A global view of the future of hospital pharmacy

Abstract

The new version of the Basel Statements on the future of hospital pharmacy (BSFHP) document
has been published in 2015 presentinga global view for the future of hospital pharmacy1.The first version was developed in 2008 under the coordination of the hospital pharmacy section of the International Pharmaceutical Federation (FIP) during the global conference on the future of hospital pharmacy held in Basel (Switzerland), with participation of representatives of 98 countries1. The first set of guidelines was drawn from consensus methodologies and aimed to identify strategic objectives
and areas for international cooperation, seeking to prioritize advances in professional practice1-3.The current 65 guidelines that make up the BSFHP have been simplified and grouped in the review process. The driving elements were preserved and new guidelines and concepts incorporated to
reflect global trends of the professional practice at present days, among which stands out “the optimization of patientoutcomes through the collaborative, interdisciplinary and judicious use of drugs, devices, and medicalhospital supplies” as the overarching goal of hospital pharmacists1-3.
The concept of judicious drug use was published by FIP in 2012 and incorporated into the BSFHP to indicate that the activities, capabilities and resources available in the health system are mobilized
to ensure that patients receive the correct medication at the right time, properly use drugs and achieve the expected benefits. FIP stressed that the purpose was to complement and not to replace the concept of
rational use of medicines of the World Health Organization1.The focus of the rational use of drugs is the patient and the medication received by this. The judicious use, on the other hand, has a broader scope whe ackowledging the importance of the patient, safety, availability and proper use of the drug, as well as the monitoring of this use. Other professionals beside pharmacists were involved in this mission, as well as managers, carers and health systems1. In that sense, according to the BSFHP, the judicious use of a given drug means to use it only when necessary and based on clinical scientific evidence of effectiveness and less damage risk 1-3. Given the growing increase of health care costs, the importance of the fundamentals and principles for Health Technology Assessment (HTA) were highlighted in the latest edition of the BSFHP. The document highlights the HTA contribution to support the decision-making process on incorporation of new drugs, the development of therapeutic clinical guidelines for hospitals and actions to guarantee the judicious use of medicines1-3. The BSFHP also emphasizes the importance of computerization of pharmaceutical care processes and the use of clinical decision support systems, always seeking optimized results, safe pharmacotherapy and cost effective use of medicines1-3.
In line with the growing concern with the sustainability of the planet, the BSFHP incorporated
the responsibility of pharmacists to minimize the effects of drugs on the environment into the new edition. Therefore, hospital pharmacists must contribute to the management of waste created by the use of drug products, evaluating the systematic disposal of wastes in order to minimize environmental impact1-2. The pharmaceutical practice as a catalyst of patient safety promoting processes is present in
several BSFHP guidelines, such as assurance of quality of in-hospital production of sterile and non-sterile
medicines, qualification of care transition, employment “seven rights” (ight patient, right medication,
right dose, right route of administration, right reason and right time) in all activities related to medicines
in the hospital environment and monitoring of the use of medicines. The guideline on preparation of
antineoplastic and other sterile drugs are in line with the General Chapter 800 (Hazardous Drugs-Handling in Healthcare Settings), published in 2016, and the General Chapter 797 (Pharmaceutical Compounding - sterile preparations), under review, both part of the United States Pharmacopeia, highlighting the necessary infrastructure and standards for practice to ensure the safe preparation and use of these medicines in hospitals and health services4-6. A significant part of the BSFHP guidelines are in line with the provisions of Ordinance Nº 4283 of December 30, 2010, which addresses the organization, strengthening and improvement of actions.