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      Policy and vision for community pharmacies in Finland: A roadmap towards enhanced integration and reduced costs

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          Abstract

          Finland’s community pharmacy system provides an example of a privately-owned regulated system being proactively developed by the profession and its stakeholders. Community pharmacists have a legal duty to promote safe and rational medicine use in outpatient care. The development of professionally oriented practice has been nationally coordinated since the 1990s with the support of a national steering group consisting of professional bodies, authorities, pharmacy schools and continuing education centers. The primary focus has been in patient counseling services and public health programs. The services have extended towards prospective medication risk management applying evidence-based tools, databases and digitalization. Research has been essential in informing progress by indicating high-risk patients, medications, practices and processes needing improvement. Despite the commitment of the profession and pharmacy owners, large-scale implementation of services has been challenging because of lack of remuneration, the pharmacy income still consisting primarily of sale of prescription and nonprescription medicines. Policy documents by the Ministry of Social Affairs and Health have supported the extension of the community pharmacists’ role beyond traditional dispensing to promote rational pharmacotherapy. The current roadmap by the Ministry of Social Affairs and Health emphasizes ensuring adequate regional availability and accessibility of medicines, regardless of the future pharmacy system. It also emphasizes the importance of strong regulation on pharmacy business operations and sale of medicines to ensure medication safety. At the same time, the roadmap requires that the regulation must enable implementation of new patient-oriented services and procedures, and further promote digitalization in service provision. Competition and balance of funding should be enhanced, e.g., through price competition, but the risk of pharmaceutical market concentration should be managed. The regulation should also consider influence of the new social and health care system on drug delivery. Year 2021 will be crucial for making long-term political decisions on the future direction of tasks and finances of Finnish community pharmacies in this framework. Government-funded studies are underway to guide decision making. Ongoing Covid-19 crisis has demonstrated the readiness of Finnish community pharmacies to adapt fast to meet the changing societal needs.

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          The quality of care. How can it be assessed?

          Before assessment can begin we must decide how quality is to be defined and that depends on whether one assesses only the performance of practitioners or also the contributions of patients and of the health care system; on how broadly health and responsibility for health are defined; on whether the maximally effective or optimally effective care is sought; and on whether individual or social preferences define the optimum. We also need detailed information about the causal linkages among the structural attributes of the settings in which care occurs, the processes of care, and the outcomes of care. Specifying the components or outcomes of care to be sampled, formulating the appropriate criteria and standards, and obtaining the necessary information are the steps that follow. Though we know much about assessing quality, much remains to be known.
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            • Article: not found

            The quality of care. How can it be assessed?

            Before assessment can begin we must decide how quality is to be defined and that depends on whether one assesses only the performance of practitioners or also the contributions of patients and of the health care system; on how broadly health and responsibility for health are defined; on whether the maximally effective or optimally effective care is sought; and on whether individual or social preferences define the optimum. We also need detailed information about the causal linkages among the structural attributes of the settings in which care occurs, the processes of care, and the outcomes of care. Specifying the components or outcomes of care to be sampled, formulating the appropriate criteria and standards, and obtaining the necessary information are the steps that follow. Though we know much about assessing quality, much remains to be known.
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              • Record: found
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              Medication review practices in European countries.

              Medication review procedures have been developed in many countries to improve rational and safe medication use. The similarities, comprehensiveness, and effectiveness of these procedures has not been assessed, or compared.
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                Author and article information

                Contributors
                Journal
                Pharm Pract (Granada)
                Pharm Pract (Granada)
                Pharmacy Practice
                Centro de Investigaciones y Publicaciones Farmaceuticas
                1885-642X
                1886-3655
                Jan-Mar 2021
                4 February 2021
                : 19
                : 1
                : 2288
                Affiliations
                MSc(Pharm), PhD. Professor, Head of Clinical Pharmacy Group. Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki . Helsinki (Finland). marja.airaksinen@ 123456helsinki.fi
                MSc(Pharm), PhD. Medication Safety Officer. Tampere University Hospital . Tampere (Finland). terhi.toivo@ 123456pshp.fi
                MSc(Pharm), PhD. Proprietary pharmacist. Runosmäki Pharmacy . Turku (Finland). lenita.jokinen@ 123456gmail.com
                MSc(Pharm), MSc(SocSci), PhD. Proprietary pharmacist. Lohja 1st Pharmacy . Lohja (Finland). eeva.savela@ 123456apteekit.net
                MSc(Pharm), PhD. Proprietary pharmacist. Willan Kehrä Pharmacy . Hyvinkää (Finland). stina.parkkamaki@ 123456gmail.com
                MSc(Pharm), PhD. Director of Pharmaceutical Affairs. The Association of Finnish Pharmacies . Helsinki (Finland). charlotta.sandler@ 123456apteekkariliitto.fi
                MSc(Pharm). Specialist Pharmacist. Helsinki University Hospital Pharmacy . Helsinki (Finland). hanna.kalliomaki@ 123456gmail.com
                MSc(Pharm), PhD. Visiting Scientist. Clinical Pharmacy Group, Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki . Helsinki (Finland). maarit.dimitrow@ 123456helsinki.fi
                Author information
                https://orcid.org/0000-0002-6077-5671
                https://orcid.org/0000-0001-8357-2714
                Article
                pharmpract-19-2288
                10.18549/PharmPract.2021.1.2288
                7886313
                33628348
                08539e71-ac9d-458f-8398-988d68cf7ef2
                Copyright: © Pharmacy Practice and the Authors

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY-NC-ND 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                International Series: Integration of community pharmacy in primary health care

                pharmacies,primary health care,delivery of health care,integrated,ambulatory care,community health services,pharmacists,community pharmacy services,professional practice,finland

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