The community pharmacy will be key to face the challenge of ageing and increased chronicity

Home pharmaceutical care starred in a course promoted by the Instituto de Formación Cofares (IFC), which under the title "Home care: continuity of care", took place on September 12 and 13 at the Menéndez Pelayo International University (UIMP) of Santander.

For the ninth consecutive year, the Palacio de la Magdalena hosted a space for reflection on key issues in the healthcare environment, giving visibility to the role of the community pharmacist. In the words of the president of the Cofares Group, Eduardo Pastor, "the aging of the population and the increase in chronicity and dependence are favoring a transformation of the social health context. As an active agent in the healthcare space, we have the mission of supporting pharmacy and defending our partners by offering high-quality training and services adapted to this new reality. "

In this sense, this meeting, led by the vice president of the Spanish Association of Health Law, Julio Sánchez Fierro, had the participation of renowned experts from different areas such as the general director of Public Health of Castilla y León, Agustín Álvarez; the general director of Pharmacy of the Basque Country, Iñaki Betolaza; the president of the General Council of Social Workers, Ana de Lima; the president of the Spanish Society of Geriatrics and Gerontology, José Antonio López, the general director of the institute for the development and integration of the health IDIS, Manuel Vilches; or the vice president of the Spanish Patient Forum, Santiago Alfonso, among others.

All of them debated on the implications of the change of the healthcare paradigm and the management of social and health resources, addressing the importance of the involvement of the pharmacist to introduce improvements in the model. "Putting the focus on collaboration, both among professionals and between service providers and private companies that work in the health system, and without losing sight of the rural environment," said Eduardo Pastor.

The health agent in first line with patients

Currently there are about 3 million people in Spain who have recognized their disability status, of which 1.2 million are over 65 years old, and more than 500,000 are over 80 years old. A situation of fragility that makes necessary a change in the approach of the health system, currently directed to the acute patient, to include the chronic patient.

The community pharmacist, as a health agent in the first line with patients, becomes a fundamental support to face this increase in life expectancy. During the meeting, Iñaki Betolaza, General Director of Pharmacy of the Basque Country, announced the new healthcare model implanted in Euskadi to face the new social reality. "In 2013 in the region, 19.8% were over 65, but by 2020 it is expected to reach 22.6%. In order to face the challenges, we are working on a Decree Regulating Services and Deposits that integrates the community and hospital pharmacy to optimize the use of medicines. This involves integrating pharmacy as an active agent in the health system, fostering a sphere of cooperation ".

The humanization of health, fundamental

Other aspects that were the subject of discussion were the changes in life habits, with the inclusion of new technologies and the increasingly active role of patients in caring for their own health, resulting in a key aspect of the new socio-health scenario: humanization of health.

In this sense, for Yolanda Tellaeche pharmacy has a very important work because in itself is a health facility "with a very powerful human component" where the pharmacist is presented as "a person of confidence who is in the front line in the treatment with the patient and their relatives or caregivers ". He also acknowledged that "it has been shown on several occasions that the intervention of the pharmacist is very positive, there are results that support an improvement in adherence to treatment after his intervention."

In this regard, Manuel Vilches, general director of the Institute for the Development and Integration of Health, stressed that "patients and their environment demand more and more benefits and want to take a more active role in the care of their health, there are initiatives such as non-face-to-face attention, interoperability and private electronic prescription, which favor efficiency and make the patient to be at the center of the system ".

In the same vein, Santiago Alfonso, vice president of the Spanish Patient Forum and as a representative of patients, called for a comprehensive and multidisciplinary patient approach based on the humanization of health. "Many patients do not comply with the treatments, nobody better than another patient to accompany and convince the patient. Therefore, the synergies with the community pharmacy are key to improve results, even more so when we talk about the rural environment, where it is a great opportunity to take advantage of the capillarity of the pharmacy network ".

Increasing implementation of home care

The experts also agreed that it is essential to move towards a national strategy that includes care coordination among the different health agents to ensure good design and proper implementation of home care.

In conclusion, Julio Sanchez Fierro, director of the course and vice president of the Spanish Association of Health Law, recalled that "it is essential to address an integrative model of care organization, based on cooperation between different professions and social and health structures, optimizing the use of all available resources through public-private collaboration ". In the same way, it considers that to avoid territorial inequalities and inequalities "home care should be the subject of a Strategy approved by the Interterritorial Council of the National Health System, which includes pharmaceutical home care".