The view of consumers PGEU Symposium 17 June 2013 Ilaria Passarani Senior health policy officer PGEU Symposium 17 June 2013

The information jungle Support Advice The information jungle 10/12/2018

Health care professionals: a trusted source of information and advice Which?, 2010

Consumers’ expectations A trusted source of information and advice Honest and credible Comparative, objective and unbiased information More questions and more answers More active role in the detection of possible interactions Proactive advice A consumer friendly pharmacy

Results of an undercover investigation in the UK 122 pharmacies across the UK 3 scenarios Good practice but also disappointing results Unsatisfactory advices in 43% of visits Better results than Which? last investigation in 2008 but lack of questioning leads to some inadequate advice and potentially serious consequences Which?, June 2013

Interactions SCENARIOS Anticoagulant + Aspirin Contraceptive pill + Hypericum Test-Achats, May 2012

Too nonchalants UFC Que Choisir inquiry 648 pharmacies in 14 French cities on 19-20 January 2012 Scenario: patient with a cold and fatigue asked for a box of acetylsalicylic acid and a box of ibuprofen. 52 % spontaneously warned the consumer about the incompatibility of the two products 11% warned about the incompatibility only in response to a specific question from the consumer 37% didn’t mention anything 14% asked about the consumer medical history

Sales out of control BEUC members mystery shopping for a weight loss medicine (Orlistat) BMI ≥28 kg/m2 , only for adults, not suitable for pregnant and breast feeding women, special care in case of diabetes, use of oral contraceptive, kidney disease, use of other medicines etc. - UK ( May 2009) - Ireland ( September 2009); - Spain ( July 2009) - Belgium (October 2009) - Portugal ( February 2010) - Italy (May 2010) - Austria ( April 2011) Disappointing results: In 70 % of the 86 pharmacies visited in Spain the product was sold to consumers with a BMI between 18 and 24. In 74% of the 103 pharmacies visited in Italy the product was sold to consumers with a BMI < 28. In most cases it was sold without any question on the consumer weight and possible health problems and with no advice on healthy diet/physical activity. In 10 out of 16 pharmacies in Vienna the product was sold to a 15 year old girl with BMI of 19,4 and in 6 of them the product was sold to a breast feeding mother with a BMI of 25,1.

Proactive advice Consumers who bought an OTC received spontaneous advice from the pharmacist: OCU, Test-Achats, Altroconsumo, DECO,2008 Total sample: 4.089 people from 18 to 92 yro

European Community pharmacists’ blueprint ENHANCE MEDICINE SAFETY AND ACCESS TO MEDICINES Further strengthen the medicines supply chain to prevent falsified medicines reaching hands of European patients Work with other stakeholders and governments to prevent medicine shortages; Make more hospital-only medicines available via community pharmacies; Deliver medicines to care homes and the patients’ homes and assist patients of our pharmacies who have complex treatment regimes in managing their medication, by providing pharmacy services such as individual single-dosage systems for our patients in the pharmacy; Have the possibility to dispense prescription only medicines without a medical prescription in emergencies, under strict conditions and in collaboration with physicians; IMPROVE TREATMENT OUTCOMES OF INDIVIDUAL PATIENTS Manage medication while further empowering patients to self-manage their condition; Maximise our patient care interventions through gaining access to the patient’s health record where appropriate according to national data protection rules and with the patient’s consent; Engage in collaborative care, e.g. while assisting in detecting and managing chronic disease or bringing our expertise in medicines to specialised care networks; Ensure the continuity of pharmaceutical care during the patient’s transition between acute care settings and home; Build a community pharmacy research strategy to support the development of services; IMPROVE PUBLIC HEALTH Support safe and effective self-care and self-medication when providing health advice, responding to symptoms and/or offering services that promote healthy living and disease prevention; Improve adverse drug reactions reporting; Participate in the setting up and development of future or existing national eHealth systems Use our network better to spread public health messages and manage public health crises; Develop screening programmes and further contribute to immunisation strategies; Develop a pharmacy-based holistic public health service package and make it available to the community according to the local needs; CONTRIBUTE TO THE EFFICIENCY AND QUALITY OF THE HEALTH SYSTEM Deliver pharmacy services aiming to improve adherence and rationalise care of polymedicated patients; Continue to promote and facilitate greater use of cheaper medicines via appropriate substitution when suitable; Encourage services such as dispensing repeat prescriptions and monitoring pharmacotherapy of individual patients, recommending dosage adjustments when appropriate 

Recommendations Maintain consumers’ trust Continue efforts to improve information and advice Assist and support consumers for health decisions Dedicated courses on communication and consumer behavior as part of the Pharmacy degree Mandatory continued professional education to improve scientific knowledge but also communication skills Quality controls mechanisms Optimize the valuable role of pharmacists as an integral part of the health care system

The safety net

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