Faculté de Médecine Ecole de Pharmacie APPROPRIATE USE OF MEDICINES IN CARE OF THE ELDERLY - FACTORS UNDERLYING INAPPROPRIATENESS, AND IMPACT OF THE CLINICAL PHARMACIST

Clinical pharmacy is a patient-centred pharmaceutical practice. The main objective is to ensure themost appropriate and safe use of medicines. A second related objective is to optimise medicines use atthe lowest possible costs. Clinical pharmacy services have existed for many years in North Americaand the UK, and they can be provided from the hospital pharmacy department (centralised services) oron the wards (decentralised services). There is robust evidence of their positive clinical andeconomical impact. This new pharmaceutical practice could be developed in Belgium, based on theexpected impact, and on real current opportunities in the Belgian healthcare situation. For the readers who do not understand French, the following paper first reviews the development ofclinical pharmacy and pharmaceutical care abroad. A historical perspective is taken, and the differenttypes of clinical pharmacy services are explained. Then the impact of different clinical pharmacyservices is reviewed, and the methodology used for evaluation of impact is discussed. In the secondsection, the current scope of practice for Belgian hospital pharmacists is reviewed. Opportunities andbarriers for a future development of clinical pharmacy practice in Belgium are discussed, and elementsof strategic planning are provided.