Perspectives in introducing pharmaceutical care in integrated care organization in Poland

Abstract

Introduction: Pharmaceutical care is a necessary element of healthcare, but pharmacies as centres of pharmaceutical care services are not included in integrated care system in Poland. Short description of practice change implemented: we developed a project of extending the range of services in integrated care organization in Poland with pharmaceutical care meant as professional drug counseling provided by pharmacists. Objectives: The first step of implementation was to identify and analyse potential obstacles in introducing pharmaceutical care as an important element of integrated care in Poland. Methods: Reviews conducted with pharmacists actively working in pharmacies and representatives of pharmaceutical software company. Targeted population and stakeholders Ca. 68000 patients in mazowieckie and lubelskie woiwodships belonging to IC organization Medical and Diagnostic Centre in Siedlce, Poland, which uses electronic health records and e-prescribing and owns 7 pharmacies. Timeline: 2014 Outcomes: There are a range of barriers identified by pharmacist, such as lack of well-trained staff, poor access to patient’s clinical data, lack of remuneration. Pharmacies in Poland have no standard software suitable for records of patients information and legal possibilities to check full 15th International Conference on Integrated Care, Edinburgh, UK, March 25-27, 2015 1 International Journal of Integrated Care – Volume 15, 27 May – URN:NBN:NL:UI:10-1-117037– http://www.ijic.org/ patient electronic record, including all medicines prescribed and currently taken. Thus the basic check-out/control of probable drug-drug interactions cannot be made. Pharmaceutical software in pharmacies allows to check such interactions only by entering medicines by hand. Moreover, pharmacist may only enter medicines which are listed on prescriptions realized in that moment of time and other medicines about which patient currently informed. Conclusions: Development is required in education, training, remuneration structure. The improvement of pharmaceutical law in data sharing process as well as integration of pharmaceutical software are crucial elements of complete adaptation of and positioning pharmaceutical care as a basic element of integrated care in Poland. Without it the basic elements of pharmaceutical care services offered in pharmacies such as real-time drug-drug interactions control will never be attainable. Discussions: This study assess perceived obstacles to pharmaceutical care implementation and indicates that the current status of patient data linkage in community pharmacies is not sufficient for medication safety monitoring. A well perception of this barrier can be a base to bridge the gap between theoretical and applied pharmaceutical care. Lessons learned: In our project we plan overcoming the above mentioned obstacles with entering medicines by hand and obtaining patient`s informed consent, but results from this survey provide clear information to the decision makers how to practically implement pharmaceutical care services into intergrated care in Poland. Without appropriate regulations implementing pharmaceutical care in Poland will remain only theoretical exercise.