EAHP Survey: The future potential of electronic product information in the hospital setting

 

 

 

 

Inspired by a project carried out in Belgium and Luxembourg evaluating the effectiveness of the electronic patient information leaflet and the key principles created by the European Medicines Agency (EMA) and the Heads of Medicines Agencies (HMA), the European Association of Hospital Pharmacists (EAHP) conducted a survey on the use of electronic product information (ePI) in European hospitals. The survey was carried out in cooperation with the Inter-Association Task Force for electronic product information composed out of Medicines for Europe, EFPIA (European Federation of Pharmaceutical Industries and Associations) and AESGP (Association of the European Self-Care Industry) from March to April 2021 and targeted hospital pharmacists in 36 European countries, ultimately receiving 534 answers.    Reflecting on the process and the results of the survey, former EAHP Board member Steffen Amann, who was involved in the project from the start, highlighted that “Digitalisation is revolutionising healthcare provision in hospitals across Europe. For EAHP it was consequently very important to learn more about the use of electronic patient leaflets and the future potential of electronic product information. It will take a lot of activity to overcome the lack of means to work with digital information, which not surprisingly is one of the main barriers for the use of ePI in hospitals.”   Almost 60% of respondents reported that healthcare professionals use the digital version when they wish to obtain information on a medicine. Hospital pharmacists (93%) are those using most frequently the digital format of the product information followed by physicians (71%) and nurses (43%). Given that the survey only targeted hospital pharmacists, it should be noted that the presumed behaviour of both healthcare professionals and patients are always the opinion of the hospital pharmacists' answering the survey.   The survey reveals that patients are usually not provided with paper package leaflets and only 21% of respondents reported that medicines information is provided orally to patients. In this regard, the majority of respondents see the potential of further informing patients by giving them access to ePI. It would also ensure that the information accessed is up to date.    The report nevertheless acknowledged that some challenges should be addressed concurrently, especially equipping hospitals with the appropriate IT infrastructure while at the same time taking into account the structural preconditions of hospitals in Europe regarding the technical equipment to use ePI in daily practice.   EAHP’s President András Süle pointed out that “The survey report provides very relevant information on the overall use of printed package leaflets and the prevalence of the application of product information in a digital format within EAHP’s membership. Hopefully, this snapshot analysis of the situation in Europe will help improve access to the up-to-date product information on medicines when and where it is needed in the hospital.”

Oath to Society – EAHP and ESCP show the public what clinical and hospital pharmacists are all about

 

 

 

 

Ensuring the safe use of medication is one of the key activities of clinical and hospital pharmacists. However, many people don’t know that both professions carry out many more activities to ensure optimal treatment outcomes for patients. The European Association of Hospital Pharmacists (EAHP) and the European Society of Clinical Pharmacy (ESCP) have collaboratively developed the “Oath to Society” that acts as a contract for excellence in providing compassionate patient care, working as part of the healthcare team and advancing the pharmacy profession, and showcasing how clinical and hospital pharmacists work every day.    The Oath to Society is the promise that the members of EAHP and ESCP make to patients and the public they serve, the healthcare professionals they interact with and the health systems they work in. The Oath functions as a compass for pharmacists to adhere to the highest standards of ethics, integrity and professionalism, as they provide service to the community over the course of their careers. Touching on trust and respect, different aspects of the patient care pathway, the multidisciplinary care team, disease prevention and health promotion, education and the future development of pharmacy practice, the Oath to Society is all-encompassing. Reflecting on their creation before the launch event, ESCP President Derek Stewart highlighted that “The development of the Oath to Society for European clinical and hospital pharmacists was inspired by similar initiatives of pharmacists and our fellow healthcare professionals around the globe. The Oath to Society emphasizes respect for patient privacy, the key contributions that our profession makes and the need for clinical and hospital pharmacists to uphold the highest standards of ethics for both themselves and their colleagues.”    The launch event brought together key stakeholders that are engaging closely with clinical and hospital pharmacists. Member of the European Parliament, István Ujhelyi, highlighted in his keynote speech the challenges faced by healthcare systems across Europe and the important role that pharmacists and their teams are playing. The panellists Sibylle Reichert (AIM - International Association of Mutual Benefit Societies), Juan José Fernández Romero (EPF - European Patients' Forum), Ber Oomen (ESNO - European Specialist Nurses Organisation), Pascal Garel (HOPE - European Hospital and Healthcare Federation) and Marc Hermans (UEMS - European Union of Medical Specialists) shared their positive experiences in working collaboratively with clinical and hospital pharmacists and showed why the Oath to Society is important to their individual organisations and patients. Equal and affordable access to medicines, patient-centred care and cooperation were amongst the themes that the panellists noted during their debate.    In his intervention during the launch event, EAHP President András Süle underlined that “It is important to communicate closely with patients, their carers and our fellow healthcare professionals, such as physicians, nurses and pharmacy technicians, to offer the best possible treatment. As the healthcare system shifts towards efficiency while still ensuring a high degree of safety and quality, pharmacists – as valued members of the interprofessional healthcare team – can and should play an integral role, focusing on medication management, medication reconciliation, preventive care and patient education.”    Stephane Steurbaut, Board member and Secretary of ESCP, echoed in his contribution very similar words while at the same time stressing that “Clinical and hospital pharmacists must not only ensure that prescriptions are appropriate, safe, and effective, but to also provide patients with guidance, reassurance, and compassion. With the Oath to Society, we hope to inspire both future and current pharmacists that all care, respect, and work toward change and preparation for the future of our profession.”

EAHP’s 25th Anniversary Congress – focusing on the future of patient care

 

The 25th Anniversary Congress of the European Association of Hospital Pharmacists (EAHP) explored the digital future of the profession. Not only was it hosted virtually but it also provided participants with a glimpse of what is to come in the not so far away future. Pharmacy prescribing and the transfer of care were a few of the topics discussed in relation to the changing roles of the profession.   Over 2200 hospital pharmacists from more than 60 countries joined EAHP over the last 6-days. Although the surroundings of the congress were different than usual the interest in the sessions was as always very high. In particular, the three Synergy Satellite events looking at oncology biosimilars, antithrombotic stewardship and biosimilars in colorectal cancers as well as the interactive workshops triggered lively discussions among the participants. Also, those that joined one or all of the three keynotes touching on artificial intelligence, pharmacist prescribing and the role of computers in the future of healthcare appreciated the outlooks provided by the different lecturers.  Centring around the theme “Hospital Pharmacy 5.0 - the future of patient care” the scientific programme developed by EAHP’s Scientific Committee did not only provide participants with a look forward but also looked back at the impact that the COVID-19 pandemic has had and still has on the profession. Besides being reflected among the different poster submissions the topic also was the focus of two sessions looking at multi-disciplinary care for COVID-19 patients and the repurposing of treatment options.  This year’s poster presentations combined the submissions from 2020 and 2021. The Scientific Committee awarded two first prizes. The winner of the 2020 poster submission is Ulrika Gillespie. She received the award for the abstract “Facilitators and barriers to performing comprehensive medication reviews and follow-up in older hospitalised patients by multiprofessional ward teams including a clinical pharmacist”. The 1st prize for poster submissions in 2021 went to Tessa Jaspers for her abstract “Effect of a multifaceted clinical decision support intervention on adherence to thromboprophylaxis guidelines in non-surgical patients”. Like every year, EAHP also awards a prize to the best Good Practice Initiative (GPI). Matts Balgård’s GPI “Inclusion of pharmacy students in an interprofessional training ward placement for health care students in Sweden” was recognised with the first prize for 2020, while Lotte Deschepper received the first prize for 2021 for her GIP  “Role of pharmacists during COVID-19 pandemic in a Belgian general hospital”. For the first time, EAHP handed out a Statement Implementation Award to acknowledge contributions with a specific emphasis on implementing the European Statements of Hospital Pharmacy which express commonly agreed objectives that every European health system should aim for in the delivery of hospital pharmacy services. Vito Ladisa won the Statement Implementation Award for his GIP titled “Multidisciplinary CAR-T team”. Also, research in hospital pharmacy conducted by a student was recognised with Teodora Bulog winning this year’s EAHP-EPSA Student Science Award for her abstract “Identification of drug-related problems in elderly patients during hospital care”.   EAHP would like to thank Platinum Partner: Amgen, Gold Partner: Bayer, Silver Partner: Clinigen, and Corporate Partner: Omnicell for their continued support.   For 2022, you can already mark the 23rd to 25th of March. Come and join us in Vienna, Austria to explore the changing roles of hospital pharmacists in a changing world.

EAHP’s 2019 Medicines Shortages Report – the problem continues to grow

Today, the European Association of Hospital Pharmacists (EAHP) released the results of its 2019 Medicines Shortages Survey which showed that the number of hospital pharmacists reporting shortages to be a problem in their hospital increased compared to data published by EAHP in 2014 and 2018.  For the first time, EAHP also reached out to patients, nurses, physicians and other healthcare professionals to gather their impressions. EAHP’s data collection aimed at obtaining more information on reasons for and management of medicines shortages as well as details on their impact on patients. The survey was open between November 2019 and mid-January 2020 and therefore did not take into account the availability problems that are currently arising due to the COVID-19 pandemic. More than half of the participating hospital pharmacists indicated that they had experienced shortages having an impact on patient care in their hospital. A similar response rate was observed for physicians and other healthcare professionals. Delays in care or therapy, suboptimal treatment, including inferior efficacy, and cancellation of care were most frequently communicated. Hospital pharmacists, physicians and nurses named antimicrobial agents as the type of medicine mostly in shortages, while other healthcare professionals noticed more frequent shortages for oncology medicines.  The 2019 EAHP Medicines Shortages Survey also collected impressions about the reasons for medicine shortages. For hospital pharmacists, the global shortage of an active pharmaceutical ingredient as well as manufacturing and supply chain problems ranked the highest, while physicians included the pricing of a medicine, supply chain problems and issues related to parallel export as the leading reasons for medicines shortages. Several patients that participated in the data collection activity stressed their dissatisfaction with how their problem was handled since they desired the provision of more detailed reasons behind not receiving the prescribed treatment.  When comparing the percentage of hospital pharmacists disclosing that medicines shortages are a problem for delivering the best care to patients, it was observed that this figure rose between 2018 and 2019.  While in 2018 91.8% of hospital pharmacists stressed that shortages are a problem in hospitals, 95% of hospital pharmacists had this impression in 2019. Feedback from the other professions differed, with 89% of healthcare professionals taking the survey agreeing that medicines shortages are a problem, while only 62% of nurses and 71% of physicians shared this view. Medicines shortages affect patient care and healthcare professionals’ daily work. Better enforcing the mandatory early notification requirements and requiring structured mitigation responses is recognised by all respondents as the best strategy to tackle shortages. EAHP consequently seeks to encourage all involved actors, including hospital pharmacists, to adopt reactive measures, such as carrying out prospective risk assessments, as well as proactive measures, like prudent tendering practices. Also, the Association would like to reiterate its request linked to the improvement of transparency and information sharing. Only a comprehensive communication strategy on shortages targeting all European states will ensure that all supply chain actors, including hospital pharmacists, receive adequate information on the shortage of medicines in their country. The information of the report is also summarised in infographics for:  - Hospital Pharmacists - Patients - Nurses - Physicians - Other Healthcare Professionals

Hospital pharmacists – the key to addressing polypharmacy and drug adherence

During the 49th General Assembly, the members of the European Association of Hospital Pharmacists (EAHP) updated the Association’s position paper on an ageing society. With this revision, hospital pharmacists acknowledged the challenges that lie ahead of the profession due to the changing healthcare requirements of the ageing population.  The overarching goal of the hospital pharmacy service, as outlined in the European Statements of Hospital Pharmacy, is to optimise patient outcomes through working collaboratively within multidisciplinary teams. EAHP’s position paper on an ageing society consequently touches upon areas in which hospital pharmacy interventions can make a difference for older patients. Medicines reconciliation and the transfer of care are mentioned as main sectors in which further investment is needed to improve outcomes for older patients. Optimising drug therapy by evaluating drug appropriateness and increasing drug adherence is one element that has been addressed by EAHP in its position paper since hospital pharmacists can make very positive contributions in this field. In addition, the Association underlines the need for heightened collaboration between different healthcare professionals, especially when transferring older patients between primary and secondary care environments.  The ageing workforce is also discussed by the EAHP’s position paper, in particular the need to respond to the demographic shift through adequate workforce planning. Likewise, education and training play an important role when dealing with both older patients and an ageing workforce. In view of these and other challenges linked to the ageing society, EAHP and its members call on national governments and health system managers to acknowledge hospital pharmacists’ drug expertise by investing in medication reconciliation and optimisation roles in all healthcare facilities, including nursing homes, as a key part of the European level response to the increasing prevalence of polypharmacy call for strengthened inter-sector communication, coordination and multi-disciplinary collaboration as critical approaches to meeting the health system challenges of an ageing society strongly support regulatory innovation to increase the participation of older patients with possible multi-morbidities in clinical trials urge both governments and the EU to address the growing challenge of an ageing health workforce by investing in education, mobility and best practice sharing.

 

EAHP Opinion on Pharmaceuticals in the Environment

EAHP is concerned about the negative effects that pharmaceuticals in the environment have on agriculture, aquaculture, livestock and, ultimately, humans and patients. Measures to better address pharmaceutical contamination put forward by the EC should be implemented in a timely and transparent manner. Interdisciplinary education, infection prevention and training programmes for healthcare professionals should be developed and implemented with the utmost urgency.

Hospital pharmacists are concerned about the negative effects of pharmaceuticals both on the environment itself as well as on animals, humans and patients. Consequently, the European Association of Hospital Pharmacists (EAHP) welcomes the adoption of the Communication on a European Union Strategic Approach to Pharmaceuticals in the Environment.  It is noted that standards to prevent environmental contamination are not complied with at all production sites, especially those that are situated beyond Europe’s borders. Responsibility has to be taken to ensure that drugs and their components distributed and used in the European Union (EU) are produced without avoidable environmental pollution. Measures supporting the uptake of greener manufacturing and the improvement in the design and implementation of environmental risk assessment are a good step in the right direction and should be pursued in a timely and transparent manner by the European Commission (EC). Some drugs are not metabolised and degraded into inactive substances by patients or animals treated with these drugs. For example some antimicrobials, hormones, cytotoxic agents or non-steroidal anti-inflammatory drugs (NSAIDs) may be partly excreted unchanged and remain pharmacologically active. The consequences of environmental contamination may be significant, e.g. active antimicrobials may induce and trigger antimicrobial resistance in patients and/or animals, thus impeding the national, European and global investments underway in the field of antimicrobial resistance. The need to minimise these negative consequences is of utmost importance and EAHP fully supports the measures put forward by the EC on the reduction and management of waste. A multi-stakeholder approach addressing, on the one hand, the design and manufacturing of pharmaceuticals and, on the other hand, best practice sharing among healthcare professionals is a sensible endeavour. The concentration of pharmaceuticals in the environment can be decreased only through meaningful and constant cooperation of all relevant actors. The Communication, however, lacks acknowledgement of the fact that pharmaceuticals in the environment are also detrimental to patient safety. As healthcare professionals in direct contact with patients, hospital pharmacists as well as doctors and community pharmacists should be encouraged and enabled to educate other healthcare professionals as well as patients about the impact of antimicrobials, hormones, cytotoxic agents and NSAIDs on the environment. Consequently, EAHP is calling on the EC and national governments to ensure continued training of healthcare professionals in best practices in relation to the prevention of pharmaceutical contamination. Such training should be provided both at undergraduate and post graduate level, as well as through lifelong learning modules.

EAHP’s 24th Congress – Putting personalised medicine front and centre to better address patient needs

Over the past 3 days, more than 3700 hospital pharmacists from over 60 different countries met in Barcelona, Spain for the annual congress of the European Association of Hospital Pharmacists (EAHP).  The Scientific Programme centred this year around the theme “Personalised Hospital Pharmacy – meeting the needs of every patient”. On each of the 3 fully packed days, congress attendees had the possibility to attend a number of seminars, workshops and Synergy Satellites. The latter addressed developments in the field of biosimilars, anticoagulation as well as the Falsified Medicines Directive (FMD) and Brexit. Keynotes were delivered on the topic of OMICS, clinical human factors and health inequalities.

EAHP’s Statement Implementation team welcomed numerous individuals to talk about the European Statements of Hospital Pharmacy, the self-assessment tool as well as the Statement Implementation Learning Collaborative Centres (SILCC) programme. In addition, the team shared information published in EAHP’s 2018 Medicines Shortages Report which outlines the seriousness of the growing problem of medicines shortages in the hospital sector. EAHP's poster walk, a unique Congress feature, brought together participants and poster authors to discuss the latest research innovations. The Scientific Committee awarded the 1st prize for poster submissions to Meshal Alshakrah for the abstract and poster titled ‘Determining the necessary components of a pharmaceutical care complexity screening tool: an e-delphi study'. The 2019 Good Practice Initiative (GIP) award went to Charlotte Olesen for her work on "Using an electronic algorithm to identify the most relevant patients for medication review". EAHP would like to thank its Platinum Partners, Amgen and Bayer, its Gold Partner, Pfizer and its Corporate Partners, Omnicell and MSD, for their support. EAHP is already looking forward to celebrating the 25th anniversary of its congress in 2020. For this occasion the Association will be returning to Gothenburg, Sweden from 25th to 27th March 2020.

EAHP Opinion on Vaccination

EAHP welcomes the Council Recommendation on strengthened cooperation against vaccine-preventable diseases.  Education of healthcare workers is crucial to protect patients in need of acute care. The growing vaccine shortage problem should be addressed at European level through an investigation into the causes and through the provision of solutions for preventable shortages.

The European Association of Hospital Pharmacists (EAHP) fully supports the Recommendation of the Council of the European Union on strengthened cooperation against vaccine-preventable diseases which was adopted in December 2018.  As outlined in the Council Recommendation, healthcare workers play a crucial role in working towards the goal of improved vaccination coverage. Patients, visitors and healthcare workers who are not vaccinated can spread infections such as measles or the flu to very ill patients in our hospitals. Vaccinations reduce, for us all, the need to be admitted to the hospital for the treatment of preventable illnesses. To protect patients who find themselves in critical health situations and to help ourselves stay healthy, hospital pharmacists recommend vaccination wherever possible. Healthcare workers have an increased risk of contracting infections at work and thus further transmitting them to colleagues and patients. Vaccinated healthcare workers are not only protecting themselves but they also act as a barrier against the spread of infections. One might say it is the ethical duty of every healthcare worker to get vaccinated and should be compulsory, unless contraindicated.  An investment is also needed in the education and training of healthcare workers, in particular in the hospital sector where patients in acute situations are cared for. To ensure adequate levels of patient and healthcare workers safety training on vaccine-preventable diseases, vaccinology and immunisation should be strengthened at both undergraduate and post-graduate level. Consequently, EAHP calls on national governments to offer healthcare workers opportunities for continuing education and training on vaccination.  Vaccine hesitancy, especially that influenced by misconceptions that still exist and prevent parents from vaccinating their children, is a concern to EAHP. Consequently, the Association welcomes the European Commission’s intention to counter online vaccine misinformation and develop evidence-based information tools and guidance to support Member States in responding to increased rates of vaccine hesitancy. As indicated in the Council Recommendation, vaccine shortages have direct consequences for the delivery and implementation of national vaccination programmes. The 2018 Medicines Shortages Survey Report1 of the EAHP identified preventative medicines – such as vaccines – as the second highest reported medication in shortage in the hospital setting. In 2018, 43% of participating hospital pharmacists from 38 different European countries underlined shortages problems with vaccines for Hepatitis B, Pneumococcal, Tuberculosis, Tetanus and Hepatitis A.  Reports on the shortage of preventative medicines increased since EAHP’s last survey in 2014 by 13%. Consequently, the EAHP would like to encourage all European institutions to tackle the growing problem of vaccine shortages. In particular, an investigation into the factors causing medicines shortages should be initiated and solutions in solving preventable shortages should be provided. European level coordination is especially crucial in the first half of 2019 since new regulations aiming at combating counterfeit drugs and Brexit might impact the availability of medicines such as vaccines.

Hospital pharmacists raise concerns about free movement and availability of medicines after Brexit

Members of the European Association of Hospital Pharmacists (EAHP) have raised increasing concerns about the availability of medicines post-Brexit in European Union (EU) countries and the United Kingdom (UK), in particular in a no-deal situation. These concerns are linked to a recent publication of the Association which underlined that medicines shortages are currently a common problem in over 90% of hospitals all across Europe. 

Even though EAHP’s 2018 Medicines Shortages Survey did not directly touch on the subject of Brexit a number of participants, especially those working in Ireland and the UK, highlighted that Brexit will worsen the situation. In addition to the increase in medicines shortages,  EAHP fears that the robustness of the EU-wide capacity to manage the shortages problem will be significantly affected due to the fact that difficulties could arise when trying to access packs from the UK market.

Free movement of hospital pharmacists is another concern of EAHP. Efforts by the European Commission to remove mobility barriers were intensified since the financial and economic crisis, with a leading action being the revision of the Professional Qualifications Directive. However, hospital pharmacists are still not benefitting from the rules and measures adopted by the EU to foster labour mobility. Labour mobility for the hospital pharmacy profession  largely depends on the flexibility of national authorities. Ireland and the UK have a high rate of inter country registrations of  pharmacists  due to the similarities of educational systems and  language. Brexit poses a threat to this practice and could in the case of the UK and Ireland lead to a significant limitation of cross-border cooperation between these countries. 

The annual congress of the EAHP, taking place in Barcelona from 27^th to 29^th March 2019 will address many of these issues. On 28^th March – a day prior to the UK’s exit from the EU – hospital pharmacists will have the opportunity to attend the Synergy Satellite event “Facing Brexit and FMD - Is Europe ready for the double “storm”?”. This session will describe and discuss how Brexit and medicines shortages can affect accessibility and availability of drugs in Europe and provide information on procedures to prevent the possible negative effects of access to medicines.