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Paper info: Community Pharmacies: from dispensing drugs to pharmaceutical care. Actors involvement in the wider health service network


Community Pharmacies: from dispensing drugs to pharmaceutical care. Actors involvement in the wider health service network


Giancarlo Nadin

Place of Publication

The paper was published at the 28th IMP-conference in Rome, Italy in 2012.


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All over Europe the index of evolution toward a pharmaceutical care approach of the community pharmacies shows rooms of improvement (Hughes C.M. et al. 2010) and in USA, MTM (Medication Therapy Management) has been put in place in order to help pharmacists to adopt practices inclined to patient surveillance, therapy compliance and generally speaking cognitive and personal care services to offer to the citizen and patient (Doucette W.R. et al., 2006).In Italy a 2009’s law introduced service offering in the pharmacies. The author administered an explorative survey aimed to assess the “sentiment” of these professionals in order to embrace the opportunity opened up by the new law (Nadin and Pacenti, 2011). Shadows and lights have emerged: one of the main issue, as detected as well as by international literature surveys, encompasses relationship with other health care operators such as GP (General Practitioners), specialists, therapists, nurses, etc.. The separated silos erected in the past among the operators do not facilitate the high level of communication required to manage, in a coordinated way, the patient pathology as in a networked perspective would be asked.In this paper the author wants to investigate problems and opportunities related to the relationship between pharmacists and health care operators revisited in the light of the patient perspective.Specified duties and responsibilities are required and clear stated but the optimization of the service offered to the patient walks through interchange and collaboration. Therefore it becomes pivotal to rethink correctly the degree of freedom and consequently the burden of risk between the operators. In this scenario technology evolution and ICT will enable in the future great opportunities for inter-organizational coordination. Patient’s file sharing procedure offers a fundamental tool for inter-professional communication and can enable cooperation of the operator in the sake of the patient. Nevertheless we encounter many resistances and stickiness toward digitalization of the patient information as it involves problems of privacy, technical instances and, far more important, issues related to power and asymmetry information management among the operators.The paper wants to cover these aspects of the relationship by the analysis of an experimental sample of dual relationship: physicians and pharmacists involved in medication therapy management (compliance, review of the therapy, drug to drug interaction, adverse effect of medication, etc.).The relationship will be examined under the lens of the ARA model depicted by the IMP’s school of though. Therefore the paper tries to outline actors bonds, resources involved and activities put in place by the operators to improve coordinated service to the patient and at the same time pursue their personal goals.This paper must be intended as a first step analysis aimed to design a wider quantitative research focused on the collaboration among health care operators.Thus first insights and findings will be discussed in the perspective of the designing the framework for an extensive research