Browsing by Subject "apteekit"

Health related issues are largely regulated at EU Member State level, whereas areas such as internal market and competition fall mainly under the remit of European Union competence. This creates tension not only between legislation governing health and that concerning internal market but also between national and EU legislation. Here the Court of Justice of the European Union (CJEU) plays a key role in developing case-law through its judgments, defining further interpretation both on European and national level. An example of a sector operating at the interphase between public health and internal market interests is community pharmacy, which was chosen as the focus area of the study. The aim of this master's thesis was, through the case-study example of the regulation of pharmacy establishment, ownership and distribution in EU Member States, to perform a documentary analysis on related CJEU judgments, focusing on statements present in them referring to public health and internal market, discussing potential impacts on the community pharmacy sector as well as relating the outcomes to the broader context of European health policy with reference to existing literature. The study material consisted of publicly available documentation related to four judgments (Case C-531/06, Joined Cases C-171/07 and C-172/07, Joined Cases C-570/07 and C-571/07 and Case C-367/12) that were made between the years 2009 and 2014, the first proceedings initiating in 2006. The prevalence and variety of statements related to public health were found to be much higher in the documents analysed compared to those relating to internal market. The most common argumentation present in the judgments was related to the statement that regulation of ownership of community pharmacies can be justified by public health reasons, deriving from the professionalism inherent to pharmacists as well as ensuring balance between public health and economic interests. This transmits a clear message of the importance of public health and indeed the Court has been perceived as a balancing force to the union's liberalisation agenda. Following this it seems unlikely that the interpretation for national regulation would change in the near future, meaning that Member States should be able to maintain community pharmacy regulation, to the extent that it is implemented in a consistent manner. However, there has been indication of other routes being used to push for the liberalisation agenda and therefore it continues being a part of the debate both at European and national level. The findings of this study support literature suggesting that spillover is taking place in relation to the Court of Justice and health. Furthermore, it has been clearly demonstrated that even though officially the EU has very limited competence (authority) in health, its influence on European health policy is in fact highly significant, taking place to a large extent via routes other than those officially assigned to it in relation to health in particular. Whether this is intentional or unintentional, it does not change the fact that health policy is being influenced. When it happens without explicit intention, the processes lose transparency and are driven by other, potentially competing agendas. Therefore it would be important to assess whether the decision making processes and other processes currently shaping the European healthcare policy are in line with what was originally intended and re-evaluate whether this dynamic is the preferred way to proceed in the future.

Background and objectives: Pharmaceutical services provided by community pharmacies have the potential to improve medication safety and support the implementation of rational pharmacotherapy. The pharmaceutical services are internationally an underused resource to support functioning of social and health care services. The literature review of this Master’s thesis provides an overview of pharmaceutical services, - their funding and remuneration. The primary objective of the empirical study was to create an overview of the development of the pharmaceutical services in Finnish community pharmacies in 2010-2020. The secondary objective was to study differences in the service provision between Finnish provinces. Materials and methods: The study was carried out as a retrospective descriptive survey study annually conducted by the Association of Finnish Pharmacies. Åland was excluded from the provincial review so that individual pharmacies could not be identified. The data was analyzed using Microsoft Excel. The number of pharmacies providing pharmaceutical services annually and the annual number of customers using these services were counted at the national level. At the provincial level, the corresponding data for the prescribing review, medication review, comprehensive medication review and assessment of inhalation technique were analyzed for the years 2017-2020. Results and conclusions: The most common service with the highest number of customers was automated dose dispensing. The second most common service was prescription review. As a whole, the provision of services and the number of customers had increased during the study period in Finnish community pharmacies. Manual dose dispensing was a diminishing service. Differences were found between provinces in the prevalence of services and in the number of customers. It was possible to identify provinces with lower service provision activity, such as Lapland. The service provision prevalence and number of customers varied widely within provinces. The number of customers for a certain service in an individual pharmacy had a large effect on the provincial average, thus, the average number of customers in the provinces does not reflect the provinces' success in implementation of services. Pharmaceutical services, with the exception of the automated dose dispensing, are not well implemented.

ommunity pharmacies and medicines information centers increasingly provide e-mail medication counseling services to consumers and health care professionals. As e-mail medication counseling services are fairly new type of pharmaceutical service, only little is known about the use and users of these services, content of e-mail enquiries and quality of these services. Objective of this study was to analyze utilization of e-mail medication counseling services in the University Pharmacy. The special focus was on e-mail enquiries concerning human and veterinary medicines and health issues. All e-mail enquiries sent to the University Pharmacy Medicines Information Center in 2009 and 2010 were recorded by using a structured data collection instrument and content-analyzed both qualitatively and quantitatively. The total numbers of e-mail enquiries were 3 376. Of those 383 (11 %) were related to human medicines, 45 (1 %) to health and diseases and 33 (1 %) veterinary medicines. The majority of e-mail enquiries (72 %) were come via web page of the University Pharmacy. Of the human medicines related e-mail enquiries 92 % were sent by consumers and 65 % by woman. The most commonly e-mail enquiries concerned sleeping pills (5 %), antiepileptics (3 %), cholesterol medicines (3 %) and virus vaccines (3 %). E-mail enquiries fell commonly into the categories of availability (28 %), cost and reimbursements questions (13 %), medicines interactions (11 %) and adverse effects (5 %). Some background information was missing from e-mail enquiries, for example user of medicine (39 %), gender of medicine user (50 %) or age of medicine user (94 %). However, only part (3 %) of e-mail enquiries were sent adjunct questions. After improvement of usability and quality of e-mail medication counseling services response rapidity was increased in the University Pharmacy. Consumers appear to have medicines-related information needs. Additionally they are actively using e-mail services for multiple functions. However, the use of these services for medicines information is still fairly uncommon. The results of this study can be utilized when designing and developing e-mail medication counseling services in community pharmacies, medicines information centers and online pharmacy services. Additionally they can be utilized in pharmacy education in universities and in continuing education. More information is needed about the quality of pharmacists' responses and consumers' needs, experiences and perceptions on e-mail medication counseling services.