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      Primary healthcare policy and vision for community pharmacy and pharmacists in Germany

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          Abstract

          Germany is the highest populated country in Europe with a population of 82.3 million in 2019. As in many other developed countries, it has an aging population. Approximately 10% of the gross domestic product is spent on healthcare. The healthcare system is characterized by its accessibility. Patients are generally free to choose their primary care physicians, both family doctors and specialists, pharmacy, dentist, or emergency service. Up to a certain income, health insurance is mandatory with the statutory health insurance (SHI) system, covering 88% of the population. Major challenges are the lack of cooperation and integration between the different sectors and healthcare providers. This is expected to change with the introduction of a telematic infrastructure that is currently being implemented. It will not only connect all providers in primary and secondary care in a secure network but will also enable access to patients’ electronic record/medical data and at the same time switch from paper to electronic prescriptions. Approximately 52,000 of the 67,000 pharmacists are working in approximately 19,000 community pharmacies. These pharmacies are owner-operated by a pharmacist. Pharmacists may own up to three subsidiaries nearby to their main pharmacy. Community pharmacy practice mainly consists of dispensing drugs, counselling patients on drug therapy and safety, and giving advice on lifestyle and healthy living. Many cognitive pharmaceutical services have been developed and evaluated in the past 20 years. Discussions within the profession and with stakeholders on the national level on the roles and responsibilities of pharmacists have resulted in nationally agreed guidelines, curricula, and services. However, cognitive services remunerated by the SHI funds on the national level remain to be negotiated and sustainably implemented. A law passed in November 2020 by parliament will regulate the remuneration of pharmaceutical services by the SHI funds with an annual budget of EUR 150 million. The type of services and their remuneration remain to be negotiated in 2021. The profession has to continue on all levels to advocate for a change in pharmacy practice by introducing pharmacy services into routine care.

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          PCNE definition of medication review: reaching agreement

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            Tools for predicting the risk of type 2 diabetes in daily practice.

            The discussion about the diagnosis and treatment of type 2 diabetes - and, more generally, dysglycaemia - should be framed in terms of a continuum of risk. A variety of tools have been developed to identify individuals with an increased risk of developing type 2 diabetes and to quantify the probability of type 2 diabetes either cross-sectionally or prospectively. Such scores are based on traditional risk factors for diabetes, such as age, body mass index (BMI), and family history, while others also evaluate metabolic risk factors such as lipid levels. The performance of a diabetes risk-prediction tool is generally assessed by measuring its accuracy, availability, practicability, and costs. This review discusses the validity and use of today's available major risk-prediction tools for clinical practice, and assesses the scope and cost-effectiveness of available tools. Among these prediction tools, American Diabetes Association (ADA) Risk Tools, Finnish Diabetes Risk Score (FINDRISC), National Health and Nutrition Examination Survey (NHANES) Risk Score, and Study to Prevent Non-Insulin Dependents Diabetes Mellitus (STOP-NIDDM) Risk Score were of our concern. We conclude that the FINDRISC tool is currently the best available tool for use in clinical practice in Caucasian populations, but modifications may be required if applied to other ethnic groups.
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              Pharmacy‐based interdisciplinary intervention for patients with chronic heart failure: results of the PHARM‐CHF randomized controlled trial

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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
                20 January 2021
                : 19
                : 1
                : 2248
                Affiliations
                RPh, PhD. Division Scientific Development, Department of Medicine, Federal Union of German Associations of Pharmacists (ABDA) . Berlin (Germany). c.eickhoff@ 123456abda.de
                RPh, PhD. Head, Division Scientific Evaluation, Department of Medicine, Federal Union of German Associations of Pharmacists (ABDA) . Berlin (Germany). n.griese-mammen@ 123456abda.de
                RPh, PhD. Head, Division Scientific Development. Department of Medicine, Federal Union of German Associations of Pharmacists (ABDA) . Berlin (Germany). u.mueller@ 123456abda.de
                RPh, PhD. Head, Office of the Drug Commission of German Pharmacists, Department of Medicine, Federal Union of German Associations of Pharmacists (ABDA) . Berlin (Germany). a.said@ 123456arzneimittelkommission.de
                RPh, PhD, FFIP, FESCP. Adjunct Professor. Director, Department of Medicine, Federal Union of German Associations of Pharmacists (ABDA) . Berlin (Germany). m.schulz@ 123456abda.de
                Author information
                https://orcid.org/0000-0003-0138-0781
                https://orcid.org/0000-0002-8830-9031
                https://orcid.org/0000-0003-0969-9084
                https://orcid.org/0000-0002-7063-2025
                https://orcid.org/0000-0002-5876-7322
                Article
                pharmpract-19-2248
                10.18549/PharmPract.2021.1.2248
                7844970
                33520040
                c6114802-775c-46ec-a584-cdee8665aadd
                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,germany

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