Integration of and visions for community pharmacy in primary health care in Denmark.

In 2014, the Danish government launched a plan for health entitled: "Healthier lives for everyone - national goals for the health of Danes within the next 10 years". The overall objective is to prolong healthy years of life and to reduce inequality in health. In Denmark, the responsibility for health and social care is shared between the central government, the regions and the municipalities. National and local strategies seek to enhance public health through national and local initiatives initiated by different stakeholders. The Danish community pharmacies also contribute to promoting public health through distribution of and counselling on medication in the entire country and through offering several pharmacy services, six of which are fully or partly remunerated on a national level. Because of greater demands from patients, health care professionals and society and a lack of general practitioners, the Danish community pharmacies now have the opportunity to suggest several new functions and services or to extend existing services. The Danish pharmacy law changed in 2015 with the objective to maintain and develop community pharmacies and to achieve increased patient accessibility. The change in the law made it possible for every community pharmacy owner to open a maximum of seven pharmacy branches (apart from the main pharmacy) in a range of 75 km. This change also increased the competition between community pharmacies and consequently the pharmacies are now under financial pressure. On the other hand, each pharmacy may have been given an incentive to develop their specific pharmacy and become the best pharmacy for the patients. Community pharmacies are working to be seen as partners in the health care system. This role is in Denmark increasingly being supported by the government through the remunerated pharmacy services and through contract with municipalities. Concurrent with the extended tasks for the Danish community pharmacies and utilisation of their excellent competencies in medication the community pharmacies need to focus on their main tasks of supplying medicines and implementing services. This requires efficient management, an increased use of technology for distribution and communication and continuing education and training.

Pharmaceutical care services available in Danish community pharmacies.

In recent years, increased longevity of the Danish population has resulted in a growing segment with age-related and chronic health conditions. This, together with a general increase in the demand on the services of doctors, has augmented the role of pharmacies in the provision of healthcare services. In Denmark, a variety of pharmacy services has been developed, evaluated and implemented since the introduction of pharmaceutical care. The services are aimed at the person responsible for administering the medicine e.g. the patient themselves or care workers, thereby supporting medication safety. The services available have been developed, evaluated and implemented in collaboration between community pharmacies, the Danish Association of Pharmacies, the Danish College of Pharmacy Practice and international collaborators. In this commentary we present an overview of the available pharmacy service, the contents of each service, remuneration and the scientific evidence behind each service. The commentary covers: Inhaler Technique Assessment Service; New Medicines Service; Medication Review; and Medication Safety in Residential Facilities.

Pharmaceutical care in Denmark: perceived importance of medicine-related problems and participation in postgraduate training.

OBJECTIVE: To investigate the readiness of Danish community pharmacists to provide pharmaceutical care. Special focus was on information provided to patients on medicine-related problems and participation in postgraduate training. METHOD: National cross-sectional survey distributed to all Danish community pharmacies (N = 288). Response rate 75.7%; non-responders were interviewed by telephone to establish their reasons for not participating. MAIN OUTCOME MEASURES: Prioritization of information to patients regarding medicine-related problems. Postgraduate courses selected by pharmacists during the past three years. RESULTS: In accordance with the profile of Danish community pharmacists, respondents were primarily female and half were below 45 years of age. The main reason given for not responding was lack of time. The prioritization of information to patients regarding medicine-related problems resulted in three clusters of answers. The overall topics of the clusters were: information related to the technical-practical use of medicines; information related to pharmacotherapeutic aspects of medicine use; and information related to the function of the medicine. The clusters accounted for 61.9% of the total variance. The most frequently attended postgraduate courses were on quality assurance and specific diseases. CONCLUSION: The patient information prioritized by Danish community pharmacists is primarily of a technical-practical nature. The postgraduate training pursued is primarily technical without much focus on the philosophy of pharmaceutical care. These factors contribute to the lack of proper readiness of pharmacists to practice pharmaceutical care.