Clinical Pharmacology in European health care—outcome of a questionnaire study in 31 countries

Abstract

In order to discover how well the discipline of clinical pharmacology (CP) has developed in Europe, a questionnaire survey was undertaken in 31 countries. The senior delegate of each of the 31 countries on the Council of the European Association for Clinical Pharmacology and Therapeutics (EACPT) was approached personally. This study was not an official EACPT survey. Based on the results of the completed survey forms, CP is recognized as an academic discipline in teaching and research fields in 28 of the 31 participating countries, but as a medical specialty in only 22 of these 31 countries. Surprisingly, France and Italy were two of the nine countries where CP was not recognized as a medical specialty. In 50 % of the countries where CP was recognized as a medical specialty, this recognition had occurred more than 30 years ago. The training of clinical pharmacologists in terms of years after internship varied between the countries. In eight countries the training was predominantly in internal medicine with shorter periods in pharmacology. In 11 countries the training was predominantly in CP, and in six countries there was dual training in pharmacology and clinical medicine. The training played a decisive role in terms of the clinical functions undertaken in health care. There was considerable variation in the numbers of clinical pharmacologists in each country, with the total figure varying between ≤ 10 to 600. In terms of the number of clinical pharmacologists per million inhabitants, nine countries have ≤ 1 (Belgium, Bulgaria, France, Greece, Italy, Lithuania, Poland, Turkey and UK) while four have ≥ 10 (Hungary, Norway, Slovakia and Sweden). Stumbling blocks which inhibit the development of CP as a discipline in health care are the lack of defined functions and consultant posts for clinical pharmacologists in health care in many countries and the underrepresentation of CP in pre- and postgraduate curricula. The majority of the responding countries suggested that EACPT should prioritize that CP becomes recognized and accredited as a European medical specialty.