Contents: A Few Words 1ESCP Life 2Articles & Reports 4Announcements 8

1E u r o p e a n S o c i e t y o f C l i n i c a l P h a r m a c y

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The overall aim of the Society is to develop and promote the rational and appropriate use of medicines by the individual and by society.

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The bi-monthly newsletterof the European Society

of Clinical Pharmacy

Clinical Pharmacy in France: a Dynamic Scenario

Marie-Claude Saux,President of theFrench Society of

Clinical Pharmacy presentssome of the activitiesundertaken by French clinicalpharmacists.

Since May 2006, in France, pharmacyhas been integrated officially asforming part of medical teachingcentres and therefore the year 2007should bring with it some changes forFrench clinical pharmacy.

Clinical pharmacy recognitionThe activities of hospital pharma-cists, especially clinical pharmacists,are services provided by pharmacistswhich focus on patient care.

Twenty-three years have passed sincethe inclusion of clinical pharmacy inthe curricula of pharmacy studies in France and the development of hospital residency teaching year programmes for all French pharmacystudents. Today pharmacy interven-tions and clinical pharmacy activitiesare recognised for their contributiontowards safe and improved therapeutics.

A variety of activitiesIn France the activities of a clinicalpharmacist include: general activitiessuch as drug information, drafting ofrecommendations and protocols;clinical research and observational

studies either drug related as a wholeor focused on patient populations;patient-targeted activities on one or a number of patients and within this framework: drug regimenhistory, pharmaceutical review of prescriptions, management of unde-sirable events, or side-effects, patientcounselling, patient education.

Pharmaceutical interventionsThese general or patient-targetedactivities result in pharmaceuticalinterventions (PI). The SFPC (FrenchSociety of Clinical Pharmacy) has setup a working group in charge of collecting, standardising, evaluatingand developing PIs.

The group produced a tool to collectdata available on the SFPC website.The tool standardises the classifica-tion of PIs which is required beforecarrying out the impact of the PIs oncosts in a hospital environment.

Drug related errors analysisClinical pharmacokinetics, thera -peutic drug monitoring, patient education, individualised counsellingabout treatment are also clinicalpharmacy activities. Analysis of drugrelated errors which often occur dueto failures in structure, organisationor operation is the objective of a working group set up under the aegis of SFPC. This group already produced a dictionary of terms whichwas disseminated earlier this yearand is available from the SFPC secretariat.

Finally I am pleased to announce thepublication of a work carried out onthe measurement of indicators inhospital pharmacy related to patientcare. This book was distributed during the 11th Meeting of the SFPCheld in Bordeaux, France lastFebruary.

Clinical pharmacy in France is richand SFPC is dynamic in ensuring thatclinical pharmacy will take the essential standing at university levelas well as in the practical setting inhospital or community pharmacies. ●

Marie-Claude SauxFrance

“Clinical pharmacy in France is rich and SFPC

is dynamic in ensuring that

clinical pharmacy will take the essential

standing at university level as well as

in the practical setting in hospital

or community pharmacies.”

Anna Olearova (Slovakia)

Anna is currentlyfinishing her PhDstudies on evidence-based pharmacyutilisation of cardio-

vascular drugs. She is attached at theDepartment of Organisation andManagement in Pharmacy at theFaculty of Pharmacy of the ComeniusUniversity, Slovakia. She decided toattend the symposium because shefound the theme very relevant to herwork.

Anna is responsible for teachingcommunication skills to under -graduate pharmacy students in thefirst semester of the fourth year of studies. It is the third year that she

has been teaching this module andtherefore she says that she is stilldeveloping the most useful programme. At the ComeniusUniversity around 250 students finish their pharmacy studies everyyear. A number of graduates leaveSlovakia. Recently a new publicpharmacy school has opened up inSlovakia, a country that has a population of around 5 million.

During the symposium, Anna presented a poster on “Healthylifestyle counselling in communitypharmacies”. The poster was co-authored by Magdalena Jurcikova.The study aimed to evaluate theknowledge of community pharma-cists practising in 37 communitypharmacies in Bratislava and Presovon healthy lifestyles and their

interventions in educating patients.The knowledge of patrons visitingthese pharmacies was also assessed.The study showed that patrons areaware of healthy lifestyle principlesbut are not willing to adopt relatedmeasures. They are not interested in receiving advice about healthylifestyles from community pharma -cists. On the other hand the commu nity pharmacists have theknowledge, are interested in providi ngadvice on healthy lifestyles, and arewilling to participate in education programmes in this area. This studyindicates that projects supporting theprovision of information on healthylifestyles by community pharmacistsare essential. Studies directedtowards diabetic patients are nowbeing planned.

Ilko Getov (Bulgaria)

Ilko is an associateprofessor in phar-macovigilance andpharmacoep ide -miology at the

Faculty of Pharmacy of the MedicalUniversity of Sofia, Bulgaria.

In Bulgaria, a country with a popula-tion of around 8 million, which isapplying to join the EuropeanCommunity, there are a number ofdiscussions on the implementationand development of clinical pharmacy,pharmaceutical care and e-health.Since 1985 the faculty of pharmacyhas been looking into the teaching ofclinical pharmacy and now offers apost-graduate specialisation in clini-cal pharmacy. To date more than 30pharmacists have obtained this certificate. Clinical pharmacy is alsoone of the specialisation areas in the

undergraduate curriculum. Howeverthe practical implementation of clinical pharmacy in hospitals is stillvery difficult. It is being proposedthat clinical pharmacy services aredeveloped in the university hospital.

The faculty of pharmacy at theMedical University of Sofia is theonly pharmacy school in Bulgaria andabout 100 students graduate inpharmacy each year. The schoolhosts a number of foreign studentsfrom Macedonia, Turkey and Greece.After finishing their undergraduatepharmacy studies, pharmacists practise mostly in community pharmacies. With the application ofBulgaria to join the EU more graduates are being recruited in the areas of regulatory affairs and medical detailing compared to previous years. The pharmaceuticalindustry is also expanding withActavis, a generic pharmaceuticalcompany also setting up in Bulgaria.

Ilko presented a poster on “Currentproblems of clinical pharmacy practice in Bulgaria”. The study was co-authored by Valentina B. Petkovaand Zlatka D. Dimitrova. The studyevaluated clinical pharmacy practicein 32 hospitals in different parts ofBulgaria. Main problems with regardsto the development of clinical pharmacy practice in Bulgaria arelack of computerisation, need toovercome communication barrierwith physicians and the currentattachment of the pharmacist to thehospital pharmacy within the hospital structure.

Ilko is aware of the value of learningfrom the experiences of others inorder to achieve implementation ofclinical pharmacy practice: he foundparticipation in the ESCP symposiumvery useful since he met with colleagues from other countries whowere sharing their experiences. ●

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Meeting Pharmacists from Slovakia and Bulgaria

E SCP News met with two pharmacists who benefited from ESCP's financial support to attendthe 35th European Symposium, held last October in Vienna.

Best of luck to Anna in her studies and to Ilko in his endeavour to participatein developments in pharmacy in Bulgaria.

Martin Schulz (Switzerland)

ESCP News met Martin Schulz, thenew representative for Germany onthe ESCP General Committee.

Martin is an adjunct professor at theDepartment of Pharmacology ofJohann Wolfgang Goethe Universityin Frankfurt, Germany, where heteaches clinical pharmacy. In hismain job, Martin is Head of the Centre for Drug Information and Pharmacy Practice (ZAPP) of the Federal Union of GermanAssociations of Pharmacists (ABDA).In addition, he is Director of theGerman Institute for Drug UseEvaluation.

Martin graduated as a pharmacistfrom the University of Hamburg in1983. From 1983 to 1984 he was ahospital pharmacist. From 1984 to1986 he studied Medicine at theUniversity of Hamburg, and in 1988 he obtained his PhD inPharmacology from the same univer-sity. In 1989, he was named Expertin Pharmacology DGPT by theGerman Society for Experimental and Clinical Pharmacology and Toxicology(DGPT). In 1993, he specialised as aDrug Information Pharmacist. Since1992, he has been Vice-Director ofthe Commission on Drugs of GermanPharmacists.

Martin has experience in the evaluation and implementation of the

pharmaceutical support, promotionof effective and safe self-medication,pharmacoepidemiology and pharma-coeonomics, drug information, drugsupply and drug usage. His mainareas of interest are outcomesresearch, quality and effectiveness ofinterventions, drug information andregulation, health/pharmacoecono -mics. He has more than 360 publications to his name and has alsodelivered a number of lectures andseminars. Martin is a member of various committees and commissionslike BfArM, Bonn; Department ofHealth, Berlin; FIP (chairman of theBoard of Pharmaceutical PracticeProgram Committee), and serves on

various advisory/expert committees.He is a founding member of thePharmaceutical Care Network Europe(PCNE) and has served as a chairmanfrom 1999 to 2001. Since 1997 hehas been a member of ESCP andsince 1995 of ACCP. In addition, he serves on the editorial boards of Drugdex®, Annals of Pharmaco -therapy and he reviews papers submitted to Pharmacy WorldScience, British Medical Journal,Thorax, Pharmacotherapy, BritishJournal of Clinical Pharmacology andAnnals of Pharmacotherapy. ●

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Who’s Who

Disrupted Appearance of PWS

I look forwardto seeing theESCP develop-ing in 2007offering excel-lent platformsfor research,education, andnetworking. Theadded value of

clinical pharmacy to assure optimalclinical, humanistic, and economicoutcomes is an ongoing process andneeds permanent input from highquality research. This includes allaspects of pharmacy research: frompatient-oriented life sciences topharmacy practice, from pharma-coepidemiology and pharmacoeco-nomics to pharmaceutical care and social pharmacy. Providing the platform for exchange of high qualityresearch is key for the future of a

scientific society. This provides alsothe opportunity for outstanding education activities. I would like the ESCP-umbrella for researchers, educators, and practitioners interested in clinical pharmacy toexpand. Hence, one of my personalgoals is to significantly increase, atbest to double the membership ofGerman ESCP members. May I suggest that every ESCP memberwill try hard to convince 1 (one!) colleague in 2007 to apply for membership in our Society, preferably in conjunction with his/herattendance at our two meetings inSpring (Edinburgh) and/or Fall(Istanbul)?If you have questions, remarks orsuggestions you would like to seeconsidered or discussed, please donot hesitate to contact me by e-mailat: zapp@abda.aponet.de

Pharmacy World & Science (PWS) isthe official journal of ESCP, UKCPAand KNMP. Many members submitarticles for publication in PWS, whichhas an impact factor of 1.007.Authors have noticed that the publishing process has not been assmooth as it should have: only oneprinted issue appeared in 2006, andaccepted papers were not publishedonline. Moreover, older papers werenot properly followed up by the editors.

Two years ago Springer boughtKluwer - thus the journal - and outsourcing changes were forcedupon the management of the journal, leading to the current problems.Since the acquisition Springer published 4 issues of PWS.

The responsible editor in Springer,Dr. Peter Butler, has recently promised ESCP that the journal willbe back on track by the end of 2006.We all hope so, and on behalf of

Springer, we do apologise to all theESCP members and submittingauthors.

We would like to remind you that as amember of ESCP you can access theelectronic version of the journal andits archives via the ESCP website atwww.escpweb.org, after login. ●

Foppe van MilPWS Editor-in-Chief

The Netherlands

The 35th ESCP EuropeanSymposium on ClinicalPharmacy that took place

last October gathered some800 clinical pharmacists from52 different countries.

Pre-symposium activitiesThe Masterclass this year focused on“Healthy Communication withPatients” while the 7th EPSA-ESCPStudents’ Symposium addressed“Patient Safety: a Task of thePharmacist, a Step for the Student”.The evening plenary lecture preceding the welcome reception was presented by Jenny Simanowitz andit was quite a differently communi-cated lecture for delegates…

Scientific programmeThe morning plenary sessions lookedat the communication with thepatient, the impact of patient infor-mation on pharmacotherapy out-comes, and the role of the pharma-cist in communication in regard topatient safety. Afternoon plenary sessions were organised by the SIGPaediatrics and SIG Cancer Care. Thepharmacotherapy updates presentedvery concise and practical informa-tion on Coxibs and on the use of sys-temic antifungal agents. The resultsof the two ESCP supported research projects on Coxibs and use of systemic antifungal agents were presented during the last pharma-cotherapy update session.

Workshops were held on informingpatients, cost effectiveness of innova-tive products, patient education incancer chemotherapy, complianceand concordance, mental health,patient safety and patient education.SIG’s organised workshops in theareas of medicine information, pharma-cokinetics, and nutritional support.

During the symposium, 25 papers from12 different countries were presentedas oral communications while 31papers from 10 countries were pres ented during poster discussionforums.

General assemblyDuring the General Assembly GertLaekeman (Belgium) took over thepresidency of ESCP and FrankJørgensen (Norway) took over as Vice-President. The newly elected president thanked Jiri Vlcek (CzechRepublic) for all his work and commitment during his term of officeas ESCP President.

Erik Gerbrands (The Netherlands) pre-sented the financial results for 2005and discussed the budget for 2007.Francesca Venturini (Italy) presentedthe work done by the Research,Education, Publications and SIGCouncil (RESP). She also announcednew members of the RESP: MarcelBouvy (The Netherlands) as chair of

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ESCP Symposium in Vienna: a Photo Report

Margarida Caramona (Portugal) and AndréRieutord (France) with Jenny Simanowitz(Austria) during the evening Plenary"Communications Cabaret"

Margarida Caramona and Kristjan Linnet(Iceland) with Jenny Simanowitz

Delegates at the exhibition

Poster viewing

Martin Schulz and Sonia Maier fromGermany discussing during a coffee break

Jiri Vlcek chairing the GA with FrancescaVenturini, Erik Gerbrands, Gert Laekeman,and Jeroen van Liempd, ESCP ExecutiveDirector

Participants browsing publications

Participants could meet “old” friendsand make new contacts during coffeebreaks and lunches

Discussing projects

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the Research Committee, AnnaCarollo (Italy) and Fikret VehbiIzzettin (Turkey) as members of theEducation Committee, and Marie-Catherine Desroches (France) as anew member of the ResearchCommittee. The SIG Council also wel-comed 3 new Leaders: Anne Gilchrist(UK) for Integrated Primary Care,Yolande Hanssens (Qatar) forMedicine Information, and MikaelDaouphars (France) for Cancer Care.

Social programmeThe welcome reception was held atthe Vienna City Hall (Rathaus), a neo-gothic building where participantscould enjoy a Viennese welcome! Forthe cultural evening participants visited the Haus der Musik which is amuseum relating different periods ofmusic in Vienna. A number ofexhibits include interactive sessionsso that participants could experimentand experience music. A traditionalHeuriger evening was held as a symposium dinner.

ConclusionDuring the closing ceremony, ElfriedeDolinar, Symposium President,thanked Elisabeth Kretschmer,Scientific Committee Chair, all members of the committee and participants for making the symposiuma success.

Erik Gerbrands announced that theHealth Base Poster Award was presented to Agnieska Skowron(Poland) for the paper on “The impactof pharmaceutical care for patientswith hypertension on patients’ knowledge”.

ESCP President Gert Laekemanthanked Elfriede Dolinar for her contribution towards the success ofthis meeting.

As the Viennese say, Auf Wiedersen.The 2007 Spring Conference on"Tackling Inequalities in the Deliveryof Pharmaceutical Care" will be held in Edinburgh, UK, 16-19 May.Abstract submission and registrationfor this event are now open atwww.escpweb.org/edinburgh.

The 36th European Symposium onClinical Pharmacy on “ImplementingClinical Pharmacy in Community andHospital Settings: Sharing theExperience” will be held in Istanbul,Turkey, 25-27 October. To learn more about this event visit www.escpweb.org/istanbul as of midDecember.

Hope to see you there. ●

Lilian M. AzzopardiMalta

ESCP gratefully acknowledges the support of its sponsors and exhibitorsand wishes to thank them for their contributions to a successful meeting.

Bronze Sponsors:

Sponsors: DIA - Fresenius Kabi Austria - Roche France

Exhibitors: Amgen - Bayer Health Care Austria - Cardinal Health - PfizerCorporation Austria - RPS Publishing - Sandoz Austria - Sanofi-aventisWolters Kluwer Health

Participants had the opportunity to admirethe Rathaus…

enjoy the music…

and network during the welcome reception

A participant directing the PhilarmonicOrchestra at the Haus der Musik duringthe cultural evening!

Anna Carollo (Italy) who has been electedto the ESCP Education Committee

Past and Present GC members: MartinSchulz (Germany), Frank Jørgensen(Norway), Johnny Beney (Switzerland)and in front row Georges Zelger(Switzerland), a past president of ESCP

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Presenting research studies as oral communications at ESCP's meetings is a good opportunityfor pharmacists to discuss their findings with peers. ESCP News presents a selection of thevariety of studies illustrated at the last ESCP Symposium.

Research Studies in Vienna

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Adherence to an initiative to promote the prescribing of preferred drugs and perceptions of health care specialists

Alexandra Pointinger (Austria)The study assessed adherence to an initiative aimed at improving conformance to drugs which areadvocated as preferred choice in a local formulary. It showed that the initiative was successful andhighlighted the need to improve communication with the primary care health professionals. Servicedevelopments including therapeutic switching by pharmacists may be considered.

Drug Information

Physician knowledge of hypertension guidelines and blood pressure control

Barry Carter (USA)The study aimed to evaluate the relationship between physician knowledge of the USA 7th JointNational Committee Guidelines on Hypertension and control of hypertension. A physician knowl-edge survey was developed and disseminated amongst physicians. Patients suffering from hyper-tension attending the clinics of physicians participating in the study were identified and blood pres-sure control rates were calculated. It resulted that the higher physician knowledge, the lower the

blood pressure control rates. The study shows that educational strategies towards prescribers are not sufficient ontheir own to ensure blood pressure control because physicians may not be compliant with the guidelines and physi-cians who are more versed with the guidelines may have negative communication skills with patients.

Communication with nonadherent patients: a training at Utrecht University

Majanne Wolters (The Netherlands)Non-adherence to medications is not only due to lack of information but may be due to lack ofpatient support in problem solving. At the University of Utrecht, a training programme, includingsimulated sessions followed by discussion, was presented to undergraduate pharmacy students.Students were assessed and 10-25% of them failed the test at their first attempt.

Education in Clinical Pharmacy

Development of a tool to assess communication skills in pharmacy students

Veerle Foulon (Belgium)The study aimed to design and evaluate a tool to assess communication skills at various stages inthe undergraduate pharmacy programme curriculum. When the tool was applied to students, it waspossible to identify differences in communication skills across the different learning levels. The toolwould be useful when combined with other assessment measures intended to evaluate developmentof communication skills by students.

Drug information service implementation in primary health care centres: its impact on enquiry activity of a hospitalpharmacy department

David Conde Estevez (Spain)In 2000, the primary health care centres in Barcelona, Spain established drug information centres.Before they used the service provided from the hospital. After 2000, there was a decline in enquiriespresented to the hospital drug information centre because of the decreased enquiries from primaryhealth care pharmacists.

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Consultation skills training: a model for pharmacy practice

Rauja Abdel-Tawab (UK)A standardised framework for a pharmaceutical consultation was developed. It presents a system ofquantitatively assessing the pharmacist’s practitioner skill in pharmaceutical consulting.

Pharmacists’ role in continuing medical education

Roberta Di Stefano (Italy)The study compared the involvement of the pharmacist in continuing medical education in threehospitals in Palermo, Italy. It was found that around 30% of the pharmacist time is dedicated tomedical education in the three settings. The education usually takes place during clinical rounds,in update courses or over the phone. The most common issues were inappropriate dosage, calcula-tion errors, paediatric dosage forms.

Pharmacoeconomics

Development and validation of an instrument to measure socioeconomic impacts of medication-related problems: the socioeconomic impact profile

Adetomilola Aderounmu (UK)The Socioeconomic Impact Profile (SEIP), a concise, cardio-specific instrument to measure socioe-conomic impacts of adverse drug reactions and of medication-related problems was developed.

Medication is prescribed during preg-nancy in 86% of expectant mothersand during labour in 79% of thepatients (WHO, 1991). Pharmacistswho want to give advice need easyaccess to sources of information.Cybele is a database that has beenlaunched in Belgium as a supportivetool in medical and pharmacy practice. The database contains mostof the DCI drug names commer-cialised in Europe.

Starting from the title page the usergets:

• a search instrument on chemicalname

• a lexicon related to pregnancy andlactation

• an index of the system

By clicking on a drug substance thecorresponding monograph is opened.

The monograph contains:

• an overview table of the substancerequested

• a code for each trimester and theperinatal and breast-feeding period

• an explanation of the codes

• a table with an overview of therisks related to all the agentsbelonging to the same therapeuticclass

• risk assessment during pregnancyaccording to internationalstandards: FDA (USA), FASS(Sweden) and ADEC (Australia)and explanation of the codes used

• information on breast-feedingaccording to the FDA standards

• a short text giving informationabout the risks during pregnancyand lactation with literature refer-ences quoted

Cybele is currently available in Frenchand Dutch.

The purpose is to look for partnershipsin order to compare it with possibleexisting databases in other countries,translate the database in English andto other European languages, and toupdate it with information from inter-national sources. An ad hoc workingparty can be developed. ●

Gert LaekemanBelgium

The programme is now available forconsultation on the ESCP websiteduring three months. Suggestions,willingness to co-operate and correspondence can be sent to: info@escpweb.org

Cybele: an Aid in Clinical Pharmacy Practice

Gert Laekeman introduces Cybele, a medical and pharmacy practice supportive database.

➤ CONTINUED FROM PAGE 6

Education in Clinical Pharmacy

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ESCP News is published by ESCPEditor: Marie Caroline Husson (France)Co-ordinator: Lilian M. Azzopardi (Malta)Technical Editing, Design & Production: MCI

The contents of this publication are compiled in goodfaith. The publisher accepts no responsibility foromissions or errors.

ESCP International Office300, Avenue de TervuerenB-1150 Brussels - BelgiumTel: +32-2-743 1542 Fax : +32-2-743 1550E-mail: info@escpweb.orgwww.escpweb.org

Deadline for the submission of material for issue number 135 is 29 March 2007.

Learn more atwww.escpweb.org

Abstract Submission Deadline: 15 December 2006

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For Your Diary2007

16-19 May Edinburgh 7th ESCP Spring Conference on Clinical PharmacyUK Tackling Inequalities in the Delivery of Pharmaceutical Care

25 - 27 October Istanbul 36th ESCP European Symposium on Clinical PharmacyTurkey Implementing Clinical Pharmacy in Community and

Hospital Settings: Sharing the Experience

Important Reminders

7th Spring Conference on Clinical Pharmacy, Edinburgh, UKAbstract Submission 30 January 2007 Early Registration 30 March 2007