In the year 2008 the project “Development of indicators for assessing pharmaceutical care in Europe” was launched by the European Directorate for the Quality of Medicines & Health Care (EDQM) (Council of Europe) with the objectives to develop pharmaceutical care indicators and the promotion of their use. In the course of the project, topic groups led by scientific collaborators were formed in order to explore already existing indicators and pharmaceutical care practices in a scoping exercise.

The results of the scoping exercise undertaken by the Gesundheit Österreich GmbH / Geschäftsbereich Österreichisches Bundesinstitut für Gesundheitswesen (GÖG/ÖBIG) which has the lead in the topic group “Health systems: policy aspects: Understanding the pharmaceutical care concept and applying it in practice” were presented in an expert workshop in Strasbourg on 19 November 2009 where possible indicators to be developed were discussed.

The aim of the present report is to understand the integration of the pharmaceutical care concept within a health system, by identifying concrete pharmaceutical care practices which could serve as good practice models for other countries. A two-step methodological approach was undertaken, which included a literature review and a case study survey.

The literature survey shows a long tradition in pharmaceutical services and care in some European countries, in particular the Nordic countries, UK, the Netherlands, Germany, but also in a few Mediterranean countries (e. g. Portugal). However, in Central and Eastern European countries the implementation of pharmaceutical care has not proven to be as advanced as in Western European countries. Another result which emerged from the literature review and personal talks with relevant stakeholders was that disease-specific pharmaceutical care (e. g. programmes for coronary heart disease, hypertension, and asthma) play an important role.

Several international initiatives related to pharmaceutical care have been undertaken such as the Pharmaceutical Care Network Europe that brought up some joint pharmaceutical care projects. Other international initiatives have been undertaken by the World Health Organisation, the Pharmaceutical Group of the European Union and the Council of Europe.

The case studies that were carried out by means of personal interviews with representatives from the Austrian Chamber of Pharmacists and the Portuguese Association of Pharmacies give an insight into specific pharmaceutical care-related projects such as the Pharmaceutical Safety Belt in Austria or the comprehensive pharmaceutical care programmes in Portugal.

IV © GÖG, Pharmaceutical Care

A few indicators were identified in the course of the present scoping exercise which will form a basis for further development of indicators. Pharmaceutical care related outcome indicators are good to measure in particular specific disease-related programmes where smaller groups are targeted, and thus in-depth documentation with a range of data is possible. However, when following the concept of pharmaceutical care as defined by Hepler & Strand, which comprises a fairly large group of people instead of focussing on specific indication groups, an outcome-indicators focused approach seems rather difficult to be implemented. Compared to outcome indicators in pharmaceutical care, process indicators seem to be more appropriate. A suggested way to move forward with indicators for pharmaceutical care is based on a check-list including several, mainly process, indicators.