On September 11, 2015 I departed Sacramento Airport for Vienna, Austria. The significance of the date did not escape me as I sat in the international terminal at LAX, waiting to board a 10-hour flight to Dusseldorf, Germany . Fortunately, the flight was uneventful and we arrived safely in Vienna. The purpose of my trip was to speak at a conference for Eastern European pharmacists. The conference, Clinical Pharmacy Week, was celebrating its tenth year.
The Clinical Pharmacy Week meeting was started in 2006 by a small group of Austrian pharmacists. The intent of the meeting was to encourage Austrian pharmacists to expand their scope of practice to provide clinical pharmacy services. At the time of the inaugural meeting, there were only about 5 clinical pharmacists in Austria. The meeting organizers invited clinical pharmacists from the United States to come and present information about their clinical practice settings and provide tips on how to implement clinical pharmacy services. Over time the meeting has grown into a multi-national event, with pharmacists coming from several Eastern European countries including the Czech Republic, Slovenia, Slovakia, Germany, Hungary and Estonia.
For this 10th Clinical Pharmacy Week Meeting, I was scheduled to provide four lectures and an interactive workshop on oncology topics that were requested by the planning committee. The other faculty included 3 pharmacists from the US and one pharmacist from Peru. The scope of lecture content was pretty diverse, including topics in oncology, infectious diseases, rheumatology and cardiology.
In many respects, this appeared to be a typical pharmacy educational conference. Four packed days of back-to-back pharmacy-based lectures, with topics spanning a wide range of diseases and practice settings. However, throughout the conference, the audience of about 50 pharmacists remained interactive and engaged with each of the speakers. They asked thoughtful and intelligent questions and were sincerely motivated to absorb as much information as they could about each topic area and, in particular, aspects of clinical pharmacy practice.
In speaking with the pharmacists during meals and social activities, it was very clear that these pharmacists were earnestly trying to develop clinical pharmacy services despite a lack of resources and/or administrative support within their practice settings. Some of the pharmacists described working in hospitals with 600-1000 beds and a pharmacy staff consisting of 6-12 pharmacists and technicians. Their strategies for implementing clinical pharmacy services frequently required them to engage a specific physician to work with and prove the value of their clinical input. However, if that physician were to move or retire, that could mean the end of that clinical pharmacy service. Most of the pharmacists reported reserving their clinical activities for after their “regular” duties were completed – frequently staying after the completion of their scheduled shift to conduct clinical activities such as therapeutic drug monitoring, medication reconciliation and patient education. Although the practice settings were so different, these pharmacists described many of the same challenges that we face in the US in taking care of patients, including obtaining insurance authorization for treatment, enrolling patients in medication assistance programs, monitoring and educating patients on the importance of medication adherence. In my opinion, the major difference is that in the US, the value and importance of clinical pharmacy services is more prominently recognized and endorsed by pharmacy organizations, colleges of pharmacy and employers. Based on my conversations with pharmacy students, pharmacists and even pharmacy organization leaders in Austria, the importance and value that clinical pharmacists can contribute to improving patient care is not widely recognized or even endorsed.
In some respects, the clinical pharmacists in Austria and other Eastern European countries are going through some of the same pharmacy practice growing pains that we experienced in the United States 30-40 years ago, before the concept, value and benefits of clinical pharmacists were fully embraced.
Based on what I observed at this meeting, these dynamic, young pharmacists are not deterred by the obstacles and challenges they face in trying to successfully create clinical pharmacy programs in their practice settings. They are passionate about their quest and they are arming themselves with knowledge, experience and networking as a means of achieving their goals. They are creating and participating in international research projects aimed at improving various aspects of patient care through clinical pharmacy services. Many of these pharmacists have visited clinical pharmacy practice settings in the US and are inspired to model new clinical practices in their institutions after US practices. These pharmacists were also intrigued about the possibility of achieving BPS Board Certification as a means of helping to achieve their goals. I was very lucky to have been invited to participate in this Clinical Pharmacy Week conference. It was truly inspiring to have the opportunity to have met with these intelligent and enthusiastic pharmacists and I feel personally motivated to help them achieve their goals in any way that I can.
Andrea Iannucci, Pharm.D.
2015 BPS Board of Directors, Oncology Specialist Member
Assistant Chief Pharmacist,
Oncology and Investigational Drugs Services
UC Davis Medical Center