The background to the new WHO/IUPHAR/CIOMS manifesto entitled “clinical pharmacology in health care, teaching and research” and the importance of the focus on health care

Abstract

The backgRound To The new who/IuPhaR/ cIoMS ManIfeSTo enTITled “clInIcal PhaRMacology In healTh caRe, TeachIng and ReSeaRch” and The IMPoRTance of The focuS on healTh caRe M. Orme Pharmacology and Therapeutics, University of Liverpool, Cheltenham, United Kingdom Summary: In 1970, the World Health Organization (WHO) published its well-known manifesto on clinical pharmacology, which for many years was the gold standard of the discipline. However, for the last 10 years or so it has been clearly in need of updating. This was finally achieved in 2012 after 3 to 4 years of work by the abovenamed editors and a team of distinguished clinical pharmacologists from around the world. Their work was supported not only by the WHO but also by the Council for International Organizations of Medical Sciences (CIOMS) and the International Union of Basic and Clinical Pharmacology (IUPHAR). The document covers a number of different facets of the work of clinical pharmacologists but in particular highlights the role of clinical pharmacology in the delivery of health care. A recent questionnaire study in 31 European countries has identified the weakness of clinical pharmacology in health care, particularly in its failure to provide clinical pharmacologic services that will promote the rational use of medicines (RUM). The main chapter on “The Clinical Pharmacologist in Patient Care” covers a number of different ways in which the discipline can help deliver better patient care. The importance of the various modalities discussed will depend on the way in which health care is delivered in different countries. In a few countries, the clinical pharmacologist (CP) will be directly involved in the care of both inpatients and outpatients. However, in the majority of countries, the CP will be more involved indirectly in patient care. In all countries, the CP will be closely involved in the critical evaluation of new and old therapies; in the work of Drug and Therapeutic committees, both national and local; and in services such as drug information, pharmacovigilance, and drug utilization studies. In addition, the CP in many countries is directly involved in therapeutic drug monitoring (TDM) and pharmacogenetic services aiming to facilitate personalized medicine. The overall purpose of the manifesto is to strengthen the role of clinical pharmacology in achieving RUM, and this is the focus of the last chapter in the manifesto. Disclosure of Interest: None declared.