Table 1. Official pharmaceutical services for the public primary health care network.
| Pharmaceutical service | Description | Patient-per-hour rates |
|---|---|---|
| Clinical services | ||
| Medication review without visit (type 2b or intermediate by PCNE) | Pharmacists conduct medication reviews using all information available in official medical records and pharmacological prescriptions. Pharmacists would add their findings and suggestions to the medical records to be considered by physicians. | 4 – 6 PPH |
| Medication review with visit (type 3 or advanced by PCNE) | A one-or-twice yearly visit added to the previous service to detect nonadherence motives and include additional patient’s information. | 3 – 4 PPH |
| Medication review with follow-up (type 3 or advanced by PCNE) | A systematic, structured service using the Polaris method as guideline. The service consists in at least three visits with the patient (initial, intervention and follow-up). The pharmacist meets with the physician after the initial visit to discuss the findings and suggest pharmacotherapy modifications if needed. Any agreed intervention would be directly implemented and registered by the pharmacist in the next visit, depending on the patient’s acceptance. The pharmacist would monitor the results of the interventions in follow-ups and perform the service until every health problem is resolved, if the patient does not want to continue or if the pharmacist discharges the patient. | 2 PPH for initial visit 3 PPH for follow-ups |
| Individual education | Pharmacists implement educational programs to increase patient’s knowledge and health literacy. This program would be comprehensive, adapting to the patient’s needs and in agreed topics. | 3 – 4 PPH |
| Pharmacovigilance | Detection, report and solving of adverse drug reactions. | 4 – 6 PPH |
| Medication reconciliation | A simplified review of the medications conducted when a patient changes their level or site of care (e.g. hospital to primary care or private to public system) to prevent therapeutic duplicities and omissions. | 6 – 12 PPH |
| Group education | A group session where the pharmacist carries out a flexible activity according to the group of patients’ needs and the educational objective. Pharmacists can implement group education in subjects such as the use of medicines, medication adherence, medicinal herbs, and others. The pharmacist can also contribute to group educations organized by other professionals. | 2 PPH |
| Home visit | Pharmacists provide pharmaceutical services at the patient’s home. This service is reserved for dependent patients and their caregivers. | 1 PPH |
| Non-clinical services | ||
| Medication quality control | Pharmacists must report to the health authorities when medication quality issues are detected in the health center, sending samples to be analyzed. | -- |
| Adverse drug events | Pharmacists must report and resolve adverse drug events that occur in the health center. | -- |
PCNE: Pharmaceutical Care Network Europe; PPH: patient-per-hour.