Pharmacists are redefining their role with deprescribing and real-life studies, emphasizing collaboration and evidence-based care over traditional practices.
Clinical pharmacy as part of daily work
Clinical pharmacy involves ongoing interactions between pharmacists and patients, focusing on proper medication use. Jean-Didier Bardet, a vice-president of the French Society of Clinical Pharmacy, emphasizes that this work is now central to a pharmacist's role, not an extra task.Integration of clinical pharmacy in practice
Despite its importance, clinical pharmacy is not always fully integrated into pharmacy operations. Antoine Dupuis, president of the Association for the Proper Use of Medication, highlights the need to shift from theoretical principles to practical implementation through deprescribing, pharmaceutical interventions, and real-life studies.Deprescribing and its goals
Deprescribing involves re-evaluating the relevance of a treatment based on a patient's current health status. Christophe Wilcke, president of a clinical pharmacy commission, prefers the term "adapted prescription," aiming to reduce risks rather than simply reduce medication use.Collaboration in medication review
Pharmacists conduct shared medication reviews, identifying issues such as drug interactions or redundancies and communicating these to physicians. This process emphasizes collaboration with both doctors and patients, though it raises questions about how pharmacists are compensated for the time spent.New approaches to remuneration
A ministerial letter from September 9 asks the Health Insurance Agency to explore remuneration models less dependent on medication volume or price. Options include per-patient forfait, mission-based pay, or a mix, though the exact structure remains to be decided.Pharmaceutical interventions in practice
Pharmaceutical interventions are part of standard dispensation practices, allowing pharmacists to formally analyze and recommend changes to prescriptions. However, these interventions are rarely recorded, creating a gap in tracking their frequency and impact.Challenges in proving pharmacist contributions
Jean-Didier Bardet notes that pharmacists face the challenge of proving their contributions, which could lead to administrative burdens. The Union of Pharmacy Shop Unions calls for simplification, emphasizing visibility without increasing workload.Electronic prescriptions as a solution
Electronic prescriptions could help track interventions by timestamping and recording each step. Julien Chauvin, president of a commission on economic strategy, suggests that this data could be used to evaluate the pharmacist's role, provided the software supports simple documentation.Future of remuneration for interventions
Julien Chauvin proposes remuneration based on the number of steps or time spent, while Jean-Didier Bardet argues for payment when anomalies are detected, not just when problems occur. The debate remains open on whether to reward corrections or the analysis itself.Pharmacies as data sources
Community pharmacists, like Arthur Piraux, see their role expanding into research. Real-world data from pharmacies, which reflect diverse patient populations, can support new practices and studies, such as evaluating the management of simple cystitis before it becomes standard care.Barriers to pharmacy research participation
Despite regulatory support, pharmacists struggle to integrate research into daily practice due to time and resource constraints. Training and suitable software are essential to encourage more pharmacists to participate in studies, though current remuneration models are not seen as the main motivator.Sustainable funding for new practices
While some compensation exists for research participation, long-term funding remains uncertain. These efforts aim to demonstrate the value of new practices and prepare for their wider adoption, allowing pharmacists to shape the future of their profession.
