Clinical pharmacy

What defines the subject?

Clinical pharmacy examines the active substance not in isolation but in relation to a patient and their condition. Content includes pharmacotherapy for individual disease patterns, dose adjustment in renal and hepatic impairment, drug interactions, adverse effect management, and medication analysis. This is complemented by pharmacokinetic principles, evidence-based assessment of studies, and communication with physicians and nursing staff. In practice the subject feeds into pharmaceutical care at the patient level. Typical examination questions begin with a case study: a medication list, an adverse effect, a laboratory constellation. A reasoned recommendation is then expected.

When did it become an examination subject?

The Federal Council approved the amending regulation to the Pharmacists' Licensing Regulations in July 2000; it came into force on 1 October 2001 and created Clinical Pharmacy as the fifth subject of the Second Section of the Pharmacy State Examination. Until 2010 transitional rules applied for examiner qualifications, because initially not every faculty had a dedicated professorship. Staffing levels still differ between institutions, which is reflected in the scope of case-based seminars. Anyone wishing to go further can subsequently qualify as a specialist pharmacist in clinical pharmacy; the advanced training takes three years.

What does this mean for graduates from EU countries?

The European Commission is working on an update to the training programme in Annex V no. 5.6.1 of Directive 2005/36/EC. Among the additions planned are adequate knowledge of clinical pharmacy and pharmaceutical care, public health, interprofessional collaboration, and the use of digital technologies. For students in Bulgaria, Romania, Hungary, or Croatia this means that the curricula there are also being adapted. Until the new requirements are transposed into national law, the existing legal position remains decisive for recognition; the competent state authority decides individual cases. The German Pharmacists' Licensing Regulations have also been awaiting a fundamental revision for years.

Common misconceptions

Clinical pharmacy is not a purely hospital-based subject. The majority of medication analyses take place in community pharmacies. And it does not replace a medical prescription: the pharmacist advises; the prescribing decision rests with the physician.