Marisol Touraine wants to strengthen the role of pharmacists in nursing homes

The Minister of Social Affairs, Health and Women's Rights wants to entrust new public health missions to pharmacists, in particular the prevention of drug-related iatrogeny among the elderly in nursing homes. This was announced by Jean Debeaupuis, Director General of Healthcare Services (DGOS), on 18 October in Reims, at the 68th National Pharmacists' Congress.

More pharmacists in nursing homes? In any case, the public authorities are working on expanding their tasks. At the National Pharmacists' Congress in Reims, Jean Debeaupuis, Director General of Healthcare, explained that the Ministry of Health, like the French National Authority for Health (HAS), was in favour of pharmacists intervening in the prevention of adverse drug reactions in elderly people with multiple medications.

According to the DGOS, the preparation of administered doses (PDA) has also been identified in a report by the Académie de pharmacie as a potential means of improving compliance and reducing the risk of iatrogeny in elderly people. "Its indications, the conditions for its feasibility and safety, both in pharmacies and in the PUI [pharmacy for internal use], remain to be defined in a consultation process that is open to all operators in the drug chain. Targeted trials will accompany this consultation", announced Jean Debeaupuis.

It should be remembered that at the beginning of June, the Union nationale des pharmacies de France (UNPF), a union of dispensing pharmacists, presented a white paper aimed at strengthening the role of dispensing pharmacists in the institutional drug circuit.

Although the July 2009 Hospital, Patients, Health and Territories Act (HPST) included PDA in the pharmacist's new missions, several health ministers belonging to the previous governmental majority had announced the publication of decrees and orders relating to this activity, without this actually taking place. Work resumed in 2013, but nothing has yet been achieved.

Supporting missions

In any case, the Director General of Healthcare Organisation told pharmacists on 18 October that "these missions should be matched by a simplification of invoicing procedures and the negotiation of appropriate fees. These fees will have to meet a dual objective: to ensure the future of pharmacies, but also to support actions that contribute to better organisation and efficiency in the provision of care", he said.

The HPST law, and then the 2012 pharmaceutical agreement, provided for pharmacists to be entrusted with support missions, which took concrete form with the launch of pharmaceutical interviews for patients on anti-vitamin K (AVK) in June 2013 and for asthma patients in December 2014.

Negotiations will begin in early November on the development of these interviews, in parallel with discussions on remuneration for public health objectives (ROSP) for generic substitution.

During the congress, the Director General of the National Union of Health Insurance Funds (Uncam), Nicolas Revel, reaffirmed his wish to consider extending the missions of pharmacies to include support for the elderly and the fight against drug-related iatrogeny.

"Medication reconciliation" in conjunction with "doctors

Pharmacists have a "vocation" to intervene in the care of the elderly "in a way that needs to be clarified with doctors", he said on 9 October at the eighth meeting of the Union of Unions of Pharmacy Professionals (Uspo). "Our priority is also the care of the elderly, to reconcile medication with doctors", he continued.

"This is a subject on which I am keen to work, but I am not convinced, at this time, that we will be ready to adopt it" in the context of the negotiations that are due to start by the end of the year on the evolution of the ROSP, he nevertheless qualified.

"Not that I do not wish to see it succeed, but I think that at some point, we must have, in an interprofessional framework [...], a shared vision of who does what", he commented.

Source : "Elderly people: Marisol Touraine wants to strengthen the role of pharmacists in Ehpad", by Guillaume Bietry. Article published on 27/10/2015 in gerontonews.