Clinical Pharmacy Education and Practice in Europe · 2020-07-01 · L. Moura, S. Steurbaut, V....
Transcript of Clinical Pharmacy Education and Practice in Europe · 2020-07-01 · L. Moura, S. Steurbaut, V....
L. Moura, S. Steurbaut, V. Jordan-von Gunten, B. Addison, S. Apikoglu-Rabus, H. Salvesen Blix, M.
Kinnear, B.van den Bemt, F. Alves da Costa
Clinical Pharmacy
Education and
Practice in Europe
On behalf of the Education Committee of
European Society of Clinical Pharmacy
2
Index
List of abbreviations .......................................................................................................................... 4
Executive Summary ........................................................................................................................... 5
Glossary ................................................................................................................................................ 7
Albania ............................................................................................................................................... 15
Belgium ............................................................................................................................................... 17
Bosnia and Hercegovina ............................................................................................................... 19
Bulgaria ............................................................................................................................................... 20
Croatia ................................................................................................................................................ 22
Cyprus ................................................................................................................................................. 24
Czech Republic ................................................................................................................................ 26
Denmark ............................................................................................................................................. 29
Estonia ................................................................................................................................................. 31
Finland ................................................................................................................................................. 33
France ................................................................................................................................................. 35
Germany ............................................................................................................................................ 37
Greece ............................................................................................................................................... 39
Hungary .............................................................................................................................................. 41
Iceland ................................................................................................................................................ 43
Ireland ................................................................................................................................................. 46
Italy....................................................................................................................................................... 48
Kosovo ................................................................................................................................................ 50
Latvia ................................................................................................................................................... 52
Lithuania ............................................................................................................................................. 54
Malta ................................................................................................................................................... 56
The Netherlands ............................................................................................................................... 58
Norway................................................................................................................................................ 60
Poland ................................................................................................................................................. 62
Portugal .............................................................................................................................................. 64
Republic of Moldova ...................................................................................................................... 66
Russian Federation .......................................................................................................................... 69
Serbia .................................................................................................................................................. 71
Slovakia ............................................................................................................................................... 73
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Slovenia .............................................................................................................................................. 75
Spain .................................................................................................................................................... 78
Sweden ............................................................................................................................................... 80
Switzerland ......................................................................................................................................... 82
Turkey .................................................................................................................................................. 84
Ukraine ................................................................................................................................................ 86
United Kingdom ............................................................................................................................... 88
Summary and conclusions ............................................................................................................ 90
4
List of abbreviations
CP - Clinical Pharmacy
ESCP – European Society of Clinical Pharmacy
EAFP – European Association of Faculties of Pharmacy
CPD - Continuous professional development
ECTS – European Credit Transfer System
ADR – Adverse Drug Reaction
OSCE – Objective Structured Clinical Examination
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Executive Summary
Education is a cornerstone in the formation of high-qualified professionals, who engaging in
long-life learning, can better meet societal needs and thus provide high quality clinical
pharmacy (CP) services to ensure the best use of medication. In order to understand the
current education situation in Europe and the level of differentiation and recognition of CP, a
mapping exercise was deemed necessary. To that end, the Education Committee of the ESCP
developed a survey to map education and practice in CP around Europe, aiming to get an
overview of the present situation and identify good examples on clinical pharmacy education
and practice.
The survey was developed from scratch using a sequential approach, where two experts1
developed an initial version to capture the three main domains (undergraduate, post
graduate education, and practice - see appendix 1), subsequently revised by a larger panel
of six experts representing the ESCP Education and General Committees 2, then supplemented
by a glossary and finally submitted and approved by the General Committee. The final survey
included an initial section introducing the ESCP definition of clinical pharmacy. The study
received approval from Egas Moniz3 and FFULisboa4 Ethics Committee.
Dissemination was multi-staged, first addressing all academic members of ESCP, secondly
adopting a snowballing approach to Educational Committee members’ contacts, and finally
targeting associates of the European Association of Faculties of Pharmacy (EAFP). Data were
collected from October 4th, 2018 till January 31st, 2019. Ideally, we intended to receive only
one response per country, reflecting the national situation of CP education and practice.
However, because we reached participants using ESCP, EAFP and individual contacts,
multiple answers from the same country were possible. To our knowledge, there is no central
registry indicating the contact person for academic matters per country. Therefore, the
validation process included unifying multiple answers from the same country. All answers
received were accepted and then mapped to decide whether they supplement or differ from
each other. Whenever possible key stakeholders in each of the countries involved were
contacted to validate the research team’s interpretation of data5. A report was produced
following the first analysis and sent to all participants asking for clarification of inconsistencies
and for missing information. When deemed necessary, face to face discussions were held to
clarify persisting inconsistencies. This report presents the outcome of this European survey,
where 36 countries participated (representing 72% of countries delivering education in
Pharmaceutical Sciences) and is open for public consultation at the ESCP’s website from July
till August. Countries that have answered the initial survey but did not provide any feedback
on the initial report that was sent, are marked as unvalidated data.
The main findings are that CP education and practice vary widely across European countries.
Undergraduate education in clinical pharmacy was reported by 97% (n=34 out of 35) of
participating countries, and 91% (n=30 out of 33) reported to also have postgraduate
education. While some countries reported a curriculum full of CP course units, with a lot of
practical teaching, others have less clinical pharmacy component at undergraduate level.
Some countries showed a wide scope of postgraduate educational possibilities (both leading
1 Filipa Alves da Costa and Stephane Steurbaut 2 Bart van den Bemt, Brian Addison, Frank Jørgensen, Hege Blix, Sule Rabus and Vera von
Gunten 3 Egas Moniz University Institute, Portugal 4 Faculty of Pharmacy, University of Lisbon, Portugal 5 Laura Moura was responsible for all data analysis
6
to an academic degree and not leading to an academic), whilst others reported very little
postgraduate possibilities.
Almost every European country reported practice around CP (97%; n=35 out of 36), the most
commonly reported applicability being at community and hospital settings (63% n=20 out of
32)), a smaller proportion in only hospital setting (31%; n=10 out of 32) and a minority (6%, n=2
out of 32) referring to applicability in all healthcare settings which might also include long-term
care and primary care, to name a few. More than half (51%) of the European countries
providing education in pharmaceutical sciences (n=18 out of 35) recognize CP as an area of
specialization, and in 65% of these countries (n=11 out of 17) this specialization includes job
specifications or professional rights.
The main results of this mapping exercise suggest education and practice in clinical pharmacy
is evolving across Europe, despite major differences between and within countries. This study
is an excellent opportunity for European countries to learn from each other and share good
practice examples on clinical pharmacy education and practice, and collectively work
towards increased pharmacists’ clinical activities in Europe. We very much appreciate the
contribution of all ESCP members who participated in this survey and encourage all others to
comment the full report.
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Glossary
Clinical Pharmacy: The latest ESCP definition states that clinical pharmacy is a scientific
discipline and a branch of pharmacy practice, which aims to optimize the therapeutic use of
medicines by patients and professionals in order to maximize the likelihood that an optimal
balance of clinical, humanistic and economic outcomes is achieved.
As an academic discipline, clinical pharmacy aims to generate and disseminate knowledge
that directly informs clinical decision-making, health care organization or policy in relation to
the therapeutic use of medicines.
As a professional practice, clinical pharmacy comprises services delivered by registered
pharmacists or pharmaceutical staff acting under their responsibility, which target the
therapeutic use of medicines at population and/or individual patient levels. Clinical pharmacy
can be delivered in any setting. Where clinical pharmacy services target therapeutic use of
medicines in individual patients, clinical pharmacy practice and pharmaceutical care
delivery (defined by the Pharmaceutical Care network Europe as “the pharmacist’s
contribution to the care of individuals in order to optimize medicines use and improve health
outcomes”) are synonymous.
Competency: a single item of knowledge, skill, behavior and attitude. Source: Bruno, A. (2011). The
Feasibility, Development and Validation of a Global Competency Framework for Pharmacy Education. Thesis for
Doctor of Philosophy, University College London (UCL), School of Pharmacy. [London]: UCL, School of Pharmacy.
Competency framework – a complete collection of competencies that are thought to be
essential to performance. Source: International Pharmaceutical Federation (FIP) Education Initiatives (FIPEd).
(2012a). A Global Competency Framework for Services Provided by Pharmacy Workforce. The Hague, Netherlands:
FIP. Available from: http://www.fip.org/files/fip/PharmacyEducation/GbCF/GbCF_v1_online_A4.pdf
Competencies – knowledge, skills, behaviors and attitudes that an individual accumulates,
develops, and acquires through education, training, and work experience. Source: International
Pharmaceutical Federation (FIP) Education Initiatives (FIPEd). (2012a). A Global Competency Framework for Services
Provided by Pharmacy Workforce. The Hague, Netherlands: FIP. Available
from: http://www.fip.org/files/fip/PharmacyEducation/GbCF/GbCF_v1_online_A4.pdf
Validated and unvalidated data: Data validity is commonly defined as the extent to which
data represents the truth. [Source: Stausberg J, Kuklik N, Jöckel KH. Opportunities and Pitfalls in the Definition of
Data Validity. Stud Health Technol Inform. 2018;247:566-570]. Various procedures may be adopted to
ensure data validity. For the purpose of the present study, data was considered valid if at least
one verification of the fidelity of the data initially provided was possible to obtain. Data was
considered as not validated when only the initial responses were obtained with no further
verification. For the final report, we shall consider three levels of validation, where the third will
be achieved by a public consultation process.
Continuing Professional Development (CPD) – the responsibility of individual pharmacists for
systematic maintenance, development and broadening of knowledge, skills and attitudes, to
ensure continuing competence as a professional throughout their careers. Source: International
Pharmaceutical Federation (FIP) Education Initiatives (FIPEd). (2012a). A Global Competency Framework for Services
Provided by Pharmacy Workforce. The Hague, Netherlands: FIP. Available
from: http://www.fip.org/files/fip/PharmacyEducation/GbCF/GbCF_v1_online_A4.pdf
Master of Science (MSc) in Pharmacy/Pharmaceutical Sciences – a postgraduate degree in
a specialist area or discipline.
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Master of Pharmacy (MPharm) – the undergraduate degree qualification in the United
Kingdom required for registration with the UK regulator as a Pharmacist. Source: General
Pharmaceutical Council (GPhC) (2018). MPharm degree. Available from:
https://www.pharmacyregulation.org/education/pharmacist/MPharm
Performance – an effective and persistent observable behavior. What an individual does as
opposed to what they can do. Source: International Pharmaceutical Federation (FIP) Education Initiatives
(FIPEd). (2012a). A Global Competency Framework for Services Provided by Pharmacy Workforce. The Hague,
Netherlands: FIP. Available from: http://www.fip.org/files/fip/PharmacyEducation/GbCF/GbCF_v1_online_A4.pdf
PharmD – a professional doctorate degree needed to be a pharmacist in the USA.
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Demographics
According to the United Nations, there are 546 European countries, although according to the
sources consulted, Andorra, Liechtenstein, Monaco and Montenegro do not have education
in pharmacy. This study includes data from 72% (n=36 out of 50) of the European countries
delivering education in pharmaceutical sciences.
Figure 1. Map of Europe with participating countries highlighted.
Legend:
6 Albania, Andorra, Armenia, Austria, Azerbaijan, Belarus, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Cyprus, Czech
Republic, Denmark, Estonia, Finland, France, Georgia, Germany, Great Britain, Greece, Hungary, Iceland, Ireland, Israel, Italy, Kazakhstan, Kosovo (it is not on United Nations’ list but we decided to include in the study), Kyrgyzstan, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Monaco, Montenegro, Netherlands, North Macedonia, Northern Ireland, Norway, Poland, Portugal, Republic of Moldova, Romania, Russian Federation, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Tajikistan, Turkey, Ukraine, Uzbekistan
Participating countries
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General overview
Table 1: General overview of responses provided by participating countries to the three survey
domains
Number of faculties
providing pharmacy studies
Undergraduate
education
Postgraduate
education
Professional
practice
Albania 5 N N Y
Belgium 6 Y Y Y
Bosnia and
Hercegovina 6 Y Y Y
Bulgaria 5 Y Y Y
Croatia 2 Y Y Y
Cyprus 5 Y Y Y
Czech
Republic 2 Y Y Y
Denmark 2 Y Y Y
Estonia 1 Y N Y
Finland 3 Y Y Y
France 24 Y Y Y
Germany 22 Y Y Y
Greece 4 Y Y Y
Hungary 4 Y Y Y
Iceland 1 Y Y Y
Ireland 3 Y Y Y
Italy 29 ND ND Y
Kosovo 3 Y Y Y
Latvia 2 Y Y Y
Lithuania 2 Y N Y
Malta 1 Y Y Y
Netherlands 3 Y Y Y
Norway 6 Y Y Y
Poland 11 Y Y Y
Portugal 9 Y Y Y
Republic of
Moldova 1 Y Y Y
Russian
Federation 15 Y ND N
Serbia 5 Y Y Y
Slovakia 2 Y Y Y
Slovenia 1 Y Y Y
Spain 22 Y Y Y
Sweden 3 Y Y Y
Switzerland 6 Y ND Y
Turkey 36 Y Y Y
Ukraine 21 Y Y Y
United
Kingdom 28 Y Y Y
Legend:
Y Yes
N No
ND No data available
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Table 1 shows that 97% (n=34 out of 35) of the participating European countries have
undergraduate education in clinical pharmacy, 91% (n=30 out of 33) have postgraduate
education and 97% (n=35 out of 36) have clinical pharmacy embedded in their professional
practice. Around 83% of participating European countries have all three – under- and
postgraduate education as well as professional practice in clinical pharmacy. This table also
shows a wide variability in the number of faculties, ranging from 1 to 36 per country, making
data validation for some countries particularly challenging.
Postgraduate education in CP
Table 2: Postgraduate education in CP reported by participating countries
Postgraduate education leading
to an academic degree
Postgraduate education not leading to an academic
degree
Masters PhD
programmes
Continuous professional
development
Postgraduate programmes/
Certifications
Belgium N Y Y Y
Bosnia and
Hercegovina Y Y N N
Bulgaria Y Y ND ND
Croatia Y N N Y
Cyprus Y Y N N
Czech Republic N Y Y Y
Denmark N N N Y
Finland N Y Y ND
France ND N Y Y
Germany N Y ND Y
Greece Y Y N N
Hungary N Y Y N
Iceland Y Y N N
Ireland Y Y Y N
Kosovo N N Y N
Latvia Y Y N N
Malta Y Y Y N
Netherlands N Y Y Y
Norway Y Y Y N
Poland Y Y N N
Portugal N N Y N
Republic of
Moldova Y N N N
Serbia Y Y ND ND
Slovakia Y Y N N
Slovenia Y Y Y N
Spain Y N Y Y
Sweden Y ND N N
Turkey Y Y Y N
Ukraine Y Y Y N
United Kingdom Y Y Y Y
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Legend:
Most countries reported to provide specific clinical pharmacy postgraduate education
leading to an academic degree. 65% (n=20 out of 31) have a master’s programme and 72%
(n=23 out of 32) have PhD programmes.
A considerable proportion also reported to provide clinical pharmacy postgraduate
education not leading to an academic degree. 55% (n=16 out of 29) have CPD courses and
35% (n=10 out of 29) have postgraduate programmes/certifications.
United Kingdom is the only European country where all the possibilities for postgraduate
education are available.
Y Yes
N No
ND No data available
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Professional practice in CP
Table 3: General overview of clinical pharmacy practice in participating countries
Clinical pharmacy practice Application setting Recognised Specialization
Albania Y C + H N
Belgium Y C + H N
Bosnia and Hercegovina Y C + H Y
Bulgaria Y H Y
Croatia Y C + H Y
Cyprus Y C + H N
Czech Republic Y AHF Y
Denmark Y C + H N
Estonia Y H N
Finland Y C + H Y
France Y C + H N
Germany Y H Y
Greece Y ND Y
Hungary Y H Y
Iceland Y ND N
Ireland Y C + H N
Italy Y H N
Kosovo Y C + H Y
Latvia Y H Y
Lithuania Y C + H N
Malta Y C + H N
Netherlands Y C + H N
Norway Y C + H Y
Poland Y H Y
Portugal Y C + H N
Republic of Moldova Y C + H Y
Russian Federation N - N
Serbia Y H Y
Slovakia Y H Y
Slovenia Y C + H Y
Spain Y C + H N
Sweden Y C + H N
Switzerland Y ND ND
Turkey Y H Y
Ukraine Y AHF Y
United Kingdom Y C + H N
Legend:
Y Yes
N No
ND No data available
C Community pharmacy setting
H Hospital setting
AHF All healthcare settings
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Almost every European country (35 out of 36 participating countries) has clinical pharmacy
practice(s), with 63% (n=20 out of 32) having its application at both the community and
hospital level, 31% (n=10 out 32) having its application only in hospital setting and 6% (n=2 out
of 32) having its application in all healthcare settings.
More than half (51%, n=18 out of 35) of the participating European countries recognize clinical
pharmacy as an area of specialization, and of these, in 11 (out of 17) countries (65%), the
specialization goes along with particular job specifications and/or professional rights.
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Albania
Indicators
Inhabitants1 2 870 324
Practicing pharmacists/ 100 000 inhabitants2 85
Hospitals/100 000 population3 1.5
Community pharmacies/ 100 000 inhabitants4 ND
1. Characterization of the Albanian Clinical Pharmacy Education
Albania has five faculties that provide an Integrated master’s degree in Pharmaceutical
Sciences.
Clinical pharmacy is not part of the university curricula in Albania as a separated module
or discipline. Topics related to clinical pharmacy are taught in different modules (such as
Pharmacology, Biopharmacy and Pharmacokinetics, professional practice, etc). Pharmacists
also offer clinical pharmacy services in their work environment (open pharmacy, hospital
pharmacy), but there is not an official title of Clinical Pharmacist.
2. Undergraduate education in CP
None of the faculties that provide an Integrated master’s degree in Pharmaceutical
Sciences covers topics of Clinical Pharmacy.
3. Postgraduate education in CP
Postgraduate education leading to an
academic degree
Postgraduate education not leading to
an academic degree
Master/ Diploma
degree PhD programmes CPD courses Certifications
N N N N
4. Professional Practice in CP
In Albania, there is no specialization in clinical pharmacy.
Clinical Pharmacy is part of the professional activities of both community and hospital
pharmacists.
In addition, there are no specific areas officially recognised as speciality areas by the
national authority or professional body in the domain of clinical pharmacy.
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References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 European Union – Eurostat. Health personnel statistics. Retrieved from
https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
17
Belgium (not validated)
Indicators
Inhabitants1 11 433 256
Practicing pharmacists/ 100 000 inhabitants2 123.2
Hospitals/100 000 population3 1.7
Community pharmacies/ 100 000 inhabitants4 43.4
1. Characterization of the Belgian Clinical Pharmacy Education
According to FIP Official World List of Pharmacy Schools5, Belgium has six faculties that
provide an Integrated Master of Pharmaceutical Sciences.
CP is a quite young discipline in Belgium. It is part of the hospital pharmacy specialization
and does not exist as a profession on its own. This specialization takes 3 additional years on top
of the 5 years to become a pharmacist in Belgium.
From 2007, the Belgian Federal Government is stimulating CP by financing 0,2 FTE per 200
beds in each hospital (except for psychiatric hospitals).
The hospital pharmacy specialization in Flanders is an interuniversity programme between the
4 Flemish universities (Antwerp, Brussels, Ghent and Leuven).
In Belgium, clinical pharmacy is beyond the starting point, but is not already fully
established (both education and practice).
2. Undergraduate education in CP
The undergraduate education in Belgium is accredited by a regulator.
The curricula of Pharmacy schools cover topics in Clinical Pharmacy, with a 20 to 60%
of practical teaching.
3. Postgraduate education in CP
Postgraduate education leading to an
academic degree
Postgraduate education not leading to an
academic degree
Master/ Diploma
degree PhD programmes CPD courses Certifications
N
Y
Y
Y
There are PhDs in
Belgium in the
domain of CP but not
leading to a specific
PhD diploma in CP.
What you obtain in
the end is a PhD in
Pharmaceutical
Sciences.
In Belgium, clinical pharmacy is
a course in the education to
obtain the diploma of hospital
pharmacist; one university
offers a post-grad certificate in
clinical pharmacy.”
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3. Professional Practice in CP
In Belgium, Clinical pharmacy is not considered an area of specialization but is part of
the professional activities of both community and hospital pharmacists.
There are no recognised speciality areas in the domain of clinical pharmacy.
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 European Union – Eurostat. Health personnel statistics. Retrieved from
https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
5 International Pharmaceutical Federation (FIP): Official World List of Pharmacy Schools. Retrieved from
http://academic_institutional_membership.fip.org/world-list-of-pharmacy-schools/ (accessed on April
26th, 2020)
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Bosnia and Hercegovina
Indicators
Inhabitants1 3 509 728
Practicing pharmacists/ 100 000 inhabitants2 11.18
Hospitals/100 000 population3 1.0
Community pharmacies/ 100 000 inhabitants4 ND
1. Characterization of the Bulgarian Clinical Pharmacy Education
Bosnia and Hercegovina have six faculties that provide an Integrated master’s degree in
Pharmaceutical Sciences.
2. Undergraduate education in CP
The postgraduate education in Bosnia and Hercegovina is accredited by a regulator.
The curricula of Pharmacy schools cover topics in Clinical Pharmacy and includes practical
teaching.
3. Postgraduate education in CP
The postgraduate education in Bosnia and Hercegovina is accredited by a regulator.
Postgraduate education leading to an academic
degree
Postgraduate education not leading
to an academic degree
Master/ Diploma
degree PhD programmes CPD courses Certifications
Y
Y N N 2-semester duration
with no practical
teaching
4. Professional Practice in CP
In Bosnia and Hercegovina, Clinical Pharmacy is recognized an area of specialization by
the Federal ministry of health. The specialization has its application setting in both community
and hospital setting.
The Clinical Pharmacy specialization includes professional rights or job specifications and
is legally anchored.
20
Bulgaria (not validated)
Indicators
Inhabitants1 7 050 034
Practicing pharmacists/ 100 000 inhabitants2 16.52
Hospitals/100 000 population3 4.8
Community pharmacies/ 100 000 inhabitants4 ND
1. Characterization of the Bulgarian Clinical Pharmacy Education
Bulgaria has five faculties that provide an Integrated master’s degree in Pharmaceutical
Sciences.
The clinical pharmacy education in Bulgaria has started in the 1990s. However, regarding
the practical realization - it is still in a very early and developing stage. Most of the pharmacists
who have completed clinical pharmacy courses and are qualified do not work as clinical
pharmacists.
In terms of education, Bulgaria have an undergraduate specialization in clinical pharmacy
and a postgraduate specialization. The discipline `Pharmaceutical Care` is studied as a
compulsory discipline in all faculties in Bulgaria.
There are several big hospitals which have appointed clinical pharmacists.
2. Undergraduate education in CP
The postgraduate education in Bulgaria is accredited by a regulator.
The curricula of Pharmacy schools cover topics in Clinical Pharmacy, with at least 30%
practical teaching.
3. Postgraduate education in CP
Postgraduate education leading to an academic
degree
Postgraduate education not leading
to an academic degree
Master/ Diploma
degree PhD programmes CPD courses Certifications
Y Y
ND ND
6-semester
duration and
with some
practical
teaching
It is only available as a post
graduate program with duration
of 3 years. Each faculty develops
its own program having in mind
the unified standards of the
Ministry of health and Ministry of
education and science. The 3-
years courses end with a state
exam. Courses are available in
Bulgarian only and can be
accessed by MSc Pharm.
21
4. Professional Practice in CP
In Bulgaria, Clinical Pharmacy is recognised an area of specialization by the Ministry of
Health and the Bulgarian Pharmaceutical Union.
The Clinical Pharmacy specialization has its application in hospital pharmacy and is legally
anchored.
Clinical pharmacists are supposed to take part in the multidisciplinary decision-making
process in patient treatment and double check MD's prescription. Clinical pharmacists give
advice and select the most appropriate therapy having in mind both patients and medicinal
products' characteristics. They also have access to all medical documentation.
Hospitals which have more than 400 hospital beds, more than 10 clinics or medical
oncology, must appoint clinical pharmacists, provided by Regulations of Ministry of Health.
Implementing of such a policy can save up to 30 percent of the money for medical treatments
as well as to prevent side effects and adverse reactions caused by some medicines.
There are no recognised speciality areas in the domain of clinical pharmacy.
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hlthres_191-practising-pharmacists-per-100-
000/ - Data from 1999 (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
22
Croatia Indicators
Inhabitants1 4 105 493
Practicing pharmacists/ 100 000 inhabitants2 74.8
Hospitals/100 000 population3 1.5
Community pharmacies/ 100 000 inhabitants4 59
1. Characterization of the Croatian Clinical Pharmacy Education
There are two faculties that have an Integrated master’s degree in Pharmaceutical
Sciences in Croatia.
Croatia have a degree in clinical pharmacy, as a postgraduate degree and a full degree
that besides the one-year post diploma degree includes two years of specialization in clinics.
2. Undergraduate education in CP
Croatian pharmacy faculties provide undergraduate education covering clinical
pharmacy topics. The clinical pharmacy component is described on the following table:
Number of
semesters
Number of
contact hours per
semester
Number of ECTS
per
semester
Percentage of
Practical
teaching
Faculty of
Zagreb
1 89 6 33.3%
Faculty of
Split
1 45 4 33.3%
3. Postgraduate education in CP
The existing postgraduate education is accredited by a regulator.
Postgraduate education leading to an academic
degree
Postgraduate education not leading
to an academic degree
Master/ Diploma degree PhD programmes CPD courses Certifications
Y
N N
Y
The postgraduate specialist
study may be enrolled by the
applicants who have
completed the graduate
study in pharmacy and
passed the professional
examination. The study can
also be enrolled by junior
doctors-residents in Clinical
Pharmacy as theoretical part
of this health specialization.
Upon completion of the
study, the academic title
3-year postgraduate
program named
“Clinical Pharmacy
Specialization”,
which includes
practical teaching
23
University Master of Clinical
pharmacy is achieved.
It is important to note that the
postgraduate specialist study
in clinical pharmacy is also a
part of a 3-year specialization
in Clinical Pharmacy. (More
details on the following table)
4. Professional Practice in CP
There are two specialization areas of Clinical Pharmacy, one of them with application in
hospital and the other one, in primary care. Both specializations are recognised by the
Croatian Ministry of Health.
Although Clinical pharmacy is recognised as an area of specialization, does not include
specific professional rights or job specifications.
Additionally, the specialization in Clinical pharmacy is partially legally anchored in the
Croatian legislation (as it is recognised by the Ministry).
There are no speciality areas in the domain of clinical pharmacy recognised.
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 European Union – Eurostat. Health personnel statistics. Retrieved from
https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 Croatian Pharmaceutical Society. Retrieved from: https://www.farmaceut.org/hfd-i-farmaceutska-
struka/ljekarnistvo-u-hrvatskoj/ljekarnistvo- (accessed on 2019)
Number of
semesters
Number of
contact hours
per semester
Number of
ECTS per
semester
Percentage
of practical
teaching
Open to
foreigns Tuition fees
2 50 60 30 Yes 20 000 kunas
(around 2600€)
24
Cyprus (Not validated)
Indicators
Inhabitants1 864 236
Practicing pharmacists/ 100 000 inhabitants2 21.7
Hospitals/100 000 population3 9.8
Community pharmacies/ 100 000 inhabitants4 ND
Introductory Note
The following information concerns only to Northern Cyprus.
1. Characterization of the Cypriot Clinical Pharmacy Education
Northern Cyprus has five faculties that provide an Integrated master’s degree in
Pharmaceutical Sciences.
In pharmacy faculties under the Turkish Ministry of Higher Education, pharmacy programs
were elongated in the year 2005 from a 4-year course programs to a 5-year programs. As the
prolongation aimed to increase the number of courses and experiences that may contribute
to students pharmaceutical care providing competency development, the last incremented
year is reserved for some elective courses, graduation project, and a minimum 6-month
mandatory traineeship under the supervision of a pharmacist in the public pharmacy or in the
hospital.
Pharmaceutical care models including mentorship of the students on applying
pharmacotherapy are facing many challenges in Turkey. Of mention, newly adopted
curriculums do not contain enough exposure of students to advanced clinical pharmacy
practices, while on the other hand, senior practitioners carrying student’s mentorship role
deem the competence of providing clinical services. While clinical pharmacy hospital
department is only available in one hospital university in North Cyprus (Near East Hospital) and
two university hospitals in Turkey. OSCEs and clinical rounds are only compulsory in Near East
University, while rounds are also provided in few universities in Turkey.
2. Undergraduate education in CP
The undergraduate education in Northern Cyprus cover topics in clinical pharmacy
and this under-graduation is accredited by a regulator.
The clinical pharmacy undergraduate education includes practical teaching.
3. Postgraduate education in CP
The postgraduate education in Northern Cyprus is accredited by a regulator.
25
Postgraduate education leading to an academic
degree
Postgraduate education not leading
to an academic degree
Master/ Diploma degree PhD programmes CPD courses Certifications
Y Y
N N One Master/Diploma
degree in Clinical
Pharmacy (more details
on the following table)
Only pharmacists can
apply for these PhD
programme
Number of
semesters
Number of
contact hours
per semester
Number of
ECTS per
semester
Percentage of
practical
teaching
Open to
foreigns
Tuition
fees
4 156 16 56 yes ND
4. Professional Practice in CP
In Northern Cyprus, Clinical pharmacy is not recognised as an area of specialization,
however, it is part of the professional activities of both community and hospital pharmacists.
There are no recognised speciality areas in the domain of clinical pharmacy.
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hlthres_191-practising-pharmacists-per-100-
000/ - Data from 2013 (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
26
Czech Republic Indicators
Inhabitants1 10 625 449
Practicing pharmacists/ 100 000 inhabitants2 60.73
Hospitals/100 000 population3 2.4
Community pharmacies/ 100 000 inhabitants4 ND
1. Characterization of the Czech Clinical Pharmacy Education
Czech Republic has two faculties that provide an Integrated master’s degree in
Pharmaceutical Sciences. (Faculty of Hradec Kralove and Faculty of Brno).
The discipline of Clinical Pharmacy is currently managed by two professional societies:
Section of Clinical Pharmacy of Czech Pharmaceutical Society (https://www.cfs-
cls.cz/Sections/Section-of-Clinical-Pharmacy/ ) and Czech Professional Society of Clinical
Pharmacy (https://www.coskf.cz/ ). The Section of Clinical Pharmacy is responsible for interests
in Clinical Pharmacy for many years.
Education focused on Clinical Pharmacy and Pharmaceutical Care is provided in curricula
of both faculties, however, in broader sense and for longer time in Faculty of Pharmacy in
Hradec Kralove.
2. Undergraduate education in CP
The undergraduate education in Czech Republic is accredited by a regulator.
Croatian pharmacy faculties provide undergraduate education covering clinical
pharmacy topics. The clinical pharmacy component is described on the following table:
Number of
semesters
Number of contact
hours per semester
Number of ECTS per
semester
Percentage of
practical teaching
Faculty 1 2
Mandatory: 70
lectures, 36
seminars
Optional: 66
lectures, 56
seminars
Mandatory: 8
Optional: 11 50%
Faculty 2 1 21 4 70%
3. Postgraduate education in CP
The postgraduate education in Czech Republic is accredited by a regulator.
27
Postgraduate education leading to
an academic degree
Postgraduate education not leading to an
academic degree
Master/ Diploma
degree PhD programmes CPD courses Certifications
N
Y Y Y
One PhD
programme called
“Clinical and Social
Pharmacy”. Can
be accessed by
any professional
who is graduated in
Master studies in
Pharmacy, Medical
Bio analytics or a
related degree
program.
There are lots of
seminars,
workshops,
symposia and
conferences
included in
continuous
professional
education
covering clinical
pharmacy topics,
which is mandatory
for pharmacists, by
the Czech law.
Many of these
activities are
developed by the
Section of Clinical
Pharmacy of the
Czech
Pharmaceutical
Society.
Pharmacists can get the
specialization in Clinical
Pharmacy managed by the
Institute of Postgraduate
Education on behalf of
Ministry of Health. There are
currently two programs in
clinical pharmacy (one
from 2005 and a new one
from 2015).
The sylabus is very
comprehensive required at
least 5 years of clinical
practice, courses and
trainings it is finnished by
passing an exam (including
defence of a thesis, case
reports and theoretical
knowledge-based
questions)
4. Professional Practice in CP
The Czech Ministry of Health recognise Clinical Pharmacy as an area of specialization.
Named as Clinical Pharmacy Specialization, this specialization has its application in healthcare
facilities for outpatient and inpatients. Czech Clinical Pharmacy specialization include some
job specifications and professional rights.
A graduate specialized in clinical pharmacy is entitled to independently provide clinical-
pharmaceutical care for outpatient or inpatient care and clinic-pharmaceutical services to
physicians, is involved in a multidisciplinary therapeutic team or works independently as a
consultant. He/she is entitled to perform systematic comprehensive and selective evaluation
of patient medication, consultancy assessment of patient medication, initial medication
control at admission to the hospital, medication control in hospitalized patients,
pharmacotherapeutic recommendations including discharge of patients, education of
patients about pharmacotherapy. He/she is entitled to lead the Clinical Pharmacy
department/ward.
The specialization is legally anchored: Act no. 95/2004.
28
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hlthres_191-practising-pharmacists-per-100-
000/ - Data from 2013 (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
29
Denmark Indicators
Inhabitants1 5 789 957
Practicing pharmacists/ 100 000 inhabitants2 51.45
Hospitals/100 000 population3 ND
Community pharmacies/ 100 000 inhabitants4 3.9
1. Characterization of the Danish Clinical Pharmacy Education
Denmark has two faculties that provide an Integrated master’s degree in Pharmaceutical
Sciences.
In 2010 was established a master’s degree in clinical pharmacy at the University of Southern
Denmark. University of Copenhagen had during several years an optional course in Clinical
Pharmacy at the Master education. Clinical pharmacy practice has gradually developed for
30 years but is best implemented in secondary care (Hospitals).
2. Undergraduate education in CP
The undergraduate education that exists covers topics about clinical pharmacy in both
two faculties.
The undergraduate education is accredited by a regulator.
3. Postgraduate education in CP
The postgraduate education in Denmark is not accredited by a regulator.
Postgraduate education leading to
an academic degree
Postgraduate education not leading to an
academic degree
Master/ Diploma
degree PhD programmes CPD courses Certifications
N N N
Y
Details on the following
table
Name of the
certification Number of Hours Practical teaching Additional details
Postgraduate
diploma in Clinical
Pharmacy
Each course 2-3
days yes
20 ECTS
Includes 8 separate
course
30
4. Professional Practice in CP
In Denmark, Clinical pharmacy is not recognised as an area of specialization. Additionally,
there is no recognition of any speciality area in the domain of clinical pharmacy.
The professional practice of Clinical Pharmacy is part of the professional activities of both
community and hospital pharmacists.
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 European Union – Eurostat. Health personnel statistics. Retrieved from
https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2017), Health at a Glance 2017: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/health_glance-2017-en.
31
Estonia Indicators
Inhabitants1 1 319 133
Practicing pharmacists/ 100 000 inhabitants2 72.47
Hospitals/100 000 population3 2.3
Community pharmacies/ 100 000 inhabitants4 37.3
1. Characterization of the Estonia’s Clinical Pharmacy Education
Estonia has one faculty that have an MSc in Pharmaceutical Sciences.
Clinical pharmacy is taught on the 4-th year (5 ECTS) within pharmacy curriculum at the
University of Tartu. The course is supported by other related courses as Clinical pharmacy (2
ECTS), Social pharmacy and drug safety II (5 ECTS) and Communication in Healthcare and
pharmacy (1 ECTS). No separate curriculum available for clinical pharmacy in Estonia.
2. Undergraduate education in CP
The undergraduate education that exists covers topics about clinical pharmacy. This
component is distributed in the following table:
Number of
semesters
Number of contact
hours per semester
Number of ECTS per
semester
Percentage of practical
teaching
8 65 5 50
The pharmacy curriculum including Clinical Pharmacy course is a subject for accreditation
by the Estonian Quality Agency for Higher and Vocational Education.
3. Postgraduate education in CP
The postgraduate education in Estonia is not accredited by a regulator.
Postgraduate education leading to
an academic degree
Postgraduate education not leading to an
academic degree
Master/ Diploma
degree PhD programmes CPD courses Certifications
N N N N
4. Professional Practice in CP
In Estonia, Clinical Pharmacy is not recognised as an area of specialization. Additionally,
there is no recognition of speciality areas in the domain of Clinical Pharmacy.
Thus, the clinical pharmacy practise is part of the professional activities of only hospital
pharmacists.
32
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 European Union – Eurostat. Health personnel statistics. Retrieved from
https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
33
Finland (Not validated)
Indicators
Inhabitants1 5 513 130
Practicing pharmacists/ 100 000 inhabitants2 107.76
Hospitals/100 000 population3 4.7
Community pharmacies/ 100 000 inhabitants4 14.7
1. Characterization of the Finland’s Clinical Pharmacy Education
Finland has three faculties that provide an Integrated master’s degree in Pharmaceutical
Sciences.
The role of clinical pharmacy has been increased markedly. In education, for example the
medication review competence is included in new curriculum. In practice, the need for
interprofessional medication review services are notified.
2. Undergraduate education in CP
The undergraduate education cover topics about clinical pharmacy.
The undergraduate education in Finland is not accredited by a regulator.
3. Postgraduate education in CP
The postgraduate education in Finland is not accredited by a regulator.
Postgraduate education leading to an
academic degree
Postgraduate education not leading to an
academic degree
Master/ Diploma
degree PhD programmes CPD courses Certifications
N
Y Y
ND
Two out of the three
existing faculties provide
PhD programmes in
Clinical Pharmacy, which
can be accessed by
Mpharm and MD.
Courses on Medication
review and
comprehensive
medication review
4. Professional Practice in CP
Finnish National Agency for education recognise Clinical Pharmacy as an area of
specialization. The specialization in Clinical Pharmacy has application in both community and
hospital pharmacies and give some job specifications and professional rights to the specialised
pharmacists, for example, the specialised pharmacists can perform comprehensive
medication review as a job specification. Also, as an area of specialization, Clinical Pharmacy
is not legally anchored in the Finnish legislation.
There is no recognition of any speciality areas in the domain of clinical pharmacy.
34
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 European Union – Eurostat. Health personnel statistics. Retrieved from
https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
35
France Indicators
Inhabitants1 64 768 552
Practicing pharmacists/ 100 000 inhabitants2 106.76
Hospitals/100 000 population3 4.8
Community pharmacies/ 100 000 inhabitants4 32.9
1. Characterization of the French Clinical Pharmacy Education
France has 24 faculties that provide an Integrated master’s degree in Pharmaceutical
Sciences.
The development of Clinical Pharmacy in France is growing since the 2000's at hospital and
more recently in community pharmacy (patient education, flu injection...). Clinical Pharmacy
is an official academic discipline at university since 1984.
France is running an important reform of pharmacy studies for under- graduated and
postgraduate (4-year residency program). This reform reinforces the theory and practical
teaching of Clinical Pharmacy and is related to the introduction of new Clinical Pharmacy
services at hospital and in the community.
2. Undergraduate education in CP
No data available on undergraduate education covering clinical pharmacy topics.
Undergraduate education is accredited by the national agency.
3. Postgraduate education in CP
For new Clinical Pharmacy services at community pharmacies it is mandatory to validate an
accredited program. For the general Continuous Education Program, there is an accreditation
by the national agency.
Postgraduate education leading to
an academic degree
Postgraduate education not leading to an
academic degree
Master/ Diploma
degree PhD programmes CPD courses Certifications
ND
N Y Y
There is no specific
PhD program in
Clinical Pharmacy
Many courses
France has postgraduate
programmes/Certifications in
Clinical Pharmacy in order to
provide
Clinical Pharmacy services at
community pharmacies, such
as, Flu injection, Patient
Therapeutic education and
medication review.
36
4. Professional Practice in CP
In France, Clinical pharmacy is not recognised as an area of specialization, although is part
of the professional activities of both community and hospital pharmacists.
- Hospital pharmacists historically have a specialization in Clinical Pharmacy during their
residency (minimum of 6 month of practice and 100 hours of teaching);
- Community pharmacists have the general education including teaching in Clinical
Pharmacy during their 5th year of pharmacy including CP activities at hospital.
There are no specific areas officially recognised in the domain of clinical pharmacy.
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 European Union – Eurostat. Health personnel statistics. Retrieved from
https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
37
Germany Indicators
Inhabitants1 82 792 351
Practicing pharmacists/ 100 000 inhabitants2 64.6
Hospitals/100 000 population3 3.9
Community pharmacies/ 100 000 inhabitants4 23.9
1. Characterization of the Germany’s Clinical Pharmacy Education
Germany has 22 faculties that provide an Integrated Master degree in Pharmaceutical
Sciences.
2. Undergraduate education in CP
The undergraduate education in Germany is not accredited by a regulator.
The License Ordinance for Pharmacists (Approbationsordnung für Apotheker) is the basis
of the uniform nationwide training for pharmacists on the 22 faculties of pharmacy in Germany.
It determines the following distribution of hours: Pharmacology and Clinical Pharmacy: in total
406 h with 112 h practical training and 98 h seminars.
The model study programme provides 9 ECST for Clinical Pharmacy, 11 ECTS for Pharmacology,
5 ECTS for Pharmacotherapy, 8 ECTS for Pathophysiology and Pathology. All these modules
belong to the main subject Pharmacology and Clinical Pharmacy.
3. Postgraduate education in CP
The postgraduate education in Germany is accredited by a regulator.
Postgraduate education leading to an
academic degree
Postgraduate education not leading to an
academic degree
Master/ Diploma
degree PhD programmes CPD courses Certifications
N
Y
ND
Y
All Germany
pharmacy faculties
provide PhD
programmes in
Clinical Pharmacy.
In general, only
pharmacists can
access to these PhD
programmes.
- 4-week course to
obtain a certificate
on Clinical
pharmacy (Uni
Tübingen);
- Specialization on
clinical pharmacy,
issued by the
chamber of
pharmacists.
4. Professional Practice in CP
Apothekerkammern der Länder (Chambers of Pharmacists of the Federal States) recognise
Clinical Pharmacy an area of specialization in Germany. Clinical Pharmacy specialization is
38
not legally anchored. This specialization has its application in hospital pharmacies and does
not include any job specifications or professional rights.
Medication Management and Infectiology are speciality areas in the domain of clinical
pharmacy.
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 European Union – Eurostat. Health personnel statistics. Retrieved from
https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
39
Greece (Not validated)
Indicators
Inhabitants1 10 741 165
Practicing pharmacists/ 100 000 inhabitants2 ND
Hospitals/100 000 population3 2.6
Community pharmacies/ 100 000 inhabitants4 88.3
1. Characterization of the Greece’s Clinical Pharmacy Education
According to FIP World List of Pharmacy Schools5, Greece has four faculties that provide
an Integrated Master in Pharmaceutical Sciences.
2. Undergraduate education in CP
The undergraduate education in Greece is accredited by a regulator.
The pharmacy schools assure that the undergraduate programmes in Pharmaceutical
Sciences covers clinical pharmacy topics, however, without practical teaching.
3. Postgraduate education in CP
The postgraduate education in Greece is accredited by a regulator.
Postgraduate education leading to an
academic degree
Postgraduate education not leading to
an academic degree
Master/ Diploma
degree PhD programmes CPD courses Certifications
Y Y
N N
One available
Master/diploma
degree (details
on the following
table)
Only one of the existing
faculties provide a PhD
programme in Clinical
Pharmacy.
The PhD programme is
available only for
pharmacists.
Number of
semesters
Number of
contact hours
per semester
Number of
ECTS per
semester
Percentage of
practical
teaching
Open to
foreigns
Tuition
fees
3 330 30 40 yes ND
4. Professional Practice in CP
In Greece, Clinical Pharmacy is considered an area of specialization but the specialization
is not legally anchored. The specialization does not include any job specifications or
professional rights.
40
There are no recognised speciality areas in the domain of clinical pharmacy.
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 European Union – Eurostat. Health personnel statistics. Retrieved from
https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
5 International Pharmaceutical Federation (FIP): Official World List of Pharmacy Schools. Retrieved from
http://academic_institutional_membership.fip.org/world-list-of-pharmacy-schools/ (accessed on April
26th, 2020)
41
Hungary Indicators
Inhabitants1 9 778 371
Practicing pharmacists/ 100 000 inhabitants2 77.28
Hospitals/100 000 population3 1.8
Community pharmacies/ 100 000 inhabitants4 23.5
1. Characterization of the Hungarian Clinical Pharmacy Education
Hungary has four faculties that provide an Integrated master’s degree in Pharmaceutical
Sciences.
Officially, the "subject clinical pharmacy" became a mandatory part of the curricula since
1987, after the declaration of the Hospital Pharmacists' Conference organised for Socialistic
Countries in 1986 in Budapest. The practical implementation was very slow, but in the last
decade important development could be seen.
2. Undergraduate education in CP
The undergraduate education that exists covers topics about clinical pharmacy in all four
faculties. The clinical pharmacy component is distributed as shown in the following table:
Number of
semesters
Number of contact
hours per semester
Number of ECTS per
semester
Percentage of
practical teaching
Faculty 1 1 98 6 40
Faculty 2 1 94 5 30
Faculty 3 1 84 4 15
Faculty 4 1 96 5 20
The undergraduate education is accredited by a regulator.
3. Postgraduate education in CP
The postgraduate education in Hungary is accredited by a regulator.
Postgraduate education leading to an
academic degree
Postgraduate education not leading to
an academic degree
Master/ Diploma
degree PhD programmes
N
Y Y
All four faculties have PhD
programmes in clinical
pharmacy, which can be
accessed only by
pharmacists.
Clinical pharmacy is not an
independent postgraduate
specialization branch but exists as part
of the 3-year hospital pharmacy post-
gradual education.
42
4. Professional Practice in CP
Clinical Pharmacy is an area of specialization in Hungary with application only at hospital
level. The specialization is recognised by The Hungary National Board of specializations in
medicine/pharmacy. The title that is gained after the successful practical and theoretical
examination is “Pharmacist specialized in hospital-clinical pharmacy”. However, this
specialization does not include specific professional rights or job specifications. Additionally,
the specialization is not legally anchored in the Hungarian legislation.
There are no other recognised speciality areas in the domain of clinical pharmacy.
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 European Union – Eurostat. Health personnel statistics. Retrieved from
https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
43
Iceland (Not validated)
Indicators
Inhabitants1 348 450
Practicing pharmacists/ 100 000 inhabitants2 110.9
Hospitals/100 000 population3 2.4
Community pharmacies/ 100 000 inhabitants4 19.2
1. Characterization of the Iceland’s Clinical Pharmacy Education
In Iceland, there is one University (University of Iceland) which graduates pharmacists. There
is both BS program in Pharmacy (three years and 180 ECTS) as well as MS program. Students
must complete the MS programme to gain a professional certification as a pharmacist. MS
program can be Pharmacy - two years and 120 ECTS (and then professional certification as a
pharmacist) or Pharmaceutical Sciences - two years and 120 ECTS.
Since 2016 you can also graduate as a clinical pharmacist - Clinical Pharmacy - three years
and 90 ECTS but only after having certification as a pharmacist. Clinical pharmacy courses are
in collaboration with National Hospital of Iceland (Landspitali) and University College London
and the Royal Pharmaceutical Society.
In comparison with other countries the pharmacist role in the Icelandic health care
system, outside community pharmacies, is rather limited. The actual development of the
clinical pharmacy in Iceland has only occurred over the past two decades, and the central
focus has been in the hospital setting. Currently, no pharmacists are in primary care clinics to
provide pharmacist cognitive services (such as pharmaceutical care) to patients or other
health care professionals. Nonetheless, there are two settings, the community pharmacy, and
hospital, where it is essential to explain the pharmacist patient-centred role.
Looking back at history, there are two milestones, which are important to note regarding
community pharmacist development in Iceland. Firstly, around 1980, pharmacies stopped
drug production and community pharmacists in Iceland almost completely lost their monopoly
on manufacturing medicine. Secondly, in 1996, following drug legislation changes,
pharmacies in Iceland went from being pharmacist owned (but their number and geographic
location were decided by the Ministry of Health) to freedom of establishment. The task of
dispensing in the community pharmacy remains, but they have not yet expanded their
responsibilities. Although community pharmacists are obliged by law (since 1996) to provide
pharmaceutical care, but presently, no pharmacists are providing pharmaceutical care in the
community pharmacy settings.
In recent years, there has been a sharp increase in the pharmacist-led clinical practice within
the hospital setting. For many years, pharmacists have frequently been helping patients and
their providers manage drug therapies wards within Landspítali - The National University
Hospital of Iceland. In 2007, three pharmacists worked on clinical tasks within the hospital
setting. Now, the pharmacists are 12 and the tasks have multiplied. Further, they consult on six
wards and are engaged in the admission centre, which prepares patients for surgeries.
Additionally, pharmacists are members of nutrition and poison control teams. In 2010, a
medicines information centre was established where pharmacists promote the use of
44
evidence-based medicine by answering all kinds of drug related questions from other health
care professionals within the hospital setting. As mentioned above since 2016, there has been
a collaboration between the University of Iceland, Landspítali - The National University Hospital
of Iceland, University College London, and Royal Pharmaceutical Society regarding a clinical
pharmacy educational program. Due to the program, it is assumed that after 2019, two clinical
pharmacists will graduate every year in Iceland.
2. Undergraduate education in CP
Iceland’s pharmacy school provides an Integrated Master in Pharmaceutical Sciences
that covers clinical pharmacy topics. The education includes practical teaching.
3. Postgraduate education in CP
Postgraduate education leading to an academic
degree
Postgraduate education not
leading to an academic degree
Master/ Diploma degree PhD programmes CPD courses Certifications
Y Y
N N
There is one available
Master/Diploma degree in
Clinical Pharmacy (3-year).
Work based learning, this
Foundation Training
programme enables
foundation pharmacists to
work, learn and develop
through access to structured
and managed training, and
offers a real opportunity to
ensure that pharmacists access
training in the early careers in
within clinical settings, to
provide safe and effective
patient care delivered in a
confident and professional
manner.
Iceland has one
PhD programme
available on the
existing faculty.
The PhD
programme is
available for
Pharmacists and
other science
majors.
4. Professional Practice in CP
In Iceland, Clinical Pharmacy is not considered an area of specialization.
Also, there are no recognised speciality areas in the domain of clinical pharmacy.
45
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hlthres_191-practising-pharmacists-per-100-
000/ - Data from 2014 (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2017), Health at a Glance 2017: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/health_glance-2017-en.
46
Ireland (Not validated)
Indicators
Inhabitants1 4 830 392
Practicing pharmacists/ 100 000 inhabitants2 ND
Hospitals/100 000 population3 2.1
Community pharmacies/ 100 000 inhabitants4 36.2
1. Characterization of the Ireland’s Clinical Pharmacy Education
Ireland has three faculties that provide an Integrated master’s degree in Pharmaceutical
Sciences.
Clinical Pharmacy in Ireland is well established in large, teaching hospitals but has
developed to different degrees and inconsistently in smaller hospitals. It is similar in its range of
activities to the UK, but without yet any formal modifying or prescribing competencies.
Pharmacists in Ireland think of clinical pharmacy as a hospital based.
2. Undergraduate education in CP
All three faculties have the same undergraduate education covering topics about clinical
pharmacy, with eight semesters, 25 contact hours per semester and 5 ECTS per semester.
The undergraduate education in Ireland is accredited by a regulator.
3. Postgraduate education in CP
All postgraduate education is not accredited by a regulator.
Postgraduate education leading to an academic
degree
Postgraduate education not leading
to an academic degree
Master/ Diploma degree PhD programmes CPD courses Certifications
Y Y Y
N
There are two
Masters/Diploma
degrees in Ireland. A
Master’s degree in
Hospital Pharmacy also
exists and this
incorporates clinical
pharmacy in its syllabus. It
has been included in the
table. Learning in both
takes place mainly in the
workplace so most of the
time is spent in practical
activities
All faculties provide a PhD
programmes in Clinical
Pharmacy. Access is
determined by academic
ability and the availability of
clinical resources. No other
health care professional
would want to access a
clinical pharmacy PhD
because it would not help
them in their career. Ireland
treats each PhD individually,
so a 'clinical pharmacy PhD
programme', does not exist.
One available
course on
“Cardiology in
clinical
pharmacy
practice”, which
takes 120 hours
to complete
and contain
practical
teaching.
47
4. Professional Practice in CP
In Ireland, Clinical Pharmacy is not recognised as an area of specialization. In addition,
there is no recognition of any speciality areas in the domain of Clinical Pharmacy.
Thus, the clinical pharmacy practise is part of the professional activities of both community
and hospital pharmacists.
Clinical Pharmacy is specified in the job descriptions of hospital pharmacy employers but
does not feature as a component of any other descriptions. Community Pharmacists and their
representatives use the term pharmacy services to include clinical activities.
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 European Union – Eurostat. Health personnel statistics. Retrieved from
https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
48
Italy (Not validated)
Indicators
Inhabitants1 60 483 973
Practicing pharmacists/ 100 000 inhabitants2 109.72
Hospitals/100 000 population3 1.9
Community pharmacies/ 100 000 inhabitants4 30.8
1. Characterization of the Italian Clinical Pharmacy Education
According to FIP World List of Pharmacy Schools5, Italy has 29 faculties that provide
an Integrated master’s degree in Pharmaceutical Sciences.
2. Undergraduate education in CP
No data available
3. Postgraduate education in CP
No data available
4. Professional Practice in CP
Clinical Pharmacy is not recognised as an area of specialization in Italy, however, is part of
the professional activities of hospital pharmacists. Evaluation of prescription appropriateness,
detection of ADRs, and near miss errors, drug therapy adherence monitoring are examples of
the practise of Clinical Pharmacy in Italy.
There are no specific areas officially recognised as speciality areas in the domain of clinical
pharmacy.
49
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 European Union – Eurostat. Health personnel statistics. Retrieved from
https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
5 International Pharmaceutical Federation (FIP): Official World List of Pharmacy Schools. Retrieved from
http://academic_institutional_membership.fip.org/world-list-of-pharmacy-schools/ (accessed on April
26th, 2020)
50
Kosovo Indicators
Inhabitants1 1 845 300
Practicing pharmacists/ 100 000 inhabitants2 ND
Hospitals/100 000 population2 ND
Community pharmacies/ 100 000 inhabitants2 ND
1. Characterization of the Kosovo’s Clinical Pharmacy Education
Kosovo has three faculties that provide an Integrated master’s degree in Pharmaceutical
Sciences.
Kosovo has only recently started to recognize Clinical Pharmacy & Pharmaceutical care as
areas requiring clear development. In this regard, there has been considerable progress in
capacity building, but specific services are yet to be designed and rolled out.
2. Undergraduate educationin CP
The undergraduate education that exists covers topics about clinical pharmacy in two
semesters, with a total of 30 contact hours per semester, 13 ECTS per semester and 60% of
practical teaching.
The undergraduate education is accredited by a regulator.
3. Postgraduate education in CP
The postgraduate education in Kosovo is not accredited by a regulator.
Postgraduate education leading to an
academic degree
Postgraduate education not leading to
an academic degree
Master/ Diploma degree PhD programmes CPD courses Certifications
N N
Y
N
Pharmaceutical Chamber
and Pharmaceutical
Society, when required
basis, offers courses related
to Clinical Pharmacy and
Pharmaceutical Care.
4. Professional Practice in CP
Clinical Pharmacy is recognised by the Kosovo Chamber of Pharmacists, as an area of
specialization. Named as Clinical Pharmacy Specialization, this specialization has its
application in both hospital and community pharmacy settings. Kosovo’s Clinical Pharmacy
specialization include some job specifications and professional rights such as clinical
pharmacy services in hospitals. The specialization is legally anchored (Administrative Instruction
for Specialistic Education in Kosovo by the Ministry of Health).
51
In addition, there are no specific areas officially recognised as speciality areas by the
national authority or professional body in the domain of clinical pharmacy.
References
1 World Bank Group. Data from 2018. Retrieved from: https://data.worldbank.org/country/XK (accessed
on June 21st, 2020);
2 Kosovo Agency of Statistics. Health Statistics, 2018. Prishtina, October 2019.
52
Latvia Indicators
Inhabitants1 1 934 379
Practicing pharmacists/ 100 000 inhabitants2 84.9
Hospitals/100 000 population3 3.2
Community pharmacies/ 100 000 inhabitants4 40.2
1. Characterization of the Latvian Clinical Pharmacy Education
Latvia has two faculties that provide an Integrated Master in Pharmaceutical Sciences:
Latvian University and Riga Stradins University. There is also the Rigas 1. Medical College, that
only provide a 1st level of higher education of pharmacy assistant. The students of Rigas
1.Medical College then, could continue 5-year studies at Riga Stradins University (part-time
studies) to receive the Master Degree.
2. Undergraduate education in CP
No data available
3. Postgraduate education in CP
Postgraduate education leading to an academic
degree
Postgraduate education not
leading to an academic degree
Master/ Diploma
degree PhD programmes CPD courses Certifications
Y Y
N N One available
master (taught in
Latvian) with 50%
practical teaching
Only one of the existing
faculties provide a PhD
programme in Clinical
Pharmacy, which can be
accessed only by
pharmacists.
4. Professional Practice in CP
Clinical Pharmacy is recognised as an area of specialization in Latvia.
The specialization does not lead to any specific professional rights or have any job
specifications. Nevertheless, Clinical pharmacists have more possibilities, such as, consultant
medical professionals, review patient drugs, but their role is as well more consultative (cannot
prescribe/remove drug without physicians’ validation).
Clinical Pharmacy is classified as a separate profession in Latvian law by the Latvian
Government. The Clinical Pharmacy specializations has its application at hospital level,
53
however, it is not mandatory to be only at hospital level. Also, some professionals start practical
work at community pharmacy level.
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 European Union – Eurostat. Health personnel statistics. Retrieved from
https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
54
Lithuania Indicators
Inhabitants1 2 796 400
Practicing pharmacists/ 100 000 inhabitants2 100.2
Hospitals/100 000 population3 3.2
Community pharmacies/ 100 000 inhabitants4 44.1
1. Characterization of the Lithuania’s Clinical Pharmacy Education
Lithuania has two faculties that have Integrated Master in Pharmaceutical Sciences.
• Lithuanian University of Health Sciences, Faculty of Pharmacy;
• Vilnius University, Faculty of Medicine
Lithuania provides five-year full-time course of pharmacy education that prepares
graduates who can function within a diverse and complex pharmaceutical setting, for
community, industrial, hospital pharmacy. It is based on personal and patient care
competencies with deep research training, integrating pharmaceutical science and practise.
However, Clinical Pharmacy is not officially recognised as a distinct specialization.
2. Undergraduate education in CP
The undergraduate education that exists covers topics about clinical pharmacy in the
following curricula modules: Disease Management, Pharmacy practice, Pharmaceutical
Care, Essentials of Internal Medicine, Pharmacology and Phytotherapy. The clinical pharmacy
component has practical teaching.
The undergraduate education is accredited.
3. Postgraduate education in CP
The postgraduate education is accredited.
Postgraduate education leading to an academic
degree
Postgraduate education not
leading to an academic degree
Master/ Diploma
degree PhD programmes CPD courses Certifications
N N N N
4. Professional Practice in CP
In Lithuania, Clinical Pharmacy is not recognised as an area of specialization. Additionally,
there is no recognition of any specialty areas in the domain of clinical pharmacy.
Clinical Pharmacy is part of the professional activities of both community and hospital
pharmacists.
55
The integrated multidisciplinary pharmacy programme focuses on the development of
pharmacists’ practical, managerial and leadership, educational and research competences
for professional practice in pharmaceutical organisations/companies, scientific research
institutions, state pharmacy offices, and other related pharmacy fields. Programme is tightly
integrated with special studies in medicine and social sciences and prepare pharmaceutical
professionals for pharmaceutical activity in different areas of health.
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 European Union – Eurostat. Health personnel statistics. Retrieved from
https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 Health Information Centre of Institute of Hygiene. Health Statistics of Lithuania 2017. Retrieved
from: http://hi.lt/uploads/pdf/leidiniai/Statistikos/LT_sveik_stat_health/Lietuvos_sveikatos_statistik
a_2017_2.pdf.
56
Malta (Not validated)
Indicators
Inhabitants1 475 701
Practicing pharmacists/ 100 000 inhabitants2 131.2
Hospitals/100 000 population3 2.1
Community pharmacies/ 100 000 inhabitants4 ND
1. Characterization of the Malta’s Clinical Pharmacy Education
Malta has one faculty that provides an Integrated master’s degree in Pharmaceutical
Sciences.
The two-cycle undergraduate programme leading to a degree in pharmacy considers
development of knowledge, skills and competences related to clinical pharmacy through a
longitudinal approach where the related aspects are tackled right from the first year of the 5.5
years of the course with increasing amounts through the programme. Moreover, the Faculty
offers a postgraduate specialized master’s in advanced clinical pharmacy and a professional
Doctorate in Pharmacy that focuses specifically to develop practice, research and leadership
skills in clinical pharmacy. In terms of professional practice, clinical pharmacy services are
offered through private community pharmacy particularly with regards to chronic disease
management, however this is unstructured and not directly remunerated. In the hospital
services, clinical pharmacy services are developed to different extents within medical
specialities.
2. Undergraduate education in CP
The only faculty that exists provide accredited undergraduate education that cover topics
about clinical pharmacy.
3. Postgraduate education in CP
The postgraduate education in Malta is accredited by a regulator.
Postgraduate education leading to an academic
degree
Postgraduate education not
leading to an academic degree
Master/ Diploma degree PhD programmes CPD courses Certifications
Y Y Y
N One available master’s in
clinical pharmacy (details
on the following table)
The available PhD
programme is open
only for pharmacists.
In-service
programmes in
hospitals (15 hours)
57
4. Professional Practice
In Malta, Clinical Pharmacy is not recognised as an area of specialization as well as there
is no speciality areas in the domain of CP.
Thus, the clinical pharmacy practise is part of the professional activities of both community
and hospital pharmacists.
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 European Union – Eurostat. Health personnel statistics. Retrieved from
https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
Number of
semesters
Number of
contact hours
per semester
Number of
ECTS per
semester
Percentage of
Practical
teaching
Open to
foreigns
Tuition
fees
2 ND 45 75 Yes ND
58
The Netherlands Indicators
Inhabitants1 17 181 084
Practicing pharmacists/ 100 000 inhabitants2 20.83
Hospitals/100 000 population3 1.6
Community pharmacies/ 100 000 inhabitants4 11.7
1. Characterization of the Dutch Clinical Pharmacy Education
Netherlands has three faculties that provide an Integrated master’s degree in
Pharmaceutical Sciences.
Clinical pharmaceutical care has been developed in pharmacy practice a research since
for more than 20 years. Clinical Pharmaceutical care is embedded in pharmacy practice
guidelines of community pharmacy as medication review and counselling practice. Further
development and innovative practices are not adequately translated in renumerations.
The master’s in pharmacy is fully dedicated to clinical pharmacy and pharmaceutical
care. The bachelors focus on beta sciences and give the necessary backbone for that master.
Clinical pharmacy is more and more patient oriented, and even more after the reform in 2019.
2. Undergraduate education in CP
The undergraduate education in Netherlands is not accredited by a regulator.
The clinical pharmacy component is described on the following table:
Number of
semesters
Number of contact
hours per semester
Number of ECTS per
semester
Percentage of
practical teaching
Faculty 1 4 30 10 15
Faculty 2 4 30 10 25
Faculty 3 4 30 10 15
59
3. Postgraduate education in CP
The postgraduate education in Netherlands is accredited by a regulator.
Postgraduate education leading to an
academic degree
Postgraduate education not leading to an
academic degree
Master/ Diploma
degree PhD programmes CPD courses Certifications
N Y Y Y
An additional master
is not necessary as
the regular
curriculum is based
on clinical pharmacy
and pharmaceutical
care.
All three existing
faculties provide PhD
programmes in
Clinical Pharmacy.
PhD programmes are
available for any
person with a MSc
degree.
PAOF is the largest
course. Also, there
are many and
diverse courses in
specific disease
areas.
“PIAF”,
“Pharmacotherapy
expert” and “IVM
medication reviews”
4. Professional Practice in CP
Clinical pharmacy is perceived as the professional expertise of the practice of
pharmaceutical patient care that is at the heart of the practice of pharmacists, independent
of the setting in community or hospital pharmacies. This care practice is described for all
pharmacists in the Netherlands as one of the foundational components of the pharmacy
practice in the Charter professionalism of the pharmacist. Ideally, clinical pharmacy practice
should be a seamless care practice over community and hospital level.
In Netherlands, Clinical Pharmacy is not recognised informally within the professional
organisations as an area of specialization but is strongly part of the professional activities of
both community and hospital pharmacists.
There are no recognised speciality areas in the domain of clinical pharmacy.
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 European Union – Eurostat. Health personnel statistics. Retrieved from
https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
60
Norway Indicators
Inhabitants1 5 295 619
Practicing pharmacists/ 100 000 inhabitants2 83.54
Hospitals/100 000 population3 0.98
Community pharmacies/ 100 000 inhabitants4 17.1
1. Characterization of the Norway’s Clinical Pharmacy Education
Norway has 6 faculties that provide an Integrated master’s degree in Pharmaceutical
Sciences.
2. Undergraduate education in CP
The undergraduate education in Norway is accredited by a regulator.
No specific clinical pharmacy course in the bachelor’s programs, except for one university,
For the others; part of the skills you need as a clinical pharmacist is integrated in other courses.
Two universities offer specific clinical pharmacy courses in the Master period.”
3. Postgraduate education in CP
Postgraduate education is organized by one University, if you take the exams you will be
credited and - if you follow the University programme with several courses plus a scientific
research project, you can ultimately get a practice-based master’s in clinical pharmacy. This
master is regarded to be similar to a master’s in pharmacy and is not accredited to be better
in clinical settings. However, when you apply for a job in hospitals with a clinical master, you
will probably have a benefit.
Postgraduate education leading to an academic
degree
Postgraduate education not
leading to an academic degree
Master/ Diploma degree PhD programmes CPD courses Certifications
Y Y Y
N
3-year Experiences based
postgraduate master’s in
clinical pharmacy. Consist of
theory and practice” (details
on the following table)
This program is practice based,
so the students come to Oslo to
take the courses (a week or so)
They are encouraged and get
tasks to get the practice in
between courses at their own
work, that could be at hospitals
or in pharmacies. The practice
should involve patients.
Students become MSc in
clinical pharmacy, many then
will have 2 MSc.
Four out of the 6
existing faculties
provide PhD
programmes
“Advanced
pharmacotherap
y (10ECTS)” – 3
different courses,
“Advanced
pharmacokinetics
(10ECTS)” and
“TDM and clinical
lab evaluation
(6ECTS).
Courses do not
include practical
teaching.
61
4. Professional Practice in CP
Clinical Pharmacy is recognised as an area of specialization in Norway, although is not
legally anchored.
In Norway, you are a clinical pharmacist if you work as a clinical pharmacist at a hospital,
or in the community, so "clinical pharmacist" is a job-title. But the Pharmacist society recognize
that you need to have special skills to work as a clinical pharmacist, that is why we have started
up the Practice based Master of clinical pharmacy.
We regard clinical pharmacy to be applied in hospitals, in nursing homes and in the
community. To apply this, you need to work with both the prescriber and the patient
Ward based work (i.e. with the patient and the team, mainly in hospitals) is recognised as
a speciality work in the domain of clinical pharmacy.
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 European Union – Eurostat. Health personnel statistics. Retrieved from
https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
Number of
semesters
Number of
contact hours
per semester
Number of
ECTS per
semester
Percentage of
practical
teaching
Open to
foreigns
Tuition
fees
6 ND 15 ND yes, but in
Norwegian
ND
62
Poland (Not validated)
Indicators
Inhabitants1 37 976 687
Practicing pharmacists/ 100 000 inhabitants2 77.23
Hospitals/100 000 population3 2.8
Community pharmacies/ 100 000 inhabitants4 35.5
1. Characterization of the Poland’s Clinical Pharmacy Education
According to FIP World List of Pharmacy Schools5, Poland has 11 faculties that provide an
Integrated Master in Pharmaceutical Sciences.
In Poland pharmacist (Master of Pharmacy) can make 3-year long specialization in Clinical
Pharmacy. It can be done on 3 universities (Kraków, Wrocław, Poznań). It is a pay study.
There is very few Clinical Pharmacists. They work in hospital pharmacies, but they usually
don't take part in pharmaceutical care, and consulting with doctors about pharmacotherapy
in hospital wards.
In Poland there is no legal regulation about pharmacists’ position in Pharmacy, Clinical
Pharmacy and Pharmaceutical Care. Because of that, there is no such thing as CP (according
to Yours definition) in Poland.
2. Undergraduate education in CP
On every University, teaching program is very similar. On Master Pharmacy study there are
usually: Clinical Pharmacy (30 hours, 2 ECTS) and Pharmaceutical Care (45 hours, 4 ECTS).
Practical teaching is very rare.
3. Postgraduate education in CP
The postgraduate education in Poland is accredited by a regulator.
Postgraduate education leading to an academic
degree
Postgraduate education not
leading to an academic degree
Master/ Diploma degree PhD programmes CPD courses Certifications
Y Y
N N
One available master’s in
clinical pharmacy,
conducted by the Polish
Centre of Postgraduate
Medical Education.
All faculties provide PhD
programmes in Clinical
Pharmacy.
Only people with MSc in
Pharmaceutical Sciences
can apply for these PhD
programmes.
63
4. Professional Practice in CP
Polish Ministry of Health recognise Clinical Pharmacy as an area of specialization.
Specialization in Clinical Pharmacy is made through Centre of Postgraduate Medical
Education.
Pharmacists with the specialization in Clinical pharmacy are Clinical Pharmacists
(Farmaceuta Kliniczny) and could work at Hospital Pharmacies.
After specialization medical environment recognizes CP competences, but there are no
legal regulations.
There are no recognised speciality areas in the domain of clinical pharmacy
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 European Union – Eurostat. Health personnel statistics. Retrieved from
https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
64
Portugal Indicators
Inhabitants1 10 291 027
Practicing pharmacists/ 100 000 inhabitants2 90.76
Hospitals/100 000 population3 2.2
Community pharmacies/ 100 000 inhabitants4 28.3
1. Characterization of the Portuguese Clinical Pharmacy Education
Portugal has 9 faculties that provide an Integrated master’s degree in Pharmaceutical
Sciences.
The definition of Clinical Pharmacy is accepted in all faculties throughout the country;
however, the rate of implementation and development varies widely, with some having a
more practice-oriented teaching in a real environment, whilst others are still very theory based.
In terms of practice, there is also wide variation, with some hospitals being centres of
excellence, whilst others have difficulty to implement clinical pharmacy due to staff shortages,
pharmacists’ lack of proactivity and suboptimal collaboration with other healthcare
professionals.”
Regarding the professional setting I think the economic crisis took a big toll in the
pharmaceutical sector leaving less pharmacists with a great workload. It is very hard to
practice CP and CP daily and you must be very resilient to do it.
2. Undergraduate education in CP
The undergraduate education in Portugal is accredited by the Ministry of Education.
All 9 faculties have Clinical Pharmacy component included in the curricula.
Number of
semesters
Number of contact
hours per semester
Number of ECTS per
semester
Percentage of
practical teaching
Faculty 1 3 56 5 73
Faculty 2 1 60 5 43
Faculty 3 2 60 4 33
Faculty 4 2 112 9 68
Faculty 5 1 60 5 50
Faculty 6 3 52 5 67
Faculty 7 2 49 4 60
Faculty 8 1 75 6 60
Faculty 9 1 52 4 50
65
3. Postgraduate education in CP
The postgraduate education leading to an academic degree in Portugal is accredited by
the Ministry of Education. The postgraduate education not leading to an academic degree is
accredited in the vast majority (not mandatory but preferable) by the Portuguese
Pharmaceutical Society.
Postgraduate education leading to an
academic degree
Postgraduate education not leading to an
academic degree
Master/ Diploma degree PhD
programmes CPD courses Certifications
N N
Y
N Some small courses, such as
“Hospital and clinical
pharmacy” and “safety
medicines”, which includes
practical teaching.
4. Professional Practice in CP
In Portugal, Clinical Pharmacy is not recognised as an area of specialization but is part of
the professional activities of both community and hospital pharmacists.
Hospital and Community Pharmacy are the existing speciality areas in the domain of
clinical pharmacy.
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 European Union – Eurostat. Health personnel statistics. Retrieved from
https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
66
Republic of Moldova Indicators
Inhabitants1 2 706 049
Practicing pharmacists/ 100 000 inhabitants2 53.42
Hospitals/100 000 population3 2.5
Community pharmacies/ 100 000 inhabitants4 38.18
1. Characterization of the Republic of Moldova’s Clinical Pharmacy Education
Republic of Moldova has one faculty that provide an Integrated master’s degree in
Pharmaceutical Sciences.
The “Regulation – type of clinical pharmacist” was approved in the Republic of Moldova
by order of the Ministry of Health nr. 70 in March 5th, 1999, according to the decision of the
SUMPh “Nicolae Testemitanu” senate. Thus, in 2007 the Department of Pharmacology was
renamed as the Department of Pharmacology and Clinical pharmacy.
The modern pharmacist that ensures the pharmaceutical assistance must have deep
knowledge in pharmacotherapy and clinical pharmacy acquired in university and deepened
during the graduate study (residency).
The course of clinical pharmacy is taught to the 5th year’ students of Pharmaceutical
Faculty and includes the following subjects:
• Clinical pharmacy of Cardiovascular diseases;
• Clinical pharmacy of Respiratory diseases;
• Clinical pharmacy of Gastrointestinal diseases;
• Clinical pharmacy of Renal diseases.
Students have practical works in hospital, where they have the possibility to consult patients
and doctors about the schemes of drug treatment.
The residence of clinical pharmacists (2 years), additionally to the courses
of pharmacology, pharmacotherapy and clinical pharmacy includes:
• Drug toxicology and pharmacovigilence
• Clinical pathology;
• Clinical laboratory;
• Clinical biochemistry;
• Drug abuse education;
• Pharmacotherapeutic evaluation;
• Patient counseling;
• Residency programs in pharmaceutical practice specializing in primary health care,
in ambulatory and clinical practice.
2. Undergraduate education in CP
The undergraduate education in Republic of Moldova is accredited by a regulator.
The existing faculty has undergraduate education that covers topics about clinical
pharmacy. The clinical pharmacy component is distributed in the following table:
67
Number of
semesters
Number of contact
hours per semester
Number of ECTS per
semester
Percentage of
practical teaching
Faculty 1 2 42 29 30
3. Postgraduate education in CP
The postgraduate education in Republic of Moldova is accredited by a regulator.
Postgraduate education leading to an
academic degree
Postgraduate education not leading to an
academic degree
Master/ Diploma degree PhD
programmes CPD courses Certifications
Y
N N N One available master
(details on the following
table)
Number of
semesters
Number of
contact hours
per semester
Number of
ECTS per
semester
Percentage of
practical
teaching
Open to
foreigns
Tuition
fees
4 810 68 50 No 1500€
4. Professional Practice in CP
Clinical Pharmacy is recognised by the Ministry of Health of Republic of Moldova as an
area of specialization.
The specialization has application in Clinical and Community Pharmacies and lead to
some professional rights. Clinical pharmacists exert two categories of activities: medical field
activities and activities with administrative profile.
Medical field activities are the analysis and the execution of the prescription, the distribution
and the control of drug administration, the therapy’s monitorization, including the activity of
pharmacovigilance and clinical research.
The activities with administrative profile include: the evidence of drugs and delivery
and economic analysis of drug therapy.
The directions of pharmaceutical assistance in the community pharmacy are:
• Consulting in the prescribed medication.
• Guiding of self-medication with OTC drugs;
• Written recommendation of OTC medication suggested by the pharmacist for 1-2 days
at the request of the patient who manifests acute symptoms;
• Release without prescription of 1-2 doses of drugs that aren’t included in the OTC
category, in case of emergencies.
In Republic of Moldova, there is insufficiently developed clinical pharmacy because there
are great divergences with clinical pharmacologists and doctors who do not yet want to
recognize the necessity of the clinical pharmacy.
68
Clinical Pharmacy specialization is taken up in the Republic of Moldova’s legislation: The
“Regulation – type of clinical pharmacist” approved in the Republic of Moldova by order of
the Ministry of Health nr. 70 in March 5th, 1999.
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hlthres_191-practising-pharmacists-per-100-
000/ - data from 2013 (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 Sanatate Info Website. http://sanatateinfo.md/News/Item/2272 (accessed on May 30th, 2020)
69
Russian Federation (Not validated)
Indicators
Inhabitants1 143 436 145
Practicing pharmacists/ 100 000 inhabitants2 5.36
Hospitals/100 000 population3 3.5
Community pharmacies/ 100 000 inhabitants4 ND
1. Characterization of the Russian Clinical Pharmacy Education
According to FIP Official World List of Pharmacy Schools5, Russia has 15 faculties that
provide an Integrated Master of Pharmaceutical Sciences.
Clinical pharmacy is just beginning to take shape in Russia. Traditionally, only
pharmacology and clinical pharmacology were taught at pharmaceutical universities. And
only two years ago in the universities started teaching the course "Pharmaceutical consulting",
which gives the basis of clinical pharmacy. Practicing pharmacists have rather small
opportunities for improvement in clinical pharmacy, as the main emphasis is on organizational
issues of pharmacy, legislation or analytical methods in pharmacy.
There is a complicated system of pharmaceutical education in Russia. We have 4 levels of
it. And none of them is directed to clinical pharmacy and PC enough. It is caused by features
of pharmaceutical legislation and traditions of education in our country.
The curriculum includes a lot of courses like pharmaceutical chemistry and other types of
chemistry, pharmacognosy, pharmaceutical economics and, of course, pharmacology and
CP.
Only last few years the course of PC was included.
In Russia, pharmaceutical services are provided mainly in pharmacies.
Currently, Russian pharmaceutical educational system focuses on trends of PC and CP. But
main obstacles are legal limitations in pharmaceutical services setting and communication
between pharmacists and physicians.
2. Undergraduate education in CP
The undergraduate education in Russia is accredited by a regulator.
Clinical pharmacy topics are covered in Russian undergraduate education.
3. Postgraduate education in CP
The postgraduate education in Russia is accredited by a regulator.
70
Postgraduate education leading to an
academic degree
Postgraduate education not leading to an
academic degree
Master/ Diploma degree PhD
programmes CPD courses Certifications
N ND ND N
4. Professional Practice in CP
In Russia, Clinical pharmacy is not recognised as an area of specialization and is not part
of the professional activities of the community or hospital pharmacists.
There are no recognised speciality areas in the domain of clinical pharmacy.
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hlthres_191-practising-pharmacists-per-100-
000/ (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
5 International Pharmaceutical Federation (FIP): Official World List of Pharmacy Schools. Retrieved from
http://academic_institutional_membership.fip.org/world-list-of-pharmacy-schools/ (accessed on April
26th, 2020)
71
Serbia (Not validated)
Indicators
Inhabitants1 7 001 444
Practicing pharmacists/ 100 000 inhabitants2 28.07
Hospitals/100 000 population3 1.4
Community pharmacies/ 100 000 inhabitants4 ND
1. Characterization of the Serbia’s Clinical Pharmacy Education
Serbia has five faculties that provide an Integrated master’s degree in Pharmaceutical
Sciences.
Education in clinical pharmacy has fifteen years established history. Pharmaceutical care
delivery at primary level is well organized, but clinical pharmacy practice (services) at the
hospitals is not developed completely.
2. Undergraduate education in CP
Undergraduate education in Serbia covers topics in Clinical Pharmacy and includes
practical teaching.
The undergraduate education in Serbia is accredited by a regulator.
3. Postgraduate education in CP
The postgraduate education that exists in Serbian are accredited by a regulator.
Postgraduate education leading to an
academic degree
Postgraduate education not leading to an
academic degree
Master/ Diploma degree PhD
programmes CPD courses Certifications
Y Y
ND ND One available master’s in
clinical pharmacy (details
on the following table)
Three out of
five faculties
provide PhD
programmes,
which are
available for
pharmacists.
Number of
semesters
Number of
contact hours
per semester
Number of
ECTS per
semester
Percentage of
practical
teaching
Open to
foreigns
Tuition
fees
4 ND 180 40 No ND
72
4. Professional Practice in CP
The Serbian Ministry of Health recognises Clinical Pharmacy as an area of specialization
and has application only in Hospital Pharmacy.
However, this specialization does not include any specific professional rights or job
specifications and is not legally anchored in the Serbian legislation.
There is no recognition of any speciality areas in the domain of clinical pharmacy.
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hlthres_191-practising-pharmacists-per-100-
000/ (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
73
Slovakia (Not validated)
Indicators
Inhabitants1 5 443 120
Practicing pharmacists/ 100 000 inhabitants2 28.07
Hospitals/100 000 population3 2.5
Community pharmacies/ 100 000 inhabitants4 36.7
1. Characterization of the Slovakia’s Clinical Pharmacy Education
There are two faculties in Slovakia that provide an Integrated master’s degree in
Pharmaceutical Sciences.
Slovakia has:
- undergraduate education in pharmacy,
- rigorous exam from Clinical Pharmacy,
- postgraduate education (PhD) in Clinical pharmacy which is accredited by Ministry of
Education and
- Specialization in Clinical Pharmacy accredited by Ministry of Health.
Slovakia have not established places for clinical pharmacy specialists - their places depend
on the interest of management of hospitals. Clinical pharmacists are also working at the
Departments of Clinical Pharmacology and hospital pharmacies.
2. Undergraduate education in CP
The undergraduate education in Slovakia is accredited by a regulator.
Both two existing faculties have undergraduate education that covers topics about
clinical pharmacy:
Number of
semesters
Number of contact
hours per semester
Number of ECTS per
semester
Percentage of
practical teaching
Faculty 1 ND 52 5 0
Faculty 2 7 58 5 0
74
3. Postgraduate education in CP
Postgraduate education leading to an academic
degree
Postgraduate education not
leading to an academic degree
Master/ Diploma degree PhD programmes CPD courses Certifications
Y Y
N N One available master’s in
clinical pharmacy (details
on the following table)
One out of two
faculties provide PhD
programmes, which
are available for
pharmacists.
Number of
semesters
Number of contact
hours per semester
Number of
ECTS per
semester
Percentage of
practical
teaching
Open to
foreigns
Tuition
fees
18 months
study
Depends on the
activity of students,
preparing rigorous
work, which is
credited
ND 0 Yes ND
4. Professional Practice in CP
Slovak Ministry of Health recognises Clinical Pharmacy as an area of specialization and is
taken up in national legislation. However, there is no recognition of any speciality areas in the
domain of clinical pharmacy.
The applications setting of the specialization are hospital pharmacy, Departments of
Clinical Pharmacology and Hospital - e.g. Department of Internal Medicines.
The recognition of the specialization in Clinical Pharmacy includes some specific
professional rights and job specifications such as interpretation of TDM and consultation for
therapy in pregnancy.
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hlthres_191-practising-pharmacists-per-100-
000/ - data from 2007 (accessed on May 30th , 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
75
Slovenia (Not validated)
Indicators
Inhabitants1 2 066 880
Practicing pharmacists/ 100 000 inhabitants2 68.8
Hospitals/100 000 population3 1.4
Community pharmacies/ 100 000 inhabitants4 ND
1. Characterization of the Slovenian Clinical Pharmacy Education
Slovenia has one faculty that provide an Integrated master’s degree in Pharmaceutical
Sciences.
Undergraduate and postgraduate focus on clinical pharmacy and pharmaceutical
care. Advanced level medication review service is payed by the Insurance Institute since 2016
that is performed at the ambulatory level in health centres by clinical pharmacist. A special
certification program at the Slovene Chamber of Pharmacy with a special group monitoring
the performance and preparing upgrades. There is another service established: medicines use
review that is performed by all pharmacists not necessarily having specialization. Now not
payed and provided free of charge in most cases by community pharmacies.
Several activities exist in hospitals related to the work of clinical pharmacist. In most cases
this is medication reconciliation. There is a scientific and educational support by the University
of Ljubljana, faculty of pharmacy. In the last fifteen years, clinical pharmacy has been
established in most health institutions in Slovenia. In doing so, it summarizes foreign experiences
and develops its own knowledge and skills, first in the form of pharmaceutical care programs,
and later in the form of pharmaceutical cognitive services (medication use review, advanced
medication review). The new Pharmacy Act represents an appropriate solution for placing
clinical pharmacy in the health system. Implementation of the law provisions is successful at all
three levels of health care. Clinical pharmacists at clinical departments of hospitals participate
in visits, carry out advanced medication reviews and run medication reconciliation.
2. Undergraduate education in CP
In the undergraduate curriculum we can find several elements spread among different
subjects that build the profile of a future pharmacist towards optimisation and rationalisation
of medicines use. This include the train sheep and workshops connected with it in the 5th year,
social pharmacy in the 4th year and an elective subject of clinical pharmacy.
The undergraduate education in Slovenia is accredited by a regulator.
76
3. Postgraduate education in CP
The postgraduate education in Slovenia is accredited by a regulator.
Postgraduate education leading to an
academic degree
Postgraduate education not leading to
an academic degree
Master/ Diploma degree PhD programmes CPD courses Certifications
Y Y Y N
A 3-year specialization exist run by the Chamber. The first year is theoretical at the Faculty,
then 1,5 of practices and 0,5 year for thesis and the defence of specialization.
Additionally, Slovenia has a PhD named “Interdisciplinary doctoral programme in
Biomedicine”. “The admission to the Interdisciplinary Doctoral Programme in Biomedicine,
graduates of the following programmes can apply: Second cycle study programmes; Study
programmes providing education for occupations regulated by Directives of the European
Union (93/16/EEC for doctors, 78/1027/EEC for veterinarians, 78/687/EEC for dentists and
85/432/EEC for pharmacists) evaluated with at least 300 credits; Study programmes leading to
specialization, if candidates have previously completed a higher education professional study
programme. The Biomedicine Programme Council will specify additional entry requirements
for candidates in individual areas amounting from 30 to 60 ECTS; Study programmes leading
to a Master of Science or to specialization after completing an academic study programme.
60 credits of study obligations will be recognised to such candidates: Academic study
programmes. Candidates with foreign qualifications are required to apply for recognition of
their entry qualifications. The procedure starts with the candidate’s application for study in the
Republic of Slovenia, which is submitted in electronic form. The procedure is run by the
authorised person at the University Member (academy or faculty).
Slovenia has several continuous professional courses in the domain of clinical pharmacy
which are detailed in the following table:
4. Professional Practice in CP
Slovenian Ministry of Health recognise Clinical Pharmacy as an area of specialization.
This specialization, named “Specialization in clinical pharmacy” appeared by the merged
of two other specializations, one for the community pharmacists and the other for the hospital
pharmacists and exist in order to become a clinical pharmacist.
The specialization is legally anchored (Legal reference: Zakon o lekarniški dejavnosti
(Uradni list RS, št. 85/16 in 77/17)
Clinical pharmacists have some job specifications such as: advanced level medication
review service and other functions that are not that distinct. However, there is no recognition
of any additional speciality areas in the domain of clinical pharmacy.
Name of the course/programme Practical teaching
Courses, meetings on different themes are offered by the Slovenian
Chamber of Pharmacy.
No
Medicines use review Yes
Advanced level medication review Yes
77
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hlthres_191-practising-pharmacists-per-100-
000/ - data from 2007 (accessed on May 30th , 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
78
Spain Indicators
Inhabitants1 46 733 038
Practicing pharmacists/ 100 000 inhabitants2 111.82
Hospitals/100 000 population3 1.6
Community pharmacies/ 100 000 inhabitants4 47.2
1. Characterization of the Spain’s Clinical Pharmacy Education
Spain has 22 faculties that provide 5-year programme of pharmacy studies.
Practice is very developed in hospitals through the pharmacy services. The situation in
community pharmacy is not so good and needs to be more developed and implemented.
Referring to education is variable depending of the University.
2. Undergraduate education in CP
The curricula vary widely from one university to another. There are still universities that do
not have in their curricula pharmacy and/or pharmaceutical care as compulsory subjects.
3. Postgraduate education in CP
Postgraduate education leading to an
academic degree
Postgraduate education not leading to
an academic degree
Master/ Diploma degree PhD programmes CPD courses Certifications
Y N Y Y
4. Professional Practice in CP
In Spain, Clinical Pharmacy is not recognised as an area of specialization and it is part of
the professional activities of community, hospital and primary health care pharmacists.
Additionally, there are a specialization in hospital pharmacy that is certified by the Spanish
Hospital Pharmacy Society. Obtaining this specialization is mandatory to practice in a hospital
pharmacy services.
79
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hlthres_191-practising-pharmacists-per-100-
000/ (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
80
Sweden Indicators
Inhabitants1 10 120 242
Practicing pharmacists/ 100 000 inhabitants2 75.13
Hospitals/100 000 population3 0.9
Community pharmacies/ 100 000 inhabitants4 13.9
1. Characterization of the Sweden’s Clinical Pharmacy Education
Sweden has three faculties (Umea, Uppsala and Gothenburg) that provide an Integrated
master’s degree in Pharmaceutical Sciences.
In addition to that, Sweden has two faculties only providing Bachelor degrees (Kalmar and
Malmoe).
Sweden have two academic degrees that lead to two different licences/professions.
• Receptarie: 3-year training;
• Apotekare: 5-year training.
The different 5-year programmes that lead to Apotekare licence do this in two different ways.
One is the Bologna way, where you first get a bachelor’s degree and then do a masters. The
other way is a full 5-year programme where you do not get a bachelor’s degree on the way.
In summary, there are a few courses in Clinical Pharmacy in Sweden:
- Malmoe has one course in their 3-year programme;
- Umea has one course in their master programme;
- Uppsala has one course in the last two years of the 5-year programme to “Apotekare”. The
same course is also available in the master programmes.
- Uppsala has a postgraduate 1-year programme in clinical pharmacy (master programme in
clinical pharmacy).
Clinical pharmacy practice has developed fast for the last 10 years and is now routine in
many parts of the country. However, it is still growing and there is still not a pharmacist on every
ward. Clinical pharmacy within health care centres in primary care is also evolving fast. The
development is closely linked to ongoing research. There is a need for educated clinical
pharmacists and currently the university provides the available courses. Since 2006 Uppsala
university has a master programme in clinical pharmacy.
However, the Clinical pharmacy services has increased very much during the last 10 years
and the hospitals employ clinical pharmacist to perform medication reconciliation and -
review. Mainly on hospitals but also on health care centrals and nursing homes. The increase
is due to extensive research and focus on improving patient care in Lund (Scania Region) and
Uppsala region. Approx. 200 clinical pharmacists are involved. Sweden have a population of
9 million.
81
The university curriculum for the BSc and MSc Pharmacy has not changed to support this
change in practice. One new BSc has Clinical pharmacy as a mandatory subject and the
students are to some extent trained to perform MedRec and MedRew at hospital wards.
2. Undergraduate education in CP
The undergraduate education in Sweden covers topics in Clinical Pharmacy.
3. Postgraduate education in CP
Postgraduate education leading to an
academic degree
Postgraduate education not leading to
an academic degree
Master/ Diploma degree PhD programmes CPD courses Certifications
Y ND N N
4. Professional practice in CP
In Sweden, Clinical pharmacy is not recognised as an area of specialization, however, it is
part of the professional activities of hospital pharmacists and pharmacists in primary care
health care centres (outside hospitals).
There are no recognised speciality areas in the domain of clinical pharmacy.
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 European Union – Eurostat. Health personnel statistics. Retrieved from
https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
82
Switzerland (Not validated)
Indicators
Inhabitants1 8 507 202
Practicing pharmacists/ 100 000 inhabitants2 69.22
Hospitals/100 000 population3 3.5
Community pharmacies/ 100 000 inhabitants4 21.0
1. Characterization of the Swiss Clinical Pharmacy Education
According to FIP Official World List of Pharmacy Schools5, Switzerland has six faculties that
provide an Integrated Master of Pharmaceutical Sciences.
Over the last decade especially the educational, theoretical format of clinical pharmacy
has developed to a discipline mostly separated from pharmaceutical sciences. As there are
not enough training positions for clinical pharmacy and hospital pharmacy the "production"
the necessary number of skilled people with adequate diploma cannot be achieved. In
addition, the profession of pharmacy - especially in the retail area will change dramatically
and request new professional format and knowledge.
Postgraduate education and training in this field provided by two universities in a
Certificate/Diploma of Advanced Studies Programme. A specialized training curriculum is
defined by the national pharmacy association.
Regarding clinical pharmacy practice, services are widespread in Swiss hospitals but to a
very varying degree of intensity and implementation. Huge differences have been shown in a
national survey (cf. Messerli M et al. Eur J Hosp Pharm 2016) between regions. In hospital
settings, more and more clinical pharmacists are involved, but the activity is not systematically
implemented.
Community pharmacists are active daily in clinical activities, but this is not yet fully
structured, documented, and hence recognized.
2. Undergraduate education in CP
The undergraduate education in Switzerland is accredited by a regulator.
Swiss undergraduate education cover topics of Clinical Pharmacy in the curricula, which
includes practical teaching.
3. Postgraduate education in CP
No data available
4. Professional Practice in CP
No data available.
83
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 European Union – Eurostat. Health personnel statistics. Retrieved from
https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
5 International Pharmaceutical Federation (FIP): Official World List of Pharmacy Schools. Retrieved from
http://academic_institutional_membership.fip.org/world-list-of-pharmacy-schools/ (accessed on April
26th, 2020)
84
Turkey Indicators
Inhabitants1 81 339 000
Practicing pharmacists/ 100 000 inhabitants2 ND
Hospitals/100 000 population3 2.0
Community pharmacies/ 100 000 inhabitants4 31.1
1. Characterization of the Turkey’s Clinical Pharmacy Education
Turkey has 36 faculties that provide an Integrated master’s degree in Pharmaceutical
Sciences.
Clinical Pharmacy is still an emerging concept in Turkey. It is included in the core pharmacy
curriculum. Therefore, establishment of clinical pharmacy related courses (both theoretical
and practical) is encouraged. Clinical Pharmacy is considered as a pharmacy specialty;
pharmacists passing a centralized examination are assigned to the available places based on
their scores. After 3 years of practical education (residency) at the hospital, they become
"Clinical Pharmacy Specialists". Besides Turkey, there are also various faculties of pharmacy in
TRNC (Turkish Republic of North Cyprus) offering clinical pharmacy graduate and
undergraduate courses to international students.
2. Undergraduate education in CP
The clinical pharmacy component varies widely at undergraduate education.
The undergraduate education in Turkey is accredited by a regulator.
3. Postgraduate education in CP
The postgraduate education in Turkey is not accredited by a regulator.
A postgraduate program can only be established upon approval of the Council of Higher
Education.
Postgraduate education leading to an
academic degree
Postgraduate education not leading to
an academic degree
Master/ Diploma degree PhD programmes CPD courses Certifications
Y Y Y
N More details on table A
Available only for
pharmacists More details on table B
85
Number of
semesters
Number of
contact hours
per semester
Number of
ECTS per
semester
Percentage
of practical
teaching
Open to
foreigns
Tuition
fees
Faculty 1 4 280 40 40 Yes no
Faculty 2 4 280 40 40 No No
Faculty 3 4 98 28 28 Yes Yes
Table A
Name of the
course/programme
Number
of hours
Practical
teaching Additional details
Course 1
Pharmaceutical
Care in
Asthma/COPD
Management
8 Yes. Case
based Programmes run by the
Turkish Pharmacists'
Association. This program is
held as "Train the trainee"
courses and "peer
teaching”. As this is a CPD,
practical part takes place in
daily pharmacy practice.
Course 2
Pharmaceutical
Care in Diabetes
Management
8 Yes. Case
based
Course 3
Pharmaceutical
Care in Hypertension
Management
8 Yes. Case
based
Table B
4. Professional Practice in CP
Clinical Pharmacy is recognised as an area of specialization by the Turkish Ministry of
Health. Named as Clinical Pharmacy specialization has its application setting in hospital wards
(not hospital pharmacy).
The clinical pharmacy specialist works at the hospital wards, have access to all patient
data and has rights to offer interventions to other healthcare professionals in order to optimise
drug therapy. They also have access to the patients, and they can collect data from them in
order that they can counsel on specific issues of drug treatment.
Clinical Pharmacy specialization is legally anchored. Legal reference: Eczacılıkta Uzmanlık
Yasası (14.11.2014 - Resmi Gazete) & Eczacılıkta Uzmanlık Eğitimi Yönetmeliği (21.10.2016 -
Resmi Gazete)
There are no recognised speciality areas in the domain of clinical pharmacy.
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 European Union – Eurostat. Health personnel statistics. Retrieved from
https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
86
Ukraine Indicators
Inhabitants1 42 263 873
Practicing pharmacists/ 100 000 inhabitants2 4.13
Hospitals/100 000 population3 4.0
Community pharmacies/ 100 000 inhabitants4 ND
1. Characterization of the Ukraine’s Clinical Pharmacy Education
Ukraine has 21 faculties that provide an Integrated master’s degree in Pharmaceutical
Sciences.
In Ukraine we had clinical pharmacy education but now only practice.
2. Undergraduate education in CP
The undergraduate education in Ukraine is accredited by a regulator.
In Ukraine, faculties that provide an Integrated master’s degree in Pharmaceutical
Sciences covers topics of Clinical Pharmacy.
3. Postgraduate education in CP
The postgraduate education in Ukraine is not accredited by a regulator.
Postgraduate education leading to an
academic degree
Postgraduate education not leading to
an academic degree
Master/ Diploma degree PhD programmes CPD courses Certifications
Y Y
Y
N More details on the
following table
4. Professional Practice in CP
In Ukraine, Clinical Pharmacy is an area of specialization.
The specialization is recognised by Danilo Halitsky Lwiw National medical university and by
the National University of Pharmacy (Kharkiv), as well as the Ukrainian Ministry of Health.
In Ukraine, the problem of recognition and actual demand for clinical pharmacists in the
hospital exists. Very often, clinical pharmacy specialists are in demand as monitors or assistant
monitors for clinical trials.”
The specialization includes job specifications and professional rights.
Name of the course/programme Number of hours Practical teaching
Modern approaches to the effective and
safe use of medicines. Pharmaceutical
care of OTC drugs.
156 yes
87
A Ukrainian Clinical Pharmacist can apply his knowledge in a variety of areas of practice:
• In pharmacy, the clinical pharmacist provides pharmaceutical care for patients
advises on the rational administration of medicines, especially over-the-counter drugs,
replaces generic drugs, selects effective and cheaper analogues of expensive and
original medicines;
• In medical establishments, as a physician consultant on pharmacotherapy, the clinical
pharmacist provides an individual approach to the choice of medicinal product;
• Hospital pharmacist - a specialist who works in a multidisciplinary hospital and
purchases medicines considering the needs of the hospital, the specific morbidity of
the region, the contingent of patients, pharmacoeconomic principles.
• The clinical pharmacist justifies the volume of financing of medical support from the
state budget and insurance funds - all this is very important for the development of
insurance medicine in Ukraine.
Clinical Pharmacy specialization is legally anchored. Legal reference: Classification of
professions DK 003: 2010 (Ukraine, 2019)
Monitor or Assistant Monitor Clinical Trials is a speciality area in the domain of clinical
pharmacy
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hlthres_191-practising-pharmacists-per-100-
000/ (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
88
United Kingdom Indicators
Inhabitants1 66 273 873
Practicing pharmacists/ 100 000 inhabitants2 89.48
Hospitals/100 000 population3 2.9
Community pharmacies/ 100 000 inhabitants4 21.3
1. Characterization of the United Kingdom’s Clinical Pharmacy Education
United Kingdom has 28 faculties that provide Pharmacy degree.
MPharm programme is 4 years, develops the student’s ability to apply the science of
chemistry, biology, pharmaceutics and pharmacology to improve patient treatment and
outcomes.
At postgraduate level, independent prescribing qualifications, develops and expands the
pharmacist provision of direct patient care.
Regarding clinical pharmacy practice is patient focused to improve patient outcomes.
2. Undergraduate education in CP
All UK Pharmacy faculties have undergraduate education covering clinical pharmacy
topics. Patient cantered pharmaceutical care is a requirement of the educational standards
and is integrated throughout the course.
This undergraduate education is accredited by a regulator.
3. Postgraduate education in CP
The postgraduate education is not accredited by a regulator except for the independent
prescribing qualification which is regulated by the General Pharmaceutical Council (GPhC).
Postgraduate education leading to an
academic degree
Postgraduate education not leading to
an academic degree
Master/ Diploma degree PhD
programmes CPD courses Certifications
Y Y Y
Most UK schools of pharmacy
offer postgraduate degree in
clinical pharmacy at either
diploma or MSc level. Some
will be distance learning and
some courses will be face to
face learning. A diploma is
equal to 1200 hours and an
MSc is equal to 1800 hours. A
Only
pharmacists can
access to these
PhD
programmes
and they can be
also accessed
by non-UK
There are many continuing education
bodies such as Centre for Pharmacy
Postgraduate Education (CPPE), Royal
Pharmaceutical Society (RPS) and NHS
Education for Scotland (NES), providing
a range of programmes and portfolios
at a foundation to advanced level.
89
few courses will be open to
non-UK registered
pharmacists. Tuition fees are
variable.
registered
pharmacists
4. Professional Practice in CP
In UK, Clinical Pharmacy is not recognised as an area of specialization, as all patient-facing
pharmacists are expected to provide pharmaceutical care.
Clinical pharmacy is part of the activities of both community and hospital pharmacists.
Pharmacist Independent Prescribing is an area where any GPhC registered pharmacists in
a patient facing role is eligible to train as a pharmacist prescriber.
References
1 United Nations Statistics Division. Population and Vital Statistics Report (Table 2: Population, latest
available census and estimates, latest available data). Retrieved from
https://unstats.un.org/unsd/demographic-social/products/vitstats/index.cshtml (accessed on May 30th,
2020);
2 European Union – Eurostat. Health personnel statistics. Retrieved from
https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do (accessed on May 30th, 2020);
3 World Health Organization - Regional Office for Europe. European Health Information Gateway.
Retrieved from https://gateway.euro.who.int/en/indicators/hfa_470-5010-hospitals-per-100-
000/visualizations/#id=19523&tab=table (accessed on May 30th, 2020);
4 OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris,
https://doi.org/10.1787/28492fb2-en.
90
Summary and conclusions
This report gives an overview of clinical pharmacy education and practice in Europe. The main
findings are that:
• There is wide variability in clinical pharmacy development between European
countries and within countries comparing different faculties;
• There was a sense, shared by country representatives, that clinical pharmacy
education and practice is progressively developing;
• Almost every European country has clinical pharmacy courses that cover clinical
pharmacy topics at undergraduate level. However, the practical teaching seems to
be suboptimal. Also, some countries do not provide practical teaching in CP;
• At the postgraduate education level, European countries and their respective
pharmaceutical faculties and professional bodies must strive to deliver high quality
education and research in clinical pharmacy in order for pharmacists to obtain
academic degrees in clinical pharmacy or alike and also, to update their knowledge
through continuous professional courses and postgraduate programmes and/or
certifications. In parallel, they should stimulate the development and implementation
of effective clinical pharmacy services tailored to societal and individual patient
needs;
• The recognition of clinical pharmacy as a specialty is not a prerequisite for advanced
clinical pharmacy practice. There are countries delivering high quality clinical
pharmacy activities/services, in the absence of a recognized specialization in clinical
pharmacy. Some examples are the United Kingdom, The Netherlands and Malta.
91
Appendix 1: ESCP Survey on Clinical Pharmacy Education in Europe
92
93
94
95
96
97
98
Glossary (included in the survey):
Bachelor’s degree/diploma in Pharmacy/Pharmaceutical Sciences – an undergraduate
degree in the discipline of Pharmacy or Pharmaceutical Sciences.
Clinical pharmacy is a health specialty, which describes the activities and services of the
clinical pharmacist to develop and promote the rational and appropriate use of medicinal
products and devices.
Clinical Pharmacy includes all the services performed by pharmacists practicing in hospitals,
community pharmacies, nursing homes, home-based care services, clinics and any
other setting where medicines are prescribed and used.
The term "clinical" does not necessarily imply an activity implemented in a hospital setting. It
describes that the type of activity is related to the health of the patient(s). This implies that
community pharmacists and hospital pharmacists both can perform clinical pharmacy
activities. (ESCP website, available at https://www.escpweb.org/ [home] assessed 13th August
2018)
Clinical pharmacy – discipline in which pharmacists provide patient care that optimizes
medication therapy and promotes health, and disease prevention.
Source: American College of Clinical Pharmacy (ACCP). (2018). Definition of clinical pharmacy.
Available from: https://www.accp.com/stunet/compass/definition.aspx
Competency – a single item of knowledge, skill, behavior and attitude. Source: Bruno, A. (2011). The Feasibility, Development and Validation of a Global Competency
Framework for Pharmacy Education. Thesis for Doctor of Philosophy, University College London (UCL),
School of Pharmacy. [London]: UCL, School of Pharmacy.
Competency framework – a complete collection of competencies that are thought to be
essential to performance.
Source: International Pharmaceutical Federation (FIP) Education Initiatives (FIPEd). (2012a). A Global
Competency Framework for Services Provided by Pharmacy Workforce. The Hague, Netherlands: FIP.
Available from: http://www.fip.org/files/fip/PharmacyEducation/GbCF/GbCF_v1_online_A4.pdf
Competencies – knowledge, skills, behaviors and attitudes that an individual accumulates,
develops, and acquires through education, training, and work experience.
Source: International Pharmaceutical Federation (FIP) Education Initiatives (FIPEd). (2012a). A Global
Competency Framework for Services Provided by Pharmacy Workforce. The Hague, Netherlands: FIP.
Available from: http://www.fip.org/files/fip/PharmacyEducation/GbCF/GbCF_v1_online_A4.pdf
Continuing Professional Development (CPD) – the responsibility of individual pharmacists for
systematic maintenance, development and broadening of knowledge, skills and attitudes, to
ensure continuing competence as a professional throughout their careers.
Source: International Pharmaceutical Federation (FIP) Education Initiatives (FIPEd). (2012a). A Global
Competency Framework for Services Provided by Pharmacy Workforce. The Hague, Netherlands: FIP.
Available from: http://www.fip.org/files/fip/PharmacyEducation/GbCF/GbCF_v1_online_A4.pdf
Master of Science (MSc) in Pharmacy/Pharmaceutical Sciences – a postgraduate degree in
a specialist area or discipline.
99
Master of Pharmacy (MPharm) – the undergraduate degree qualification in the United
Kingdom required for registration with the UK regulator as a Pharmacist.
Source: General Pharmaceutical Council (GPhC) (2018). MPharm degree. Available from:
https://www.pharmacyregulation.org/education/pharmacist/MPharm
Performance – an effective and persistent observable behavior. What an individual does as
opposed to what they can do.
Source: International Pharmaceutical Federation (FIP) Education Initiatives (FIPEd). (2012a). A
Global Competency Framework for Services Provided by Pharmacy Workforce. The Hague,
Netherlands: FIP. Available
from: http://www.fip.org/files/fip/PharmacyEducation/GbCF/GbCF_v1_online_A4.pdf
PharmD – a professional doctorate degree needed to be a pharmacist in the USA.