceutical care – a quality concept and a working method for professionals involved in prescribing, dispensing and administering medicines – is indispensable to ensure the appropriate and safe use of medicines. The Committee of Experts on Quality and Safety Standards in Pharmaceutical Practices and Pharmaceutical Care, co-ordinated by the EDQM, developed indicators to assess the implementation and quality of pharmaceutical care services in Europe. Governments and policy-makers are encouraged to take action to prevent the harm, impaired quality of life, work time lost and wasted resources that arise from the inappropriate use of medicines and from drug-related problems.
Pharmaceutical care is a fundamental part of healthcare. According to Hepler and Strand (1989), “pharmaceutical care is the responsible provision of medicine therapy for the purpose of achieving definite outcomes that improve a patient’s quality of life”. Pharmaceutical care is based on a relationship between patients and the healthcare professionals who are responsible for them. Active participation of patients in the medicine therapy decisions concerning them, and co-operation between healthcare professionals across disciplines are central in this concept whose goal is direct benefit to the patient. The Committee of Experts on Quality and Safety Standards in Pharmaceutical Practices and Pharmaceutical Care contributes to the EDQM’s mission of promoting access to good quality medicines and healthcare. In 2008-2009, as part of its programme of activities, this Committee of Experts carried out a survey designed to assess awareness and understanding of the concept of pharmaceutical care in Europe. The resulting report analyses and discusses the responses received from national public health authorities and associations of physicians, pharmacists, nurses and patients from 17 countries.
Guidelines on medication review
The implementation of pharmaceutical care in daily practice in SEEHN member states. Survey report
Guidance to disseminate the deliverables related to pharmaceuticals and pharmaceutical care
Automated Dose Dispensing (ADD): Guidelines on best practice for the ADD process and care and safety of patients
Pharmaceutical care: Where do we stand? Where should we go?