The concept of pharmaceutical care, which was first described by Hepler and Strand in 1990, will not be new to pharmacists. This book — in which an international group of experts in the field share their knowledge — provides extremely comprehensive coverage of the topic, ranging from the basics through to implementation, finishing with teaching of the subject at university.
Adherence to treatment regimens is a major problem in almost all therapy areas. Chapter five was particularly interesting as it explores how pharmaceutical care could be deployed to help improve treatment adherence. The chapter provides a complete description of the topic and the different forms of adherence, as well as the various factors that contribute to the problem. However, when discussing interventions that promote therapeutic adherence, the authors make it clear that there is no single intervention guaranteed to address non-adherence. While the rest of the chapter provides a great overview of the various interventional strategies — such as educational interventions and motivational counselling — readers may be left scratching their heads, wondering exactly which approach they should adopt to help the non-adherent patient.
Nevertheless, the fourth part of the book was particularly useful. It deals with implementing pharmaceutical care in practice. Chapter 27, for example, discusses pharmaceutical care for people with asthma and chronic obstructive pulmonary disease, which provides a useful refresher on the therapeutic management of each condition and is packed with useful hints and information. The table describing specific drug-related problems and potential solutions is especially helpful. There is also an extremely useful figure that deconstructs the different steps (and appropriate actions for pharmacists) that should be used by applying pharmaceutical care for patients with each condition. This is illustrated with a case study (a technique used for all other conditions) and the approach that should be taken for patients with the different conditions.
While pharmaceutical care is clearly an important role for pharmacists, cynics may wonder how pharmacists will be remunerated for providing such a service. Later chapters describe potential funding models and it was interesting to read how various systems are already in place in some European countries. While the medicines use review and the new medicine service are now firmly established in UK pharmacies, a similar service, the ‘polymedikation check’, has been adopted in Switzerland. There are several other systems that have been developed and adopted around the world, and the book discusses the various systems that have been implemented in the United States, Canada, Australia and New Zealand.
The book ends by describing how schools of pharmacy across the globe have recognised and embraced the need for pharmaceutical care to become an important part of training pharmacists.
Many of the concepts of pharmaceutical care can be incorporated into the medicines use review or new medicine service, so this book may be a valuable resource for UK pharmacists (and even final-year students). While pharmaceutical care was first described nearly 30 years ago, its value is being increasingly recognised around the globe. Hopefully it will become commonplace in the future.
Rod Tucker
References
The Pharmacist Guide to Implementing Pharmaceutical Care, edited by Filipa Alves da Costa, JW Foppe van Mil & Aldo Alvarez-Risco. Pp 506. US$179.99. Springer International Publishing, Switzerland. ISBN 978-3-319-92575-2
