In the year 2008 the project “Development of indicators for assessing
care in Europe” was launched by the European Directorate for the Quality of
& Health Care (EDQM) (Council of Europe) with the objectives to develop
pharmaceutical care indicators and the promotion of their use. In the course of
project, topic groups led by scientific collaborators were formed in order to
already existing indicators and pharmaceutical care practices in a scoping
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:
the pharmaceutical care concept and applying it in practice” were presented in
expert workshop in Strasbourg on 19 November 2009 where possible indicators to
developed were discussed.
The aim of the present report is to understand the integration of the
care concept within a health system, by identifying concrete pharmaceutical care
practices which could serve as good practice models for other countries. A
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
some European countries, in particular the Nordic countries, UK, the
Germany, but also in a few Mediterranean countries (e. g. Portugal). However, in
Central and Eastern European countries the implementation of pharmaceutical care
not proven to be as advanced as in Western European countries. Another result
emerged from the literature review and personal talks with relevant stakeholders
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
such as the Pharmaceutical Care Network Europe that brought up some joint
pharmaceutical care projects. Other international initiatives have been
the World Health Organisation, the Pharmaceutical Group of the European Union
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
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
will form a basis for further development of indicators. Pharmaceutical care
outcome indicators are good to measure in particular specific disease-related
where smaller groups are targeted, and thus in-depth documentation with a
range of data is possible. However, when following the concept of pharmaceutical
as defined by Hepler & Strand, which comprises a fairly large group of people
of focussing on specific indication groups, an outcome-indicators focused
seems rather difficult to be implemented. Compared to outcome indicators in
pharmaceutical care, process indicators seem to be more appropriate. A suggested
to move forward with indicators for pharmaceutical care is based on a check-list
including several, mainly process, indicators.