Rational use of medicines in the hospitals of Poland: role of the pharmacists Iga Pawłowska, Ivan Kocić Department of Pharmacology, Medical University of Gdańsk, Gdańsk, Poland Correspondence to Dr Iga Pawłowska, Medical University of Gdańsk, ul. Dębowa 23, Gdańsk 80- 204, Poland; iga112@gumed. edu.pl Received 7 September 2013 Revised 14 March 2014 Accepted 1 April 2014 Published Online First 28 April 2014 To cite: Pawłowska I, Kocić I. Eur J Hosp Pharm 2014;21:372–377. ABSTRACT Objectives The aim of this study was to find information about participation of hospital pharmacists in rational use of medicines at Polish university hospitals. Thus, pharmaceutical services and other tasks performed by hospital pharmacists were determined. Methods A simple questionnaire-based survey was applied. All pharmacist team managers of Polish university hospitals were invited to the study. The obtained data considered the present situation and future perspectives of the pharmacists’ role in rational use of medicines at Polish university hospitals. Results Each hospital pharmacy arranges hospital supplies of drugs and medical devices. The majority of pharmacists are involved in compounding. Also, pharmacists participate in pharmacotherapy rationalisation and monitoring of adverse drug reactions as well, as they are involved in clinical trials. Clinical activities, like participating in hospital rounds are not common Polish hospitals. Conclusions Generally, the role of hospital pharmacists is limited to performing pharmaceutical services at hospital pharmacies, and it should become more patient oriented as is observed in other countries. Similarly, they do not contribute essentially to rational use of medicines. More precise legal regulations, better postgraduate education of pharmacists may be helpful in improving this situation. Hospital pharmacy should become a significant part in medication management in Polish teaching hospitals. INTRODUCTION Pharmacists working at hospitals provide pharmacy services according to the hospitals’ demands and needs. They have got clinical, administrative, organ- isational and educational responsibilities. 1 In cooperation with medical and nursing staff, they are responsible for the most appropriate, effective, safe and economic use of drugs. The role of hos- pital pharmacists may be concluded in ensuring seven aspects (‘rights’): right patient, right dose, right route, right time, right drug with the right information, and right documentation. 2 There are a lot of studies demonstrating the posi- tive impact of pharmacists on drug usage in inpati- ents. 3–7 Moreover, authors of a systematic review of literature concerning the involvement of clinical pharmacists in patient care did not find any harm caused by pharmacists’ interventions. 8 According to Polish law, a hospital pharmacy should be established at every hospital. Furthermore, legal regulations, especially Pharmaceutical Law and Pharmaceutical Chambers’ Act enumerate pharmaceutical services that may be performed only at hospital pharmacies by professional staff as Masters of pharmacy and phar- macy technicians. In Poland, Master of pharmacy is an academic degree awarded for 11 semesters of academic study at a public medical university. The Master study programme is compliant with EU directive 2005/ 36/EC and covers the material of general pharmacy with a focus on community pharmacy, because most of the postgraduates work at community pharmacies. The student spends the last semester at a community pharmacy under the supervision of a licensed pharmacist in order to gain work experi- ence. What is more, the young Master of pharmacy can also provide pharmaceutical services at hospital pharmacies without any additional training. On the other hand, to become a Clinical Pharmacist Specialised or a Hospital Pharmacist Specialised, the pharmacist has to complete 3 years of post- graduate training ended with a national exam. Nevertheless, according to the Polish healthcare system, these specialisations are not insisted upon to work at a hospital. Hopefully, it will change in the future, because such legal regulations do not give encouragement to pharmacists to broaden their clinical knowledge and gain valuable practical experience. Although, clinical pharmacists from Poland and other countries perform similar tasks, some differ- ences can be found, for example, prescribing drugs, which the clinical pharmacist in Poland is not allowed to do. Only at community pharmacy, under extraordinary circumstances (eg, life- threatening situations), can the pharmacists dis- pense one package of the drug. On the other hand, in the USA or UK, the clinical pharmacists are given prescriptive authority, which is beneficial for patients and the whole healthcare system. The aim of this study was to describe the role of hospital pharmacists and their contribution to rational use of medicines at university hospitals in Poland. In particular, we determined and analysed the pharmaceutical services and other tasks per- formed by hospital pharmacists, as well as their involvement in patient healthcare. METHODS The diagnostic survey method was used. The research instrument was an anonymous question- naire. For this preliminary study we invited phar- macy team managers working at all hospital pharmacies established at medical university hospi- tals in Poland (the total number of these settings was 39). The participants were selected on the basis of Registry of Health Care Institutions. Hence, 39 questionnaires with a letter of intent (containing information about the research), and a Review 372 Pawłowska I, et al. Eur J Hosp Pharm 2014;21:372–377. doi:10.1136/ejhpharm-2013-000393 group.bmj.com on November 20, 2014 - Published by http://ejhp.bmj.com/ Downloaded from