Clinical Pharmacy Education and Practice in Europe · 2020-07-01 · L. Moura, S. Steurbaut, V. Jordan-von Gunten, B. Addison, S. Apikoglu-Rabus, H. Salvesen Blix, M. Kinnear, B.van

L. Moura, S. Steurbaut, V. Jordan-von Gunten, B. Addison, S. Apikoglu-Rabus, H. Salvesen Blix, M.

Kinnear, B.van den Bemt, F. Alves da Costa

Clinical Pharmacy

Education and

Practice in Europe

On behalf of the Education Committee of

European Society of Clinical Pharmacy

2

Index

List of abbreviations .......................................................................................................................... 4

Executive Summary ........................................................................................................................... 5

Glossary ................................................................................................................................................ 7

Albania ............................................................................................................................................... 15

Belgium ............................................................................................................................................... 17

Bosnia and Hercegovina ............................................................................................................... 19

Bulgaria ............................................................................................................................................... 20

Croatia ................................................................................................................................................ 22

Cyprus ................................................................................................................................................. 24

Czech Republic ................................................................................................................................ 26

Denmark ............................................................................................................................................. 29

Estonia ................................................................................................................................................. 31

Finland ................................................................................................................................................. 33

France ................................................................................................................................................. 35

Germany ............................................................................................................................................ 37

Greece ............................................................................................................................................... 39

Hungary .............................................................................................................................................. 41

Iceland ................................................................................................................................................ 43

Ireland ................................................................................................................................................. 46

Italy....................................................................................................................................................... 48

Kosovo ................................................................................................................................................ 50

Latvia ................................................................................................................................................... 52

Lithuania ............................................................................................................................................. 54

Malta ................................................................................................................................................... 56

The Netherlands ............................................................................................................................... 58

Norway................................................................................................................................................ 60

Poland ................................................................................................................................................. 62

Portugal .............................................................................................................................................. 64

Republic of Moldova ...................................................................................................................... 66

Russian Federation .......................................................................................................................... 69

Serbia .................................................................................................................................................. 71

Slovakia ............................................................................................................................................... 73

3

Slovenia .............................................................................................................................................. 75

Spain .................................................................................................................................................... 78

Sweden ............................................................................................................................................... 80

Switzerland ......................................................................................................................................... 82

Turkey .................................................................................................................................................. 84

Ukraine ................................................................................................................................................ 86

United Kingdom ............................................................................................................................... 88

Summary and conclusions ............................................................................................................ 90

4

List of abbreviations

CP - Clinical Pharmacy

ESCP – European Society of Clinical Pharmacy

EAFP – European Association of Faculties of Pharmacy

CPD - Continuous professional development

ECTS – European Credit Transfer System

ADR – Adverse Drug Reaction

OSCE – Objective Structured Clinical Examination

5

Executive Summary

Education is a cornerstone in the formation of high-qualified professionals, who engaging in

long-life learning, can better meet societal needs and thus provide high quality clinical

pharmacy (CP) services to ensure the best use of medication. In order to understand the

current education situation in Europe and the level of differentiation and recognition of CP, a

mapping exercise was deemed necessary. To that end, the Education Committee of the ESCP

developed a survey to map education and practice in CP around Europe, aiming to get an

overview of the present situation and identify good examples on clinical pharmacy education

and practice.

The survey was developed from scratch using a sequential approach, where two experts1

developed an initial version to capture the three main domains (undergraduate, post

graduate education, and practice - see appendix 1), subsequently revised by a larger panel

of six experts representing the ESCP Education and General Committees 2, then supplemented

by a glossary and finally submitted and approved by the General Committee. The final survey

included an initial section introducing the ESCP definition of clinical pharmacy. The study

received approval from Egas Moniz3 and FFULisboa4 Ethics Committee.

Dissemination was multi-staged, first addressing all academic members of ESCP, secondly

adopting a snowballing approach to Educational Committee members’ contacts, and finally

targeting associates of the European Association of Faculties of Pharmacy (EAFP). Data were

collected from October 4th, 2018 till January 31st, 2019. Ideally, we intended to receive only

one response per country, reflecting the national situation of CP education and practice.

However, because we reached participants using ESCP, EAFP and individual contacts,

multiple answers from the same country were possible. To our knowledge, there is no central

registry indicating the contact person for academic matters per country. Therefore, the

validation process included unifying multiple answers from the same country. All answers

received were accepted and then mapped to decide whether they supplement or differ from

each other. Whenever possible key stakeholders in each of the countries involved were

contacted to validate the research team’s interpretation of data5. A report was produced

following the first analysis and sent to all participants asking for clarification of inconsistencies

and for missing information. When deemed necessary, face to face discussions were held to

clarify persisting inconsistencies. This report presents the outcome of this European survey,

where 36 countries participated (representing 72% of countries delivering education in

Pharmaceutical Sciences) and is open for public consultation at the ESCP’s website from July

till August. Countries that have answered the initial survey but did not provide any feedback

on the initial report that was sent, are marked as unvalidated data.

The main findings are that CP education and practice vary widely across European countries.

Undergraduate education in clinical pharmacy was reported by 97% (n=34 out of 35) of

participating countries, and 91% (n=30 out of 33) reported to also have postgraduate

education. While some countries reported a curriculum full of CP course units, with a lot of

practical teaching, others have less clinical pharmacy component at undergraduate level.

Some countries showed a wide scope of postgraduate educational possibilities (both leading

1 Filipa Alves da Costa and Stephane Steurbaut 2 Bart van den Bemt, Brian Addison, Frank Jørgensen, Hege Blix, Sule Rabus and Vera von

Gunten 3 Egas Moniz University Institute, Portugal 4 Faculty of Pharmacy, University of Lisbon, Portugal 5 Laura Moura was responsible for all data analysis

6

to an academic degree and not leading to an academic), whilst others reported very little

postgraduate possibilities.

Almost every European country reported practice around CP (97%; n=35 out of 36), the most

commonly reported applicability being at community and hospital settings (63% n=20 out of

32)), a smaller proportion in only hospital setting (31%; n=10 out of 32) and a minority (6%, n=2

out of 32) referring to applicability in all healthcare settings which might also include long-term

care and primary care, to name a few. More than half (51%) of the European countries

providing education in pharmaceutical sciences (n=18 out of 35) recognize CP as an area of

specialization, and in 65% of these countries (n=11 out of 17) this specialization includes job

specifications or professional rights.

The main results of this mapping exercise suggest education and practice in clinical pharmacy

is evolving across Europe, despite major differences between and within countries. This study

is an excellent opportunity for European countries to learn from each other and share good

practice examples on clinical pharmacy education and practice, and collectively work

towards increased pharmacists’ clinical activities in Europe. We very much appreciate the

contribution of all ESCP members who participated in this survey and encourage all others to

comment the full report.

7

Glossary

Clinical Pharmacy: The latest ESCP definition states that clinical pharmacy is a scientific

discipline and a branch of pharmacy practice, which aims to optimize the therapeutic use of

medicines by patients and professionals in order to maximize the likelihood that an optimal

balance of clinical, humanistic and economic outcomes is achieved.

As an academic discipline, clinical pharmacy aims to generate and disseminate knowledge

that directly informs clinical decision-making, health care organization or policy in relation to

the therapeutic use of medicines.

As a professional practice, clinical pharmacy comprises services delivered by registered

pharmacists or pharmaceutical staff acting under their responsibility, which target the

therapeutic use of medicines at population and/or individual patient levels. Clinical pharmacy

can be delivered in any setting. Where clinical pharmacy services target therapeutic use of

medicines in individual patients, clinical pharmacy practice and pharmaceutical care

delivery (defined by the Pharmaceutical Care network Europe as “the pharmacist’s

contribution to the care of individuals in order to optimize medicines use and improve health

outcomes”) are synonymous.

Competency: a single item of knowledge, skill, behavior and attitude. Source: Bruno, A. (2011). The

Feasibility, Development and Validation of a Global Competency Framework for Pharmacy Education. Thesis for

Doctor of Philosophy, University College London (UCL), School of Pharmacy. [London]: UCL, School of Pharmacy.

Competency framework – a complete collection of competencies that are thought to be

essential to performance. Source: International Pharmaceutical Federation (FIP) Education Initiatives (FIPEd).

(2012a). A Global Competency Framework for Services Provided by Pharmacy Workforce. The Hague, Netherlands:

FIP. Available from: http://www.fip.org/files/fip/PharmacyEducation/GbCF/GbCF_v1_online_A4.pdf

Competencies – knowledge, skills, behaviors and attitudes that an individual accumulates,

develops, and acquires through education, training, and work experience. Source: International

Pharmaceutical Federation (FIP) Education Initiatives (FIPEd). (2012a). A Global Competency Framework for Services

Provided by Pharmacy Workforce. The Hague, Netherlands: FIP. Available

from: http://www.fip.org/files/fip/PharmacyEducation/GbCF/GbCF_v1_online_A4.pdf

Validated and unvalidated data: Data validity is commonly defined as the extent to which

data represents the truth. [Source: Stausberg J, Kuklik N, Jöckel KH. Opportunities and Pitfalls in the Definition of

Data Validity. Stud Health Technol Inform. 2018;247:566-570]. Various procedures may be adopted to

ensure data validity. For the purpose of the present study, data was considered valid if at least

one verification of the fidelity of the data initially provided was possible to obtain. Data was

considered as not validated when only the initial responses were obtained with no further

verification. For the final report, we shall consider three levels of validation, where the third will

be achieved by a public consultation process.

Continuing Professional Development (CPD) – the responsibility of individual pharmacists for

systematic maintenance, development and broadening of knowledge, skills and attitudes, to

ensure continuing competence as a professional throughout their careers. Source: International

Pharmaceutical Federation (FIP) Education Initiatives (FIPEd). (2012a). A Global Competency Framework for Services

Provided by Pharmacy Workforce. The Hague, Netherlands: FIP. Available


Master of Science (MSc) in Pharmacy/Pharmaceutical Sciences – a postgraduate degree in

a specialist area or discipline.

http://www.fip.org/files/fip/PharmacyEducation/GbCF/GbCF_v1_online_A4.pdf



8

Master of Pharmacy (MPharm) – the undergraduate degree qualification in the United

Kingdom required for registration with the UK regulator as a Pharmacist. Source: General

Pharmaceutical Council (GPhC) (2018). MPharm degree. Available from:

https://www.pharmacyregulation.org/education/pharmacist/MPharm

Performance – an effective and persistent observable behavior. What an individual does as

opposed to what they can do. Source: International Pharmaceutical Federation (FIP) Education Initiatives

(FIPEd). (2012a). A Global Competency Framework for Services Provided by Pharmacy Workforce. The Hague,

Netherlands: FIP. Available from: http://www.fip.org/files/fip/PharmacyEducation/GbCF/GbCF_v1_online_A4.pdf

PharmD – a professional doctorate degree needed to be a pharmacist in the USA.



9

Demographics

According to the United Nations, there are 546 European countries, although according to the

sources consulted, Andorra, Liechtenstein, Monaco and Montenegro do not have education

in pharmacy. This study includes data from 72% (n=36 out of 50) of the European countries

delivering education in pharmaceutical sciences.

Figure 1. Map of Europe with participating countries highlighted.

Legend:

6 Albania, Andorra, Armenia, Austria, Azerbaijan, Belarus, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Cyprus, Czech

Republic, Denmark, Estonia, Finland, France, Georgia, Germany, Great Britain, Greece, Hungary, Iceland, Ireland, Israel, Italy, Kazakhstan, Kosovo (it is not on United Nations’ list but we decided to include in the study), Kyrgyzstan, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Monaco, Montenegro, Netherlands, North Macedonia, Northern Ireland, Norway, Poland, Portugal, Republic of Moldova, Romania, Russian Federation, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Tajikistan, Turkey, Ukraine, Uzbekistan

Participating countries

10

General overview

Table 1: General overview of responses provided by participating countries to the three survey

domains

Number of faculties

providing pharmacy studies

Undergraduate

education

Postgraduate

education

Professional

practice

Albania 5 N N Y

Belgium 6 Y Y Y

Bosnia and

Hercegovina 6 Y Y Y

Bulgaria 5 Y Y Y

Croatia 2 Y Y Y

Cyprus 5 Y Y Y

Czech

Republic 2 Y Y Y

Denmark 2 Y Y Y

Estonia 1 Y N Y

Finland 3 Y Y Y

France 24 Y Y Y

Germany 22 Y Y Y

Greece 4 Y Y Y

Hungary 4 Y Y Y

Iceland 1 Y Y Y

Ireland 3 Y Y Y

Italy 29 ND ND Y

Kosovo 3 Y Y Y

Latvia 2 Y Y Y

Lithuania 2 Y N Y

Malta 1 Y Y Y

Netherlands 3 Y Y Y

Norway 6 Y Y Y

Poland 11 Y Y Y

Portugal 9 Y Y Y

Republic of

Moldova 1 Y Y Y

Russian

Federation 15 Y ND N

Serbia 5 Y Y Y

Slovakia 2 Y Y Y

Slovenia 1 Y Y Y

Spain 22 Y Y Y

Sweden 3 Y Y Y

Switzerland 6 Y ND Y

Turkey 36 Y Y Y

Ukraine 21 Y Y Y

United

Kingdom 28 Y Y Y

Legend:

Y Yes

N No

ND No data available

11

Table 1 shows that 97% (n=34 out of 35) of the participating European countries have

undergraduate education in clinical pharmacy, 91% (n=30 out of 33) have postgraduate

education and 97% (n=35 out of 36) have clinical pharmacy embedded in their professional

practice. Around 83% of participating European countries have all three – under- and

postgraduate education as well as professional practice in clinical pharmacy. This table also

shows a wide variability in the number of faculties, ranging from 1 to 36 per country, making

data validation for some countries particularly challenging.

Postgraduate education in CP

Table 2: Postgraduate education in CP reported by participating countries

Postgraduate education leading

to an academic degree

Postgraduate education not leading to an academic

degree

Masters PhD

programmes

Continuous professional

development

Postgraduate programmes/

Certifications

Belgium N Y Y Y

Bosnia and

Hercegovina Y Y N N

Bulgaria Y Y ND ND

Croatia Y N N Y

Cyprus Y Y N N

Czech Republic N Y Y Y

Denmark N N N Y

Finland N Y Y ND

France ND N Y Y

Germany N Y ND Y

Greece Y Y N N

Hungary N Y Y N

Iceland Y Y N N

Ireland Y Y Y N

Kosovo N N Y N

Latvia Y Y N N

Malta Y Y Y N

Netherlands N Y Y Y

Norway Y Y Y N

Poland Y Y N N

Portugal N N Y N

Republic of

Moldova Y N N N

Serbia Y Y ND ND

Slovakia Y Y N N

Slovenia Y Y Y N

Spain Y N Y Y

Sweden Y ND N N

Turkey Y Y Y N

Ukraine Y Y Y N

United Kingdom Y Y Y Y

12

Legend:

Most countries reported to provide specific clinical pharmacy postgraduate education

leading to an academic degree. 65% (n=20 out of 31) have a master’s programme and 72%

(n=23 out of 32) have PhD programmes.

A considerable proportion also reported to provide clinical pharmacy postgraduate

education not leading to an academic degree. 55% (n=16 out of 29) have CPD courses and

35% (n=10 out of 29) have postgraduate programmes/certifications.

United Kingdom is the only European country where all the possibilities for postgraduate

education are available.

Y Yes

N No


13

Professional practice in CP

Table 3: General overview of clinical pharmacy practice in participating countries

Clinical pharmacy practice Application setting Recognised Specialization

Albania Y C + H N

Belgium Y C + H N

Bosnia and Hercegovina Y C + H Y

Bulgaria Y H Y

Croatia Y C + H Y

Cyprus Y C + H N

Czech Republic Y AHF Y

Denmark Y C + H N

Estonia Y H N

Finland Y C + H Y

France Y C + H N

Germany Y H Y

Greece Y ND Y

Hungary Y H Y

Iceland Y ND N

Ireland Y C + H N

Italy Y H N

Kosovo Y C + H Y

Latvia Y H Y

Lithuania Y C + H N

Malta Y C + H N

Netherlands Y C + H N

Norway Y C + H Y

Poland Y H Y

Portugal Y C + H N

Republic of Moldova Y C + H Y

Russian Federation N - N

Serbia Y H Y

Slovakia Y H Y

Slovenia Y C + H Y

Spain Y C + H N

Sweden Y C + H N

Switzerland Y ND ND

Turkey Y H Y

Ukraine Y AHF Y

United Kingdom Y C + H N

Legend:

Y Yes

N No


C Community pharmacy setting

H Hospital setting

AHF All healthcare settings

14

Almost every European country (35 out of 36 participating countries) has clinical pharmacy

practice(s), with 63% (n=20 out of 32) having its application at both the community and

hospital level, 31% (n=10 out 32) having its application only in hospital setting and 6% (n=2 out

of 32) having its application in all healthcare settings.

More than half (51%, n=18 out of 35) of the participating European countries recognize clinical

pharmacy as an area of specialization, and of these, in 11 (out of 17) countries (65%), the

specialization goes along with particular job specifications and/or professional rights.

15

Albania

Indicators

Inhabitants1 2 870 324

Practicing pharmacists/ 100 000 inhabitants2 85

Hospitals/100 000 population3 1.5

Community pharmacies/ 100 000 inhabitants4 ND

1. Characterization of the Albanian Clinical Pharmacy Education

Albania has five faculties that provide an Integrated master’s degree in Pharmaceutical

Sciences.

Clinical pharmacy is not part of the university curricula in Albania as a separated module

or discipline. Topics related to clinical pharmacy are taught in different modules (such as

Pharmacology, Biopharmacy and Pharmacokinetics, professional practice, etc). Pharmacists

also offer clinical pharmacy services in their work environment (open pharmacy, hospital

pharmacy), but there is not an official title of Clinical Pharmacist.

2. Undergraduate education in CP

None of the faculties that provide an Integrated master’s degree in Pharmaceutical

Sciences covers topics of Clinical Pharmacy.

3. Postgraduate education in CP

Postgraduate education leading to an

academic degree

Postgraduate education not leading to

an academic degree

Master/ Diploma

degree PhD programmes CPD courses Certifications

N N N N

4. Professional Practice in CP

In Albania, there is no specialization in clinical pharmacy.

Clinical Pharmacy is part of the professional activities of both community and hospital

pharmacists.

In addition, there are no specific areas officially recognised as speciality areas by the

national authority or professional body in the domain of clinical pharmacy.

16

References

1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest

available census and estimates, latest available data). Retrieved from

https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,

2020);

2 European Union – Eurostat. Health personnel statistics. Retrieved from

https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do (accessed on May 30th, 2020);

3 World Health Organization - Regional Office for Europe. European Health Information Gateway.

Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-

000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);

4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,

https://doi.org/10.1787/28492fb2-en.

https://unstats.un.org/unsd/demographic-social/products/vitstats/seratab2.pdf


https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml

https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do

https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-000/visualizations/#id=19523&tab=table


https://doi.org/10.1787/28492fb2-en

17

Belgium (not validated)

Indicators


Practicing pharmacists/ 100 000 inhabitants2 123.2


Community pharmacies/ 100 000 inhabitants4 43.4

1. Characterization of the Belgian Clinical Pharmacy Education

According to FIP Official World List of Pharmacy Schools5, Belgium has six faculties that

provide an Integrated Master of Pharmaceutical Sciences.

CP is a quite young discipline in Belgium. It is part of the hospital pharmacy specialization

and does not exist as a profession on its own. This specialization takes 3 additional years on top

of the 5 years to become a pharmacist in Belgium.

From 2007, the Belgian Federal Government is stimulating CP by financing 0,2 FTE per 200

beds in each hospital (except for psychiatric hospitals).

The hospital pharmacy specialization in Flanders is an interuniversity programme between the

4 Flemish universities (Antwerp, Brussels, Ghent and Leuven).

In Belgium, clinical pharmacy is beyond the starting point, but is not already fully

established (both education and practice).


The undergraduate education in Belgium is accredited by a regulator.

The curricula of Pharmacy schools cover topics in Clinical Pharmacy, with a 20 to 60%

of practical teaching.



academic degree

Postgraduate education not leading to an

academic degree

Master/ Diploma


N

Y

Y

Y

There are PhDs in

Belgium in the

domain of CP but not

leading to a specific

PhD diploma in CP.

What you obtain in

the end is a PhD in

Pharmaceutical

Sciences.

In Belgium, clinical pharmacy is

a course in the education to

obtain the diploma of hospital

pharmacist; one university

offers a post-grad certificate in

clinical pharmacy.”

18


In Belgium, Clinical pharmacy is not considered an area of specialization but is part of

the professional activities of both community and hospital pharmacists.

There are no recognised speciality areas in the domain of clinical pharmacy.

References




2020);








5 International Pharmaceutical Federation (FIP): Official World List of Pharmacy Schools. Retrieved from

http://academic_institutional_membership.fip.org/world-list-of-pharmacy-schools/ (accessed on April

26th, 2020)








http://academic_institutional_membership.fip.org/world-list-of-pharmacy-schools/

19

Bosnia and Hercegovina

Indicators





1. Characterization of the Bulgarian Clinical Pharmacy Education

Bosnia and Hercegovina have six faculties that provide an Integrated master’s degree in

Pharmaceutical Sciences.


The postgraduate education in Bosnia and Hercegovina is accredited by a regulator.

The curricula of Pharmacy schools cover topics in Clinical Pharmacy and includes practical

teaching.


The postgraduate education in Bosnia and Hercegovina is accredited by a regulator.

Postgraduate education leading to an academic

degree

Postgraduate education not leading


Master/ Diploma


Y

Y N N 2-semester duration

with no practical

teaching


In Bosnia and Hercegovina, Clinical Pharmacy is recognized an area of specialization by

the Federal ministry of health. The specialization has its application setting in both community

and hospital setting.

The Clinical Pharmacy specialization includes professional rights or job specifications and

is legally anchored.

20

Bulgaria (not validated)

Indicators





1. Characterization of the Bulgarian Clinical Pharmacy Education

Bulgaria has five faculties that provide an Integrated master’s degree in Pharmaceutical

Sciences.

The clinical pharmacy education in Bulgaria has started in the 1990s. However, regarding

the practical realization - it is still in a very early and developing stage. Most of the pharmacists

who have completed clinical pharmacy courses and are qualified do not work as clinical

pharmacists.

In terms of education, Bulgaria have an undergraduate specialization in clinical pharmacy

and a postgraduate specialization. The discipline `Pharmaceutical Care` is studied as a

compulsory discipline in all faculties in Bulgaria.

There are several big hospitals which have appointed clinical pharmacists.


The postgraduate education in Bulgaria is accredited by a regulator.

The curricula of Pharmacy schools cover topics in Clinical Pharmacy, with at least 30%

practical teaching.



degree



Master/ Diploma


Y Y

ND ND

6-semester

duration and

with some

practical

teaching

It is only available as a post

graduate program with duration

of 3 years. Each faculty develops

its own program having in mind

the unified standards of the

Ministry of health and Ministry of

education and science. The 3-

years courses end with a state

exam. Courses are available in

Bulgarian only and can be

accessed by MSc Pharm.

21


In Bulgaria, Clinical Pharmacy is recognised an area of specialization by the Ministry of

Health and the Bulgarian Pharmaceutical Union.

The Clinical Pharmacy specialization has its application in hospital pharmacy and is legally

anchored.

Clinical pharmacists are supposed to take part in the multidisciplinary decision-making

process in patient treatment and double check MD's prescription. Clinical pharmacists give

advice and select the most appropriate therapy having in mind both patients and medicinal

products' characteristics. They also have access to all medical documentation.

Hospitals which have more than 400 hospital beds, more than 10 clinics or medical

oncology, must appoint clinical pharmacists, provided by Regulations of Ministry of Health.

Implementing of such a policy can save up to 30 percent of the money for medical treatments

as well as to prevent side effects and adverse reactions caused by some medicines.


References




2020);


Retrieved from https://gateway.euro.who.int/en/indicators/hlthres_191-practising-pharmacists-per-100-

000/ - Data from 1999 (accessed on May 30th, 2020);









https://gateway.euro.who.int/en/indicators/hlthres_191-practising-pharmacists-per-100-000/





22

Croatia Indicators




Community pharmacies/ 100 000 inhabitants4 59

1. Characterization of the Croatian Clinical Pharmacy Education

There are two faculties that have an Integrated master’s degree in Pharmaceutical

Sciences in Croatia.

Croatia have a degree in clinical pharmacy, as a postgraduate degree and a full degree

that besides the one-year post diploma degree includes two years of specialization in clinics.


Croatian pharmacy faculties provide undergraduate education covering clinical

pharmacy topics. The clinical pharmacy component is described on the following table:

Number of

semesters

Number of

contact hours per

semester

Number of ECTS

per

semester

Percentage of

Practical

teaching

Faculty of

Zagreb

1 89 6 33.3%

Faculty of

Split

1 45 4 33.3%


The existing postgraduate education is accredited by a regulator.


degree



Master/ Diploma degree PhD programmes CPD courses Certifications

Y

N N

Y

The postgraduate specialist

study may be enrolled by the

applicants who have

completed the graduate

study in pharmacy and

passed the professional

examination. The study can

also be enrolled by junior

doctors-residents in Clinical

Pharmacy as theoretical part

of this health specialization.

Upon completion of the

study, the academic title

3-year postgraduate

program named

“Clinical Pharmacy

Specialization”,

which includes

practical teaching

23

University Master of Clinical

pharmacy is achieved.

It is important to note that the

postgraduate specialist study

in clinical pharmacy is also a

part of a 3-year specialization

in Clinical Pharmacy. (More

details on the following table)


There are two specialization areas of Clinical Pharmacy, one of them with application in

hospital and the other one, in primary care. Both specializations are recognised by the

Croatian Ministry of Health.

Although Clinical pharmacy is recognised as an area of specialization, does not include

specific professional rights or job specifications.

Additionally, the specialization in Clinical pharmacy is partially legally anchored in the

Croatian legislation (as it is recognised by the Ministry).

There are no speciality areas in the domain of clinical pharmacy recognised.

References




2020);






4 Croatian Pharmaceutical Society. Retrieved from: https://www.farmaceut.org/hfd-i-farmaceutska-

struka/ljekarnistvo-u-hrvatskoj/ljekarnistvo- (accessed on 2019)

Number of

semesters

Number of

contact hours

per semester

Number of

ECTS per

semester

Percentage

of practical

teaching

Open to

foreigns Tuition fees

2 50 60 30 Yes 20 000 kunas

(around 2600€)







https://www.farmaceut.org/hfd-i-farmaceutska-struka/ljekarnistvo-u-hrvatskoj/ljekarnistvo-

https://www.farmaceut.org/hfd-i-farmaceutska-struka/ljekarnistvo-u-hrvatskoj/ljekarnistvo-

24

Cyprus (Not validated)

Indicators

Inhabitants1 864 236




Introductory Note

The following information concerns only to Northern Cyprus.

1. Characterization of the Cypriot Clinical Pharmacy Education

Northern Cyprus has five faculties that provide an Integrated master’s degree in


In pharmacy faculties under the Turkish Ministry of Higher Education, pharmacy programs

were elongated in the year 2005 from a 4-year course programs to a 5-year programs. As the

prolongation aimed to increase the number of courses and experiences that may contribute

to students pharmaceutical care providing competency development, the last incremented

year is reserved for some elective courses, graduation project, and a minimum 6-month

mandatory traineeship under the supervision of a pharmacist in the public pharmacy or in the

hospital.

Pharmaceutical care models including mentorship of the students on applying

pharmacotherapy are facing many challenges in Turkey. Of mention, newly adopted

curriculums do not contain enough exposure of students to advanced clinical pharmacy

practices, while on the other hand, senior practitioners carrying student’s mentorship role

deem the competence of providing clinical services. While clinical pharmacy hospital

department is only available in one hospital university in North Cyprus (Near East Hospital) and

two university hospitals in Turkey. OSCEs and clinical rounds are only compulsory in Near East

University, while rounds are also provided in few universities in Turkey.


The undergraduate education in Northern Cyprus cover topics in clinical pharmacy

and this under-graduation is accredited by a regulator.

The clinical pharmacy undergraduate education includes practical teaching.


The postgraduate education in Northern Cyprus is accredited by a regulator.

25


degree




Y Y

N N One Master/Diploma

degree in Clinical

Pharmacy (more details

on the following table)

Only pharmacists can

apply for these PhD

programme

Number of

semesters

Number of

contact hours

per semester

Number of

ECTS per

semester

Percentage of

practical

teaching

Open to

foreigns

Tuition

fees

4 156 16 56 yes ND


In Northern Cyprus, Clinical pharmacy is not recognised as an area of specialization,

however, it is part of the professional activities of both community and hospital pharmacists.


References




2020);

















26

Czech Republic Indicators





1. Characterization of the Czech Clinical Pharmacy Education

Czech Republic has two faculties that provide an Integrated master’s degree in

Pharmaceutical Sciences. (Faculty of Hradec Kralove and Faculty of Brno).

The discipline of Clinical Pharmacy is currently managed by two professional societies:

Section of Clinical Pharmacy of Czech Pharmaceutical Society (https://www.cfs-

cls.cz/Sections/Section-of-Clinical-Pharmacy/ ) and Czech Professional Society of Clinical

Pharmacy (https://www.coskf.cz/ ). The Section of Clinical Pharmacy is responsible for interests

in Clinical Pharmacy for many years.

Education focused on Clinical Pharmacy and Pharmaceutical Care is provided in curricula

of both faculties, however, in broader sense and for longer time in Faculty of Pharmacy in

Hradec Kralove.


The undergraduate education in Czech Republic is accredited by a regulator.

Croatian pharmacy faculties provide undergraduate education covering clinical

pharmacy topics. The clinical pharmacy component is described on the following table:

Number of

semesters

Number of contact

hours per semester

Number of ECTS per

semester

Percentage of

practical teaching

Faculty 1 2

Mandatory: 70

lectures, 36

seminars

Optional: 66

lectures, 56

seminars

Mandatory: 8

Optional: 11 50%

Faculty 2 1 21 4 70%


The postgraduate education in Czech Republic is accredited by a regulator.

https://www.cfs-cls.cz/Sections/Section-of-Clinical-Pharmacy/

https://www.cfs-cls.cz/Sections/Section-of-Clinical-Pharmacy/

https://www.coskf.cz/

27

Postgraduate education leading to

an academic degree


academic degree

Master/ Diploma


N

Y Y Y

One PhD

programme called

“Clinical and Social

Pharmacy”. Can

be accessed by

any professional

who is graduated in

Master studies in

Pharmacy, Medical

Bio analytics or a

related degree

program.

There are lots of

seminars,

workshops,

symposia and

conferences

included in

continuous

professional

education

covering clinical

pharmacy topics,

which is mandatory

for pharmacists, by

the Czech law.

Many of these

activities are

developed by the

Section of Clinical

Pharmacy of the

Czech

Pharmaceutical

Society.

Pharmacists can get the

specialization in Clinical

Pharmacy managed by the

Institute of Postgraduate

Education on behalf of

Ministry of Health. There are

currently two programs in

clinical pharmacy (one

from 2005 and a new one

from 2015).

The sylabus is very

comprehensive required at

least 5 years of clinical

practice, courses and

trainings it is finnished by

passing an exam (including

defence of a thesis, case

reports and theoretical

knowledge-based

questions)


The Czech Ministry of Health recognise Clinical Pharmacy as an area of specialization.

Named as Clinical Pharmacy Specialization, this specialization has its application in healthcare

facilities for outpatient and inpatients. Czech Clinical Pharmacy specialization include some

job specifications and professional rights.

A graduate specialized in clinical pharmacy is entitled to independently provide clinical-

pharmaceutical care for outpatient or inpatient care and clinic-pharmaceutical services to

physicians, is involved in a multidisciplinary therapeutic team or works independently as a

consultant. He/she is entitled to perform systematic comprehensive and selective evaluation

of patient medication, consultancy assessment of patient medication, initial medication

control at admission to the hospital, medication control in hospitalized patients,

pharmacotherapeutic recommendations including discharge of patients, education of

patients about pharmacotherapy. He/she is entitled to lead the Clinical Pharmacy

department/ward.

The specialization is legally anchored: Act no. 95/2004.

28

References




2020);

















29

Denmark Indicators



Hospitals/100 000 population3 ND


1. Characterization of the Danish Clinical Pharmacy Education

Denmark has two faculties that provide an Integrated master’s degree in Pharmaceutical

Sciences.

In 2010 was established a master’s degree in clinical pharmacy at the University of Southern

Denmark. University of Copenhagen had during several years an optional course in Clinical

Pharmacy at the Master education. Clinical pharmacy practice has gradually developed for

30 years but is best implemented in secondary care (Hospitals).


The undergraduate education that exists covers topics about clinical pharmacy in both

two faculties.

The undergraduate education is accredited by a regulator.


The postgraduate education in Denmark is not accredited by a regulator.


an academic degree


academic degree

Master/ Diploma


N N N

Y

Details on the following

table

Name of the

certification Number of Hours Practical teaching Additional details

Postgraduate

diploma in Clinical

Pharmacy

Each course 2-3

days yes

20 ECTS

Includes 8 separate

course

30


In Denmark, Clinical pharmacy is not recognised as an area of specialization. Additionally,

there is no recognition of any speciality area in the domain of clinical pharmacy.

The professional practice of Clinical Pharmacy is part of the professional activities of both

community and hospital pharmacists.

References




2020);







https://doi.org/10.1787/health_glance-2017-en.







https://doi.org/10.1787/health_glance-2017-en

31

Estonia Indicators





1. Characterization of the Estonia’s Clinical Pharmacy Education

Estonia has one faculty that have an MSc in Pharmaceutical Sciences.

Clinical pharmacy is taught on the 4-th year (5 ECTS) within pharmacy curriculum at the

University of Tartu. The course is supported by other related courses as Clinical pharmacy (2

ECTS), Social pharmacy and drug safety II (5 ECTS) and Communication in Healthcare and

pharmacy (1 ECTS). No separate curriculum available for clinical pharmacy in Estonia.


The undergraduate education that exists covers topics about clinical pharmacy. This

component is distributed in the following table:

Number of

semesters

Number of contact

hours per semester

Number of ECTS per

semester

Percentage of practical

teaching

8 65 5 50

The pharmacy curriculum including Clinical Pharmacy course is a subject for accreditation

by the Estonian Quality Agency for Higher and Vocational Education.


The postgraduate education in Estonia is not accredited by a regulator.


an academic degree


academic degree

Master/ Diploma


N N N N


In Estonia, Clinical Pharmacy is not recognised as an area of specialization. Additionally,

there is no recognition of speciality areas in the domain of Clinical Pharmacy.

Thus, the clinical pharmacy practise is part of the professional activities of only hospital

pharmacists.

32

References




2020);















33

Finland (Not validated)

Indicators





1. Characterization of the Finland’s Clinical Pharmacy Education

Finland has three faculties that provide an Integrated master’s degree in Pharmaceutical

Sciences.

The role of clinical pharmacy has been increased markedly. In education, for example the

medication review competence is included in new curriculum. In practice, the need for

interprofessional medication review services are notified.


The undergraduate education cover topics about clinical pharmacy.

The undergraduate education in Finland is not accredited by a regulator.


The postgraduate education in Finland is not accredited by a regulator.


academic degree


academic degree

Master/ Diploma


N

Y Y

ND

Two out of the three

existing faculties provide

PhD programmes in

Clinical Pharmacy, which

can be accessed by

Mpharm and MD.

Courses on Medication

review and

comprehensive

medication review


Finnish National Agency for education recognise Clinical Pharmacy as an area of

specialization. The specialization in Clinical Pharmacy has application in both community and

hospital pharmacies and give some job specifications and professional rights to the specialised

pharmacists, for example, the specialised pharmacists can perform comprehensive

medication review as a job specification. Also, as an area of specialization, Clinical Pharmacy

is not legally anchored in the Finnish legislation.

There is no recognition of any speciality areas in the domain of clinical pharmacy.

34

References




2020);















35

France Indicators





1. Characterization of the French Clinical Pharmacy Education

France has 24 faculties that provide an Integrated master’s degree in Pharmaceutical

Sciences.

The development of Clinical Pharmacy in France is growing since the 2000's at hospital and

more recently in community pharmacy (patient education, flu injection...). Clinical Pharmacy

is an official academic discipline at university since 1984.

France is running an important reform of pharmacy studies for under- graduated and

postgraduate (4-year residency program). This reform reinforces the theory and practical

teaching of Clinical Pharmacy and is related to the introduction of new Clinical Pharmacy

services at hospital and in the community.


No data available on undergraduate education covering clinical pharmacy topics.

Undergraduate education is accredited by the national agency.


For new Clinical Pharmacy services at community pharmacies it is mandatory to validate an

accredited program. For the general Continuous Education Program, there is an accreditation

by the national agency.


an academic degree


academic degree

Master/ Diploma


ND

N Y Y

There is no specific

PhD program in

Clinical Pharmacy

Many courses

France has postgraduate

programmes/Certifications in

Clinical Pharmacy in order to

provide

Clinical Pharmacy services at

community pharmacies, such

as, Flu injection, Patient

Therapeutic education and

medication review.

36


In France, Clinical pharmacy is not recognised as an area of specialization, although is part

of the professional activities of both community and hospital pharmacists.

- Hospital pharmacists historically have a specialization in Clinical Pharmacy during their

residency (minimum of 6 month of practice and 100 hours of teaching);

- Community pharmacists have the general education including teaching in Clinical

Pharmacy during their 5th year of pharmacy including CP activities at hospital.

There are no specific areas officially recognised in the domain of clinical pharmacy.

References




2020);















37

Germany Indicators





1. Characterization of the Germany’s Clinical Pharmacy Education

Germany has 22 faculties that provide an Integrated Master degree in Pharmaceutical

Sciences.


The undergraduate education in Germany is not accredited by a regulator.

The License Ordinance for Pharmacists (Approbationsordnung für Apotheker) is the basis

of the uniform nationwide training for pharmacists on the 22 faculties of pharmacy in Germany.

It determines the following distribution of hours: Pharmacology and Clinical Pharmacy: in total

406 h with 112 h practical training and 98 h seminars.

The model study programme provides 9 ECST for Clinical Pharmacy, 11 ECTS for Pharmacology,

5 ECTS for Pharmacotherapy, 8 ECTS for Pathophysiology and Pathology. All these modules

belong to the main subject Pharmacology and Clinical Pharmacy.


The postgraduate education in Germany is accredited by a regulator.


academic degree


academic degree

Master/ Diploma


N

Y

ND

Y

All Germany

pharmacy faculties

provide PhD

programmes in

Clinical Pharmacy.

In general, only

pharmacists can

access to these PhD

programmes.

- 4-week course to

obtain a certificate

on Clinical

pharmacy (Uni

Tübingen);

- Specialization on

clinical pharmacy,

issued by the

chamber of

pharmacists.


Apothekerkammern der Länder (Chambers of Pharmacists of the Federal States) recognise

Clinical Pharmacy an area of specialization in Germany. Clinical Pharmacy specialization is

38

not legally anchored. This specialization has its application in hospital pharmacies and does

not include any job specifications or professional rights.

Medication Management and Infectiology are speciality areas in the domain of clinical

pharmacy.

References




2020);















39

Greece (Not validated)

Indicators


Practicing pharmacists/ 100 000 inhabitants2 ND



1. Characterization of the Greece’s Clinical Pharmacy Education

According to FIP World List of Pharmacy Schools5, Greece has four faculties that provide

an Integrated Master in Pharmaceutical Sciences.


The undergraduate education in Greece is accredited by a regulator.

The pharmacy schools assure that the undergraduate programmes in Pharmaceutical

Sciences covers clinical pharmacy topics, however, without practical teaching.


The postgraduate education in Greece is accredited by a regulator.


academic degree


an academic degree

Master/ Diploma


Y Y

N N

One available

Master/diploma

degree (details

on the following

table)

Only one of the existing

faculties provide a PhD

programme in Clinical

Pharmacy.

The PhD programme is

available only for

pharmacists.

Number of

semesters

Number of

contact hours

per semester

Number of

ECTS per

semester

Percentage of

practical

teaching

Open to

foreigns

Tuition

fees

3 330 30 40 yes ND


In Greece, Clinical Pharmacy is considered an area of specialization but the specialization

is not legally anchored. The specialization does not include any job specifications or

professional rights.

40


References




2020);










26th, 2020)









41

Hungary Indicators





1. Characterization of the Hungarian Clinical Pharmacy Education

Hungary has four faculties that provide an Integrated master’s degree in Pharmaceutical

Sciences.

Officially, the "subject clinical pharmacy" became a mandatory part of the curricula since

1987, after the declaration of the Hospital Pharmacists' Conference organised for Socialistic

Countries in 1986 in Budapest. The practical implementation was very slow, but in the last

decade important development could be seen.


The undergraduate education that exists covers topics about clinical pharmacy in all four

faculties. The clinical pharmacy component is distributed as shown in the following table:

Number of

semesters

Number of contact

hours per semester

Number of ECTS per

semester

Percentage of

practical teaching

Faculty 1 1 98 6 40

Faculty 2 1 94 5 30

Faculty 3 1 84 4 15

Faculty 4 1 96 5 20



The postgraduate education in Hungary is accredited by a regulator.


academic degree


an academic degree

Master/ Diploma

degree PhD programmes

N

Y Y

All four faculties have PhD

programmes in clinical

pharmacy, which can be

accessed only by

pharmacists.

Clinical pharmacy is not an

independent postgraduate

specialization branch but exists as part

of the 3-year hospital pharmacy post-

gradual education.

42


Clinical Pharmacy is an area of specialization in Hungary with application only at hospital

level. The specialization is recognised by The Hungary National Board of specializations in

medicine/pharmacy. The title that is gained after the successful practical and theoretical

examination is “Pharmacist specialized in hospital-clinical pharmacy”. However, this

specialization does not include specific professional rights or job specifications. Additionally,

the specialization is not legally anchored in the Hungarian legislation.

There are no other recognised speciality areas in the domain of clinical pharmacy.

References




2020);















43

Iceland (Not validated)

Indicators





1. Characterization of the Iceland’s Clinical Pharmacy Education

In Iceland, there is one University (University of Iceland) which graduates pharmacists. There

is both BS program in Pharmacy (three years and 180 ECTS) as well as MS program. Students

must complete the MS programme to gain a professional certification as a pharmacist. MS

program can be Pharmacy - two years and 120 ECTS (and then professional certification as a

pharmacist) or Pharmaceutical Sciences - two years and 120 ECTS.

Since 2016 you can also graduate as a clinical pharmacist - Clinical Pharmacy - three years

and 90 ECTS but only after having certification as a pharmacist. Clinical pharmacy courses are

in collaboration with National Hospital of Iceland (Landspitali) and University College London

and the Royal Pharmaceutical Society.

In comparison with other countries the pharmacist role in the Icelandic health care

system, outside community pharmacies, is rather limited. The actual development of the

clinical pharmacy in Iceland has only occurred over the past two decades, and the central

focus has been in the hospital setting. Currently, no pharmacists are in primary care clinics to

provide pharmacist cognitive services (such as pharmaceutical care) to patients or other

health care professionals. Nonetheless, there are two settings, the community pharmacy, and

hospital, where it is essential to explain the pharmacist patient-centred role.

Looking back at history, there are two milestones, which are important to note regarding

community pharmacist development in Iceland. Firstly, around 1980, pharmacies stopped

drug production and community pharmacists in Iceland almost completely lost their monopoly

on manufacturing medicine. Secondly, in 1996, following drug legislation changes,

pharmacies in Iceland went from being pharmacist owned (but their number and geographic

location were decided by the Ministry of Health) to freedom of establishment. The task of

dispensing in the community pharmacy remains, but they have not yet expanded their

responsibilities. Although community pharmacists are obliged by law (since 1996) to provide

pharmaceutical care, but presently, no pharmacists are providing pharmaceutical care in the

community pharmacy settings.

In recent years, there has been a sharp increase in the pharmacist-led clinical practice within

the hospital setting. For many years, pharmacists have frequently been helping patients and

their providers manage drug therapies wards within Landspítali - The National University

Hospital of Iceland. In 2007, three pharmacists worked on clinical tasks within the hospital

setting. Now, the pharmacists are 12 and the tasks have multiplied. Further, they consult on six

wards and are engaged in the admission centre, which prepares patients for surgeries.

Additionally, pharmacists are members of nutrition and poison control teams. In 2010, a

medicines information centre was established where pharmacists promote the use of

44

evidence-based medicine by answering all kinds of drug related questions from other health

care professionals within the hospital setting. As mentioned above since 2016, there has been

a collaboration between the University of Iceland, Landspítali - The National University Hospital

of Iceland, University College London, and Royal Pharmaceutical Society regarding a clinical

pharmacy educational program. Due to the program, it is assumed that after 2019, two clinical

pharmacists will graduate every year in Iceland.


Iceland’s pharmacy school provides an Integrated Master in Pharmaceutical Sciences

that covers clinical pharmacy topics. The education includes practical teaching.



degree

Postgraduate education not

leading to an academic degree


Y Y

N N

There is one available

Master/Diploma degree in

Clinical Pharmacy (3-year).

Work based learning, this

Foundation Training

programme enables

foundation pharmacists to

work, learn and develop

through access to structured

and managed training, and

offers a real opportunity to

ensure that pharmacists access

training in the early careers in

within clinical settings, to

provide safe and effective

patient care delivered in a

confident and professional

manner.

Iceland has one

PhD programme

available on the

existing faculty.

The PhD

programme is

available for

Pharmacists and

other science

majors.


In Iceland, Clinical Pharmacy is not considered an area of specialization.

Also, there are no recognised speciality areas in the domain of clinical pharmacy.

45

References




2020);








https://doi.org/10.1787/health_glance-2017-en.








https://doi.org/10.1787/health_glance-2017-en

46

Ireland (Not validated)

Indicators





1. Characterization of the Ireland’s Clinical Pharmacy Education

Ireland has three faculties that provide an Integrated master’s degree in Pharmaceutical

Sciences.

Clinical Pharmacy in Ireland is well established in large, teaching hospitals but has

developed to different degrees and inconsistently in smaller hospitals. It is similar in its range of

activities to the UK, but without yet any formal modifying or prescribing competencies.

Pharmacists in Ireland think of clinical pharmacy as a hospital based.


All three faculties have the same undergraduate education covering topics about clinical

pharmacy, with eight semesters, 25 contact hours per semester and 5 ECTS per semester.

The undergraduate education in Ireland is accredited by a regulator.


All postgraduate education is not accredited by a regulator.


degree




Y Y Y

N

There are two

Masters/Diploma

degrees in Ireland. A

Master’s degree in

Hospital Pharmacy also

exists and this

incorporates clinical

pharmacy in its syllabus. It

has been included in the

table. Learning in both

takes place mainly in the

workplace so most of the

time is spent in practical

activities

All faculties provide a PhD

programmes in Clinical

Pharmacy. Access is

determined by academic

ability and the availability of

clinical resources. No other

health care professional

would want to access a

clinical pharmacy PhD

because it would not help

them in their career. Ireland

treats each PhD individually,

so a 'clinical pharmacy PhD

programme', does not exist.

One available

course on

“Cardiology in

clinical

pharmacy

practice”, which

takes 120 hours

to complete

and contain

practical

teaching.

47


In Ireland, Clinical Pharmacy is not recognised as an area of specialization. In addition,

there is no recognition of any speciality areas in the domain of Clinical Pharmacy.

Thus, the clinical pharmacy practise is part of the professional activities of both community

and hospital pharmacists.

Clinical Pharmacy is specified in the job descriptions of hospital pharmacy employers but

does not feature as a component of any other descriptions. Community Pharmacists and their

representatives use the term pharmacy services to include clinical activities.

References




2020);















48

Italy (Not validated)

Indicators





1. Characterization of the Italian Clinical Pharmacy Education

According to FIP World List of Pharmacy Schools5, Italy has 29 faculties that provide

an Integrated master’s degree in Pharmaceutical Sciences.


No data available


No data available


Clinical Pharmacy is not recognised as an area of specialization in Italy, however, is part of

the professional activities of hospital pharmacists. Evaluation of prescription appropriateness,

detection of ADRs, and near miss errors, drug therapy adherence monitoring are examples of

the practise of Clinical Pharmacy in Italy.

There are no specific areas officially recognised as speciality areas in the domain of clinical

pharmacy.

49

References




2020);










26th, 2020)









50

Kosovo Indicators



Hospitals/100 000 population2 ND


1. Characterization of the Kosovo’s Clinical Pharmacy Education

Kosovo has three faculties that provide an Integrated master’s degree in Pharmaceutical

Sciences.

Kosovo has only recently started to recognize Clinical Pharmacy & Pharmaceutical care as

areas requiring clear development. In this regard, there has been considerable progress in

capacity building, but specific services are yet to be designed and rolled out.

2. Undergraduate educationin CP

The undergraduate education that exists covers topics about clinical pharmacy in two

semesters, with a total of 30 contact hours per semester, 13 ECTS per semester and 60% of

practical teaching.



The postgraduate education in Kosovo is not accredited by a regulator.


academic degree


an academic degree


N N

Y

N

Pharmaceutical Chamber

and Pharmaceutical

Society, when required

basis, offers courses related

to Clinical Pharmacy and

Pharmaceutical Care.


Clinical Pharmacy is recognised by the Kosovo Chamber of Pharmacists, as an area of

specialization. Named as Clinical Pharmacy Specialization, this specialization has its

application in both hospital and community pharmacy settings. Kosovo’s Clinical Pharmacy

specialization include some job specifications and professional rights such as clinical

pharmacy services in hospitals. The specialization is legally anchored (Administrative Instruction

for Specialistic Education in Kosovo by the Ministry of Health).

51

In addition, there are no specific areas officially recognised as speciality areas by the

national authority or professional body in the domain of clinical pharmacy.

References

1 World Bank Group. Data from 2018. Retrieved from: https://data.worldbank.org/country/XK (accessed

on June 21st, 2020);

2 Kosovo Agency of Statistics. Health Statistics, 2018. Prishtina, October 2019.

https://data.worldbank.org/country/XK

52

Latvia Indicators





1. Characterization of the Latvian Clinical Pharmacy Education

Latvia has two faculties that provide an Integrated Master in Pharmaceutical Sciences:

Latvian University and Riga Stradins University. There is also the Rigas 1. Medical College, that

only provide a 1st level of higher education of pharmacy assistant. The students of Rigas

1.Medical College then, could continue 5-year studies at Riga Stradins University (part-time

studies) to receive the Master Degree.


No data available



degree



Master/ Diploma


Y Y

N N One available

master (taught in

Latvian) with 50%

practical teaching

Only one of the existing

faculties provide a PhD

programme in Clinical

Pharmacy, which can be

accessed only by

pharmacists.


Clinical Pharmacy is recognised as an area of specialization in Latvia.

The specialization does not lead to any specific professional rights or have any job

specifications. Nevertheless, Clinical pharmacists have more possibilities, such as, consultant

medical professionals, review patient drugs, but their role is as well more consultative (cannot

prescribe/remove drug without physicians’ validation).

Clinical Pharmacy is classified as a separate profession in Latvian law by the Latvian

Government. The Clinical Pharmacy specializations has its application at hospital level,

53

however, it is not mandatory to be only at hospital level. Also, some professionals start practical

work at community pharmacy level.

References




2020);















54

Lithuania Indicators





1. Characterization of the Lithuania’s Clinical Pharmacy Education

Lithuania has two faculties that have Integrated Master in Pharmaceutical Sciences.

• Lithuanian University of Health Sciences, Faculty of Pharmacy;

• Vilnius University, Faculty of Medicine

Lithuania provides five-year full-time course of pharmacy education that prepares

graduates who can function within a diverse and complex pharmaceutical setting, for

community, industrial, hospital pharmacy. It is based on personal and patient care

competencies with deep research training, integrating pharmaceutical science and practise.

However, Clinical Pharmacy is not officially recognised as a distinct specialization.


The undergraduate education that exists covers topics about clinical pharmacy in the

following curricula modules: Disease Management, Pharmacy practice, Pharmaceutical

Care, Essentials of Internal Medicine, Pharmacology and Phytotherapy. The clinical pharmacy

component has practical teaching.

The undergraduate education is accredited.


The postgraduate education is accredited.


degree



Master/ Diploma


N N N N


In Lithuania, Clinical Pharmacy is not recognised as an area of specialization. Additionally,

there is no recognition of any specialty areas in the domain of clinical pharmacy.

Clinical Pharmacy is part of the professional activities of both community and hospital

pharmacists.

55

The integrated multidisciplinary pharmacy programme focuses on the development of

pharmacists’ practical, managerial and leadership, educational and research competences

for professional practice in pharmaceutical organisations/companies, scientific research

institutions, state pharmacy offices, and other related pharmacy fields. Programme is tightly

integrated with special studies in medicine and social sciences and prepare pharmaceutical

professionals for pharmaceutical activity in different areas of health.

References




2020);






4 Health Information Centre of Institute of Hygiene. Health Statistics of Lithuania 2017. Retrieved

from: http://hi.lt/uploads/pdf/leidiniai/Statistikos/LT_sveik_stat_health/Lietuvos_sveikatos_statistik

a_2017_2.pdf.







56

Malta (Not validated)

Indicators





1. Characterization of the Malta’s Clinical Pharmacy Education

Malta has one faculty that provides an Integrated master’s degree in Pharmaceutical

Sciences.

The two-cycle undergraduate programme leading to a degree in pharmacy considers

development of knowledge, skills and competences related to clinical pharmacy through a

longitudinal approach where the related aspects are tackled right from the first year of the 5.5

years of the course with increasing amounts through the programme. Moreover, the Faculty

offers a postgraduate specialized master’s in advanced clinical pharmacy and a professional

Doctorate in Pharmacy that focuses specifically to develop practice, research and leadership

skills in clinical pharmacy. In terms of professional practice, clinical pharmacy services are

offered through private community pharmacy particularly with regards to chronic disease

management, however this is unstructured and not directly remunerated. In the hospital

services, clinical pharmacy services are developed to different extents within medical

specialities.


The only faculty that exists provide accredited undergraduate education that cover topics

about clinical pharmacy.


The postgraduate education in Malta is accredited by a regulator.


degree




Y Y Y

N One available master’s in

clinical pharmacy (details


The available PhD

programme is open

only for pharmacists.

In-service

programmes in

hospitals (15 hours)

57

4. Professional Practice

In Malta, Clinical Pharmacy is not recognised as an area of specialization as well as there

is no speciality areas in the domain of CP.

Thus, the clinical pharmacy practise is part of the professional activities of both community

and hospital pharmacists.

References




2020);








Number of

semesters

Number of

contact hours

per semester

Number of

ECTS per

semester

Percentage of

Practical

teaching

Open to

foreigns

Tuition

fees

2 ND 45 75 Yes ND








58

The Netherlands Indicators





1. Characterization of the Dutch Clinical Pharmacy Education

Netherlands has three faculties that provide an Integrated master’s degree in


Clinical pharmaceutical care has been developed in pharmacy practice a research since

for more than 20 years. Clinical Pharmaceutical care is embedded in pharmacy practice

guidelines of community pharmacy as medication review and counselling practice. Further

development and innovative practices are not adequately translated in renumerations.

The master’s in pharmacy is fully dedicated to clinical pharmacy and pharmaceutical

care. The bachelors focus on beta sciences and give the necessary backbone for that master.

Clinical pharmacy is more and more patient oriented, and even more after the reform in 2019.


The undergraduate education in Netherlands is not accredited by a regulator.

The clinical pharmacy component is described on the following table:

Number of

semesters

Number of contact

hours per semester

Number of ECTS per

semester

Percentage of

practical teaching

Faculty 1 4 30 10 15

Faculty 2 4 30 10 25

Faculty 3 4 30 10 15

59


The postgraduate education in Netherlands is accredited by a regulator.


academic degree


academic degree

Master/ Diploma


N Y Y Y

An additional master

is not necessary as

the regular

curriculum is based

on clinical pharmacy

and pharmaceutical

care.

All three existing

faculties provide PhD

programmes in

Clinical Pharmacy.

PhD programmes are

available for any

person with a MSc

degree.

PAOF is the largest

course. Also, there

are many and

diverse courses in

specific disease

areas.

“PIAF”,

“Pharmacotherapy

expert” and “IVM

medication reviews”


Clinical pharmacy is perceived as the professional expertise of the practice of

pharmaceutical patient care that is at the heart of the practice of pharmacists, independent

of the setting in community or hospital pharmacies. This care practice is described for all

pharmacists in the Netherlands as one of the foundational components of the pharmacy

practice in the Charter professionalism of the pharmacist. Ideally, clinical pharmacy practice

should be a seamless care practice over community and hospital level.

In Netherlands, Clinical Pharmacy is not recognised informally within the professional

organisations as an area of specialization but is strongly part of the professional activities of

both community and hospital pharmacists.


References




2020);















60

Norway Indicators





1. Characterization of the Norway’s Clinical Pharmacy Education

Norway has 6 faculties that provide an Integrated master’s degree in Pharmaceutical

Sciences.


The undergraduate education in Norway is accredited by a regulator.

No specific clinical pharmacy course in the bachelor’s programs, except for one university,

For the others; part of the skills you need as a clinical pharmacist is integrated in other courses.

Two universities offer specific clinical pharmacy courses in the Master period.”


Postgraduate education is organized by one University, if you take the exams you will be

credited and - if you follow the University programme with several courses plus a scientific

research project, you can ultimately get a practice-based master’s in clinical pharmacy. This

master is regarded to be similar to a master’s in pharmacy and is not accredited to be better

in clinical settings. However, when you apply for a job in hospitals with a clinical master, you

will probably have a benefit.


degree




Y Y Y

N

3-year Experiences based

postgraduate master’s in

clinical pharmacy. Consist of

theory and practice” (details


This program is practice based,

so the students come to Oslo to

take the courses (a week or so)

They are encouraged and get

tasks to get the practice in

between courses at their own

work, that could be at hospitals

or in pharmacies. The practice

should involve patients.

Students become MSc in

clinical pharmacy, many then

will have 2 MSc.

Four out of the 6

existing faculties

provide PhD

programmes

“Advanced

pharmacotherap

y (10ECTS)” – 3

different courses,

“Advanced

pharmacokinetics

(10ECTS)” and

“TDM and clinical

lab evaluation

(6ECTS).

Courses do not

include practical

teaching.

61


Clinical Pharmacy is recognised as an area of specialization in Norway, although is not

legally anchored.

In Norway, you are a clinical pharmacist if you work as a clinical pharmacist at a hospital,

or in the community, so "clinical pharmacist" is a job-title. But the Pharmacist society recognize

that you need to have special skills to work as a clinical pharmacist, that is why we have started

up the Practice based Master of clinical pharmacy.

We regard clinical pharmacy to be applied in hospitals, in nursing homes and in the

community. To apply this, you need to work with both the prescriber and the patient

Ward based work (i.e. with the patient and the team, mainly in hospitals) is recognised as

a speciality work in the domain of clinical pharmacy.

References




2020);








Number of

semesters

Number of

contact hours

per semester

Number of

ECTS per

semester

Percentage of

practical

teaching

Open to

foreigns

Tuition

fees

6 ND 15 ND yes, but in

Norwegian

ND








62

Poland (Not validated)

Indicators





1. Characterization of the Poland’s Clinical Pharmacy Education

According to FIP World List of Pharmacy Schools5, Poland has 11 faculties that provide an

Integrated Master in Pharmaceutical Sciences.

In Poland pharmacist (Master of Pharmacy) can make 3-year long specialization in Clinical

Pharmacy. It can be done on 3 universities (Kraków, Wrocław, Poznań). It is a pay study.

There is very few Clinical Pharmacists. They work in hospital pharmacies, but they usually

don't take part in pharmaceutical care, and consulting with doctors about pharmacotherapy

in hospital wards.

In Poland there is no legal regulation about pharmacists’ position in Pharmacy, Clinical

Pharmacy and Pharmaceutical Care. Because of that, there is no such thing as CP (according

to Yours definition) in Poland.


On every University, teaching program is very similar. On Master Pharmacy study there are

usually: Clinical Pharmacy (30 hours, 2 ECTS) and Pharmaceutical Care (45 hours, 4 ECTS).

Practical teaching is very rare.


The postgraduate education in Poland is accredited by a regulator.


degree




Y Y

N N

One available master’s in

clinical pharmacy,

conducted by the Polish

Centre of Postgraduate

Medical Education.

All faculties provide PhD

programmes in Clinical

Pharmacy.

Only people with MSc in

Pharmaceutical Sciences

can apply for these PhD

programmes.

63


Polish Ministry of Health recognise Clinical Pharmacy as an area of specialization.

Specialization in Clinical Pharmacy is made through Centre of Postgraduate Medical

Education.

Pharmacists with the specialization in Clinical pharmacy are Clinical Pharmacists

(Farmaceuta Kliniczny) and could work at Hospital Pharmacies.

After specialization medical environment recognizes CP competences, but there are no

legal regulations.

There are no recognised speciality areas in the domain of clinical pharmacy

References




2020);















64

Portugal Indicators





1. Characterization of the Portuguese Clinical Pharmacy Education

Portugal has 9 faculties that provide an Integrated master’s degree in Pharmaceutical

Sciences.

The definition of Clinical Pharmacy is accepted in all faculties throughout the country;

however, the rate of implementation and development varies widely, with some having a

more practice-oriented teaching in a real environment, whilst others are still very theory based.

In terms of practice, there is also wide variation, with some hospitals being centres of

excellence, whilst others have difficulty to implement clinical pharmacy due to staff shortages,

pharmacists’ lack of proactivity and suboptimal collaboration with other healthcare

professionals.”

Regarding the professional setting I think the economic crisis took a big toll in the

pharmaceutical sector leaving less pharmacists with a great workload. It is very hard to

practice CP and CP daily and you must be very resilient to do it.


The undergraduate education in Portugal is accredited by the Ministry of Education.

All 9 faculties have Clinical Pharmacy component included in the curricula.

Number of

semesters

Number of contact

hours per semester

Number of ECTS per

semester

Percentage of

practical teaching

Faculty 1 3 56 5 73

Faculty 2 1 60 5 43

Faculty 3 2 60 4 33

Faculty 4 2 112 9 68

Faculty 5 1 60 5 50

Faculty 6 3 52 5 67

Faculty 7 2 49 4 60

Faculty 8 1 75 6 60

Faculty 9 1 52 4 50

65


The postgraduate education leading to an academic degree in Portugal is accredited by

the Ministry of Education. The postgraduate education not leading to an academic degree is

accredited in the vast majority (not mandatory but preferable) by the Portuguese

Pharmaceutical Society.


academic degree


academic degree

Master/ Diploma degree PhD

programmes CPD courses Certifications

N N

Y

N Some small courses, such as

“Hospital and clinical

pharmacy” and “safety

medicines”, which includes

practical teaching.


In Portugal, Clinical Pharmacy is not recognised as an area of specialization but is part of

the professional activities of both community and hospital pharmacists.

Hospital and Community Pharmacy are the existing speciality areas in the domain of

clinical pharmacy.

References




2020);















66

Republic of Moldova Indicators





1. Characterization of the Republic of Moldova’s Clinical Pharmacy Education

Republic of Moldova has one faculty that provide an Integrated master’s degree in


The “Regulation – type of clinical pharmacist” was approved in the Republic of Moldova

by order of the Ministry of Health nr. 70 in March 5th, 1999, according to the decision of the

SUMPh “Nicolae Testemitanu” senate. Thus, in 2007 the Department of Pharmacology was

renamed as the Department of Pharmacology and Clinical pharmacy.

The modern pharmacist that ensures the pharmaceutical assistance must have deep

knowledge in pharmacotherapy and clinical pharmacy acquired in university and deepened

during the graduate study (residency).

The course of clinical pharmacy is taught to the 5th year’ students of Pharmaceutical

Faculty and includes the following subjects:

• Clinical pharmacy of Cardiovascular diseases;

• Clinical pharmacy of Respiratory diseases;

• Clinical pharmacy of Gastrointestinal diseases;

• Clinical pharmacy of Renal diseases.

Students have practical works in hospital, where they have the possibility to consult patients

and doctors about the schemes of drug treatment.

The residence of clinical pharmacists (2 years), additionally to the courses

of pharmacology, pharmacotherapy and clinical pharmacy includes:

• Drug toxicology and pharmacovigilence

• Clinical pathology;

• Clinical laboratory;

• Clinical biochemistry;

• Drug abuse education;

• Pharmacotherapeutic evaluation;

• Patient counseling;

• Residency programs in pharmaceutical practice specializing in primary health care,

in ambulatory and clinical practice.


The undergraduate education in Republic of Moldova is accredited by a regulator.

The existing faculty has undergraduate education that covers topics about clinical

pharmacy. The clinical pharmacy component is distributed in the following table:

67

Number of

semesters

Number of contact

hours per semester

Number of ECTS per

semester

Percentage of

practical teaching

Faculty 1 2 42 29 30


The postgraduate education in Republic of Moldova is accredited by a regulator.


academic degree


academic degree



Y

N N N One available master

(details on the following

table)

Number of

semesters

Number of

contact hours

per semester

Number of

ECTS per

semester

Percentage of

practical

teaching

Open to

foreigns

Tuition

fees

4 810 68 50 No 1500€


Clinical Pharmacy is recognised by the Ministry of Health of Republic of Moldova as an

area of specialization.

The specialization has application in Clinical and Community Pharmacies and lead to

some professional rights. Clinical pharmacists exert two categories of activities: medical field

activities and activities with administrative profile.

Medical field activities are the analysis and the execution of the prescription, the distribution

and the control of drug administration, the therapy’s monitorization, including the activity of

pharmacovigilance and clinical research.

The activities with administrative profile include: the evidence of drugs and delivery

and economic analysis of drug therapy.

The directions of pharmaceutical assistance in the community pharmacy are:

• Consulting in the prescribed medication.

• Guiding of self-medication with OTC drugs;

• Written recommendation of OTC medication suggested by the pharmacist for 1-2 days

at the request of the patient who manifests acute symptoms;

• Release without prescription of 1-2 doses of drugs that aren’t included in the OTC

category, in case of emergencies.

In Republic of Moldova, there is insufficiently developed clinical pharmacy because there

are great divergences with clinical pharmacologists and doctors who do not yet want to

recognize the necessity of the clinical pharmacy.

68

Clinical Pharmacy specialization is taken up in the Republic of Moldova’s legislation: The

“Regulation – type of clinical pharmacist” approved in the Republic of Moldova by order of

the Ministry of Health nr. 70 in March 5th, 1999.

References




2020);



000/ - data from 2013 (accessed on May 30th, 2020);




4 Sanatate Info Website. http://sanatateinfo.md/News/Item/2272 (accessed on May 30th, 2020)








http://sanatateinfo.md/News/Item/2272

69

Russian Federation (Not validated)

Indicators





1. Characterization of the Russian Clinical Pharmacy Education

According to FIP Official World List of Pharmacy Schools5, Russia has 15 faculties that


Clinical pharmacy is just beginning to take shape in Russia. Traditionally, only

pharmacology and clinical pharmacology were taught at pharmaceutical universities. And

only two years ago in the universities started teaching the course "Pharmaceutical consulting",

which gives the basis of clinical pharmacy. Practicing pharmacists have rather small

opportunities for improvement in clinical pharmacy, as the main emphasis is on organizational

issues of pharmacy, legislation or analytical methods in pharmacy.

There is a complicated system of pharmaceutical education in Russia. We have 4 levels of

it. And none of them is directed to clinical pharmacy and PC enough. It is caused by features

of pharmaceutical legislation and traditions of education in our country.

The curriculum includes a lot of courses like pharmaceutical chemistry and other types of

chemistry, pharmacognosy, pharmaceutical economics and, of course, pharmacology and

CP.

Only last few years the course of PC was included.

In Russia, pharmaceutical services are provided mainly in pharmacies.

Currently, Russian pharmaceutical educational system focuses on trends of PC and CP. But

main obstacles are legal limitations in pharmaceutical services setting and communication

between pharmacists and physicians.


The undergraduate education in Russia is accredited by a regulator.

Clinical pharmacy topics are covered in Russian undergraduate education.


The postgraduate education in Russia is accredited by a regulator.

70


academic degree


academic degree



N ND ND N


In Russia, Clinical pharmacy is not recognised as an area of specialization and is not part

of the professional activities of the community or hospital pharmacists.


References




2020);



000/ (accessed on May 30th, 2020);








26th, 2020)










71

Serbia (Not validated)

Indicators





1. Characterization of the Serbia’s Clinical Pharmacy Education

Serbia has five faculties that provide an Integrated master’s degree in Pharmaceutical

Sciences.

Education in clinical pharmacy has fifteen years established history. Pharmaceutical care

delivery at primary level is well organized, but clinical pharmacy practice (services) at the

hospitals is not developed completely.


Undergraduate education in Serbia covers topics in Clinical Pharmacy and includes

practical teaching.

The undergraduate education in Serbia is accredited by a regulator.


The postgraduate education that exists in Serbian are accredited by a regulator.


academic degree


academic degree



Y Y

ND ND One available master’s in



Three out of

five faculties

provide PhD

programmes,

which are

available for

pharmacists.

Number of

semesters

Number of

contact hours

per semester

Number of

ECTS per

semester

Percentage of

practical

teaching

Open to

foreigns

Tuition

fees

4 ND 180 40 No ND

72


The Serbian Ministry of Health recognises Clinical Pharmacy as an area of specialization

and has application only in Hospital Pharmacy.

However, this specialization does not include any specific professional rights or job

specifications and is not legally anchored in the Serbian legislation.

There is no recognition of any speciality areas in the domain of clinical pharmacy.

References




2020);

















73

Slovakia (Not validated)

Indicators





1. Characterization of the Slovakia’s Clinical Pharmacy Education

There are two faculties in Slovakia that provide an Integrated master’s degree in


Slovakia has:

- undergraduate education in pharmacy,

- rigorous exam from Clinical Pharmacy,

- postgraduate education (PhD) in Clinical pharmacy which is accredited by Ministry of

Education and

- Specialization in Clinical Pharmacy accredited by Ministry of Health.

Slovakia have not established places for clinical pharmacy specialists - their places depend

on the interest of management of hospitals. Clinical pharmacists are also working at the

Departments of Clinical Pharmacology and hospital pharmacies.


The undergraduate education in Slovakia is accredited by a regulator.

Both two existing faculties have undergraduate education that covers topics about

clinical pharmacy:

Number of

semesters

Number of contact

hours per semester

Number of ECTS per

semester

Percentage of

practical teaching

Faculty 1 ND 52 5 0

Faculty 2 7 58 5 0

74



degree




Y Y

N N One available master’s in



One out of two

faculties provide PhD

programmes, which

are available for

pharmacists.

Number of

semesters

Number of contact

hours per semester

Number of

ECTS per

semester

Percentage of

practical

teaching

Open to

foreigns

Tuition

fees

18 months

study

Depends on the

activity of students,

preparing rigorous

work, which is

credited

ND 0 Yes ND


Slovak Ministry of Health recognises Clinical Pharmacy as an area of specialization and is

taken up in national legislation. However, there is no recognition of any speciality areas in the

domain of clinical pharmacy.

The applications setting of the specialization are hospital pharmacy, Departments of

Clinical Pharmacology and Hospital - e.g. Department of Internal Medicines.

The recognition of the specialization in Clinical Pharmacy includes some specific

professional rights and job specifications such as interpretation of TDM and consultation for

therapy in pregnancy.

References




2020);



000/ - data from 2007 (accessed on May 30th , 2020);














75

Slovenia (Not validated)

Indicators





1. Characterization of the Slovenian Clinical Pharmacy Education

Slovenia has one faculty that provide an Integrated master’s degree in Pharmaceutical

Sciences.

Undergraduate and postgraduate focus on clinical pharmacy and pharmaceutical

care. Advanced level medication review service is payed by the Insurance Institute since 2016

that is performed at the ambulatory level in health centres by clinical pharmacist. A special

certification program at the Slovene Chamber of Pharmacy with a special group monitoring

the performance and preparing upgrades. There is another service established: medicines use

review that is performed by all pharmacists not necessarily having specialization. Now not

payed and provided free of charge in most cases by community pharmacies.

Several activities exist in hospitals related to the work of clinical pharmacist. In most cases

this is medication reconciliation. There is a scientific and educational support by the University

of Ljubljana, faculty of pharmacy. In the last fifteen years, clinical pharmacy has been

established in most health institutions in Slovenia. In doing so, it summarizes foreign experiences

and develops its own knowledge and skills, first in the form of pharmaceutical care programs,

and later in the form of pharmaceutical cognitive services (medication use review, advanced

medication review). The new Pharmacy Act represents an appropriate solution for placing

clinical pharmacy in the health system. Implementation of the law provisions is successful at all

three levels of health care. Clinical pharmacists at clinical departments of hospitals participate

in visits, carry out advanced medication reviews and run medication reconciliation.


In the undergraduate curriculum we can find several elements spread among different

subjects that build the profile of a future pharmacist towards optimisation and rationalisation

of medicines use. This include the train sheep and workshops connected with it in the 5th year,

social pharmacy in the 4th year and an elective subject of clinical pharmacy.

The undergraduate education in Slovenia is accredited by a regulator.

76


The postgraduate education in Slovenia is accredited by a regulator.


academic degree


an academic degree


Y Y Y N

A 3-year specialization exist run by the Chamber. The first year is theoretical at the Faculty,

then 1,5 of practices and 0,5 year for thesis and the defence of specialization.

Additionally, Slovenia has a PhD named “Interdisciplinary doctoral programme in

Biomedicine”. “The admission to the Interdisciplinary Doctoral Programme in Biomedicine,

graduates of the following programmes can apply: Second cycle study programmes; Study

programmes providing education for occupations regulated by Directives of the European

Union (93/16/EEC for doctors, 78/1027/EEC for veterinarians, 78/687/EEC for dentists and

85/432/EEC for pharmacists) evaluated with at least 300 credits; Study programmes leading to

specialization, if candidates have previously completed a higher education professional study

programme. The Biomedicine Programme Council will specify additional entry requirements

for candidates in individual areas amounting from 30 to 60 ECTS; Study programmes leading

to a Master of Science or to specialization after completing an academic study programme.

60 credits of study obligations will be recognised to such candidates: Academic study

programmes. Candidates with foreign qualifications are required to apply for recognition of

their entry qualifications. The procedure starts with the candidate’s application for study in the

Republic of Slovenia, which is submitted in electronic form. The procedure is run by the

authorised person at the University Member (academy or faculty).

Slovenia has several continuous professional courses in the domain of clinical pharmacy

which are detailed in the following table:


Slovenian Ministry of Health recognise Clinical Pharmacy as an area of specialization.

This specialization, named “Specialization in clinical pharmacy” appeared by the merged

of two other specializations, one for the community pharmacists and the other for the hospital

pharmacists and exist in order to become a clinical pharmacist.

The specialization is legally anchored (Legal reference: Zakon o lekarniški dejavnosti

(Uradni list RS, št. 85/16 in 77/17)

Clinical pharmacists have some job specifications such as: advanced level medication

review service and other functions that are not that distinct. However, there is no recognition

of any additional speciality areas in the domain of clinical pharmacy.

Name of the course/programme Practical teaching

Courses, meetings on different themes are offered by the Slovenian

Chamber of Pharmacy.

No

Medicines use review Yes

Advanced level medication review Yes

77

References




2020);



000/ - data from 2007 (accessed on May 30th , 2020);














78

Spain Indicators





1. Characterization of the Spain’s Clinical Pharmacy Education

Spain has 22 faculties that provide 5-year programme of pharmacy studies.

Practice is very developed in hospitals through the pharmacy services. The situation in

community pharmacy is not so good and needs to be more developed and implemented.

Referring to education is variable depending of the University.


The curricula vary widely from one university to another. There are still universities that do

not have in their curricula pharmacy and/or pharmaceutical care as compulsory subjects.



academic degree


an academic degree


Y N Y Y


In Spain, Clinical Pharmacy is not recognised as an area of specialization and it is part of

the professional activities of community, hospital and primary health care pharmacists.

Additionally, there are a specialization in hospital pharmacy that is certified by the Spanish

Hospital Pharmacy Society. Obtaining this specialization is mandatory to practice in a hospital

pharmacy services.

79

References




2020);

















80

Sweden Indicators





1. Characterization of the Sweden’s Clinical Pharmacy Education

Sweden has three faculties (Umea, Uppsala and Gothenburg) that provide an Integrated

master’s degree in Pharmaceutical Sciences.

In addition to that, Sweden has two faculties only providing Bachelor degrees (Kalmar and

Malmoe).

Sweden have two academic degrees that lead to two different licences/professions.

• Receptarie: 3-year training;

• Apotekare: 5-year training.

The different 5-year programmes that lead to Apotekare licence do this in two different ways.

One is the Bologna way, where you first get a bachelor’s degree and then do a masters. The

other way is a full 5-year programme where you do not get a bachelor’s degree on the way.

In summary, there are a few courses in Clinical Pharmacy in Sweden:

- Malmoe has one course in their 3-year programme;

- Umea has one course in their master programme;

- Uppsala has one course in the last two years of the 5-year programme to “Apotekare”. The

same course is also available in the master programmes.

- Uppsala has a postgraduate 1-year programme in clinical pharmacy (master programme in

clinical pharmacy).

Clinical pharmacy practice has developed fast for the last 10 years and is now routine in

many parts of the country. However, it is still growing and there is still not a pharmacist on every

ward. Clinical pharmacy within health care centres in primary care is also evolving fast. The

development is closely linked to ongoing research. There is a need for educated clinical

pharmacists and currently the university provides the available courses. Since 2006 Uppsala

university has a master programme in clinical pharmacy.

However, the Clinical pharmacy services has increased very much during the last 10 years

and the hospitals employ clinical pharmacist to perform medication reconciliation and -

review. Mainly on hospitals but also on health care centrals and nursing homes. The increase

is due to extensive research and focus on improving patient care in Lund (Scania Region) and

Uppsala region. Approx. 200 clinical pharmacists are involved. Sweden have a population of

9 million.

81

The university curriculum for the BSc and MSc Pharmacy has not changed to support this

change in practice. One new BSc has Clinical pharmacy as a mandatory subject and the

students are to some extent trained to perform MedRec and MedRew at hospital wards.


The undergraduate education in Sweden covers topics in Clinical Pharmacy.



academic degree


an academic degree


Y ND N N

4. Professional practice in CP

In Sweden, Clinical pharmacy is not recognised as an area of specialization, however, it is

part of the professional activities of hospital pharmacists and pharmacists in primary care

health care centres (outside hospitals).


References




2020);















82

Switzerland (Not validated)

Indicators





1. Characterization of the Swiss Clinical Pharmacy Education

According to FIP Official World List of Pharmacy Schools5, Switzerland has six faculties that


Over the last decade especially the educational, theoretical format of clinical pharmacy

has developed to a discipline mostly separated from pharmaceutical sciences. As there are

not enough training positions for clinical pharmacy and hospital pharmacy the "production"

the necessary number of skilled people with adequate diploma cannot be achieved. In

addition, the profession of pharmacy - especially in the retail area will change dramatically

and request new professional format and knowledge.

Postgraduate education and training in this field provided by two universities in a

Certificate/Diploma of Advanced Studies Programme. A specialized training curriculum is

defined by the national pharmacy association.

Regarding clinical pharmacy practice, services are widespread in Swiss hospitals but to a

very varying degree of intensity and implementation. Huge differences have been shown in a

national survey (cf. Messerli M et al. Eur J Hosp Pharm 2016) between regions. In hospital

settings, more and more clinical pharmacists are involved, but the activity is not systematically

implemented.

Community pharmacists are active daily in clinical activities, but this is not yet fully

structured, documented, and hence recognized.


The undergraduate education in Switzerland is accredited by a regulator.

Swiss undergraduate education cover topics of Clinical Pharmacy in the curricula, which

includes practical teaching.


No data available


No data available.

83

References




2020);










26th, 2020)









84

Turkey Indicators





1. Characterization of the Turkey’s Clinical Pharmacy Education

Turkey has 36 faculties that provide an Integrated master’s degree in Pharmaceutical

Sciences.

Clinical Pharmacy is still an emerging concept in Turkey. It is included in the core pharmacy

curriculum. Therefore, establishment of clinical pharmacy related courses (both theoretical

and practical) is encouraged. Clinical Pharmacy is considered as a pharmacy specialty;

pharmacists passing a centralized examination are assigned to the available places based on

their scores. After 3 years of practical education (residency) at the hospital, they become

"Clinical Pharmacy Specialists". Besides Turkey, there are also various faculties of pharmacy in

TRNC (Turkish Republic of North Cyprus) offering clinical pharmacy graduate and

undergraduate courses to international students.


The clinical pharmacy component varies widely at undergraduate education.

The undergraduate education in Turkey is accredited by a regulator.


The postgraduate education in Turkey is not accredited by a regulator.

A postgraduate program can only be established upon approval of the Council of Higher

Education.


academic degree


an academic degree


Y Y Y

N More details on table A

Available only for

pharmacists More details on table B

85

Number of

semesters

Number of

contact hours

per semester

Number of

ECTS per

semester

Percentage

of practical

teaching

Open to

foreigns

Tuition

fees

Faculty 1 4 280 40 40 Yes no

Faculty 2 4 280 40 40 No No

Faculty 3 4 98 28 28 Yes Yes

Table A

Name of the

course/programme

Number

of hours

Practical

teaching Additional details

Course 1

Pharmaceutical

Care in

Asthma/COPD

Management

8 Yes. Case

based Programmes run by the

Turkish Pharmacists'

Association. This program is

held as "Train the trainee"

courses and "peer

teaching”. As this is a CPD,

practical part takes place in

daily pharmacy practice.

Course 2

Pharmaceutical

Care in Diabetes

Management

8 Yes. Case

based

Course 3

Pharmaceutical

Care in Hypertension

Management

8 Yes. Case

based

Table B


Clinical Pharmacy is recognised as an area of specialization by the Turkish Ministry of

Health. Named as Clinical Pharmacy specialization has its application setting in hospital wards

(not hospital pharmacy).

The clinical pharmacy specialist works at the hospital wards, have access to all patient

data and has rights to offer interventions to other healthcare professionals in order to optimise

drug therapy. They also have access to the patients, and they can collect data from them in

order that they can counsel on specific issues of drug treatment.

Clinical Pharmacy specialization is legally anchored. Legal reference: Eczacılıkta Uzmanlık

Yasası (14.11.2014 - Resmi Gazete) & Eczacılıkta Uzmanlık Eğitimi Yönetmeliği (21.10.2016 -

Resmi Gazete)


References




2020);














86

Ukraine Indicators





1. Characterization of the Ukraine’s Clinical Pharmacy Education

Ukraine has 21 faculties that provide an Integrated master’s degree in Pharmaceutical

Sciences.

In Ukraine we had clinical pharmacy education but now only practice.


The undergraduate education in Ukraine is accredited by a regulator.

In Ukraine, faculties that provide an Integrated master’s degree in Pharmaceutical

Sciences covers topics of Clinical Pharmacy.


The postgraduate education in Ukraine is not accredited by a regulator.


academic degree


an academic degree


Y Y

Y

N More details on the

following table


In Ukraine, Clinical Pharmacy is an area of specialization.

The specialization is recognised by Danilo Halitsky Lwiw National medical university and by

the National University of Pharmacy (Kharkiv), as well as the Ukrainian Ministry of Health.

In Ukraine, the problem of recognition and actual demand for clinical pharmacists in the

hospital exists. Very often, clinical pharmacy specialists are in demand as monitors or assistant

monitors for clinical trials.”

The specialization includes job specifications and professional rights.

Name of the course/programme Number of hours Practical teaching

Modern approaches to the effective and

safe use of medicines. Pharmaceutical

care of OTC drugs.

156 yes

87

A Ukrainian Clinical Pharmacist can apply his knowledge in a variety of areas of practice:

• In pharmacy, the clinical pharmacist provides pharmaceutical care for patients

advises on the rational administration of medicines, especially over-the-counter drugs,

replaces generic drugs, selects effective and cheaper analogues of expensive and

original medicines;

• In medical establishments, as a physician consultant on pharmacotherapy, the clinical

pharmacist provides an individual approach to the choice of medicinal product;

• Hospital pharmacist - a specialist who works in a multidisciplinary hospital and

purchases medicines considering the needs of the hospital, the specific morbidity of

the region, the contingent of patients, pharmacoeconomic principles.

• The clinical pharmacist justifies the volume of financing of medical support from the

state budget and insurance funds - all this is very important for the development of

insurance medicine in Ukraine.

Clinical Pharmacy specialization is legally anchored. Legal reference: Classification of

professions DK 003: 2010 (Ukraine, 2019)

Monitor or Assistant Monitor Clinical Trials is a speciality area in the domain of clinical

pharmacy

References




2020);
















88

United Kingdom Indicators





1. Characterization of the United Kingdom’s Clinical Pharmacy Education

United Kingdom has 28 faculties that provide Pharmacy degree.

MPharm programme is 4 years, develops the student’s ability to apply the science of

chemistry, biology, pharmaceutics and pharmacology to improve patient treatment and

outcomes.

At postgraduate level, independent prescribing qualifications, develops and expands the

pharmacist provision of direct patient care.

Regarding clinical pharmacy practice is patient focused to improve patient outcomes.


All UK Pharmacy faculties have undergraduate education covering clinical pharmacy

topics. Patient cantered pharmaceutical care is a requirement of the educational standards

and is integrated throughout the course.

This undergraduate education is accredited by a regulator.


The postgraduate education is not accredited by a regulator except for the independent

prescribing qualification which is regulated by the General Pharmaceutical Council (GPhC).


academic degree


an academic degree



Y Y Y

Most UK schools of pharmacy

offer postgraduate degree in

clinical pharmacy at either

diploma or MSc level. Some

will be distance learning and

some courses will be face to

face learning. A diploma is

equal to 1200 hours and an

MSc is equal to 1800 hours. A

Only

pharmacists can

access to these

PhD

programmes

and they can be

also accessed

by non-UK

There are many continuing education

bodies such as Centre for Pharmacy

Postgraduate Education (CPPE), Royal

Pharmaceutical Society (RPS) and NHS

Education for Scotland (NES), providing

a range of programmes and portfolios

at a foundation to advanced level.

89

few courses will be open to

non-UK registered

pharmacists. Tuition fees are

variable.

registered

pharmacists


In UK, Clinical Pharmacy is not recognised as an area of specialization, as all patient-facing

pharmacists are expected to provide pharmaceutical care.

Clinical pharmacy is part of the activities of both community and hospital pharmacists.

Pharmacist Independent Prescribing is an area where any GPhC registered pharmacists in

a patient facing role is eligible to train as a pharmacist prescriber.

References




2020);














90

Summary and conclusions

This report gives an overview of clinical pharmacy education and practice in Europe. The main

findings are that:

• There is wide variability in clinical pharmacy development between European

countries and within countries comparing different faculties;

• There was a sense, shared by country representatives, that clinical pharmacy

education and practice is progressively developing;

• Almost every European country has clinical pharmacy courses that cover clinical

pharmacy topics at undergraduate level. However, the practical teaching seems to

be suboptimal. Also, some countries do not provide practical teaching in CP;

• At the postgraduate education level, European countries and their respective

pharmaceutical faculties and professional bodies must strive to deliver high quality

education and research in clinical pharmacy in order for pharmacists to obtain

academic degrees in clinical pharmacy or alike and also, to update their knowledge

through continuous professional courses and postgraduate programmes and/or

certifications. In parallel, they should stimulate the development and implementation

of effective clinical pharmacy services tailored to societal and individual patient

needs;

• The recognition of clinical pharmacy as a specialty is not a prerequisite for advanced

clinical pharmacy practice. There are countries delivering high quality clinical

pharmacy activities/services, in the absence of a recognized specialization in clinical

pharmacy. Some examples are the United Kingdom, The Netherlands and Malta.

91

Appendix 1: ESCP Survey on Clinical Pharmacy Education in Europe

92

93

94

95

96

97

98

Glossary (included in the survey):

Bachelor’s degree/diploma in Pharmacy/Pharmaceutical Sciences – an undergraduate

degree in the discipline of Pharmacy or Pharmaceutical Sciences.

Clinical pharmacy is a health specialty, which describes the activities and services of the

clinical pharmacist to develop and promote the rational and appropriate use of medicinal

products and devices.

Clinical Pharmacy includes all the services performed by pharmacists practicing in hospitals,

community pharmacies, nursing homes, home-based care services, clinics and any

other setting where medicines are prescribed and used.

The term "clinical" does not necessarily imply an activity implemented in a hospital setting. It

describes that the type of activity is related to the health of the patient(s). This implies that

community pharmacists and hospital pharmacists both can perform clinical pharmacy

activities. (ESCP website, available at https://www.escpweb.org/ [home] assessed 13th August

2018)

Clinical pharmacy – discipline in which pharmacists provide patient care that optimizes

medication therapy and promotes health, and disease prevention.

Source: American College of Clinical Pharmacy (ACCP). (2018). Definition of clinical pharmacy.

Available from: https://www.accp.com/stunet/compass/definition.aspx

Competency – a single item of knowledge, skill, behavior and attitude. Source: Bruno, A. (2011). The Feasibility, Development and Validation of a Global Competency

Framework for Pharmacy Education. Thesis for Doctor of Philosophy, University College London (UCL),

School of Pharmacy. [London]: UCL, School of Pharmacy.

Competency framework – a complete collection of competencies that are thought to be

essential to performance.

Source: International Pharmaceutical Federation (FIP) Education Initiatives (FIPEd). (2012a). A Global

Competency Framework for Services Provided by Pharmacy Workforce. The Hague, Netherlands: FIP.

Available from: http://www.fip.org/files/fip/PharmacyEducation/GbCF/GbCF_v1_online_A4.pdf

Competencies – knowledge, skills, behaviors and attitudes that an individual accumulates,

develops, and acquires through education, training, and work experience.




Continuing Professional Development (CPD) – the responsibility of individual pharmacists for

systematic maintenance, development and broadening of knowledge, skills and attitudes, to

ensure continuing competence as a professional throughout their careers.




Master of Science (MSc) in Pharmacy/Pharmaceutical Sciences – a postgraduate degree in

a specialist area or discipline.

https://www.escpweb.org/

https://www.accp.com/stunet/compass/definition.aspx




99

Master of Pharmacy (MPharm) – the undergraduate degree qualification in the United

Kingdom required for registration with the UK regulator as a Pharmacist.

Source: General Pharmaceutical Council (GPhC) (2018). MPharm degree. Available from:


Performance – an effective and persistent observable behavior. What an individual does as

opposed to what they can do.

Source: International Pharmaceutical Federation (FIP) Education Initiatives (FIPEd). (2012a). A

Global Competency Framework for Services Provided by Pharmacy Workforce. The Hague,

Netherlands: FIP. Available


PharmD – a professional doctorate degree needed to be a pharmacist in the USA.



Documents

Clinical Pharmacy Education and Practice in Europe · 2020-07-01 · L. Moura, S. Steurbaut, V. Jordan-von Gunten, B. Addison, S. Apikoglu-Rabus, H. Salvesen Blix, M. Kinnear, B.van