Pharmaceutical care

What does pharmaceutical care involve?

At its core there are four steps: documenting a patient's medication, identifying drug-related problems, working with the physician and patient to agree on solutions, and following up on the outcome. This includes interaction screening, adherence counselling, instruction in how to use medication, and clear documentation. The approach targets measurable outcomes, not merely the correct dispensing of medication. Professionally it draws on clinical pharmacy, which has been an independent examination subject in the pharmacy curriculum since 2001.

What is the legal framework?

The term "pharmaceutical care" does not appear as such in statute. § 1a(3) of the Pharmacy Operating Ordinance (ApBetrO) refers to information and counselling on medicinal products and defines medication management as repeated analysis of the total medication, including self-medication, with the aim of improving medication safety and adherence. Since June 2022, five pharmaceutical services have been remunerated under § 129(5e) of Book V of the Social Code: standardised risk assessment for hypertension, extended instruction in inhalation technique, medication counselling for polypharmacy patients, and care for organ transplant recipients and patients on oral antitumour therapy. The workload per case is high, and billing requires training and documentation.

What does this mean for graduates from EU countries abroad?

The European Commission is preparing an update to the training programme in Annex V, Point 5.6.1 of Directive 2005/36/EC that explicitly requires adequate knowledge of clinical pharmacy and pharmaceutical care. Degree programmes in Bulgaria, Romania, Hungary, and Croatia are also being aligned with this. For work in a German pharmacy, language skills for counselling are additionally required, which is why the authorities generally require specialist language proficiency at C1 level. Those wishing to offer the pharmaceutical services also need the corresponding chamber continuing education certificates; further development through the specialist pharmacist route is possible.

Common misconceptions

Pharmaceutical care is more than a friendly advisory conversation at the dispensing counter. It is a structured, documented process over an extended period. Without access to the complete medication record it remains piecemeal, which is why the electronic medication plan plays an important role.