Hospital pharmacy across Europe has undergone significant evolution over the last decades, guided by the European Association of Hospital Pharmacists (EAHP) statements. The latest investigation, carried out between November 2022 and March 2023, sought to assess how well hospital pharmacies were implementing these statements and identify persistent challenges. The findings suggest steady progress in traditional areas such as procurement and compounding, but also reveal stagnation and low performance in clinical pharmacy services and research. The impact of the COVID-19 pandemic and regulatory demands, particularly the Falsified Medicines Directive (FMD), have reshaped operational priorities and reinforced the need for structural support, workforce development and increased visibility for the profession.
Traditional Strengths and Operational Resilience
Responses from 653 chief hospital pharmacists indicated a high degree of alignment with EAHP standards in traditional operational areas. Most positive responses were recorded in sections covering procurement, production and patient safety, where implementation rates often exceeded 75%. For example, medicine procurement processes, quality assurance systems and logistics were widely embedded in hospital workflows. Hospital pharmacists reported having established contingency plans for medicine shortages, effective systems for hazardous products and appropriate packaging and labelling protocols. The infrastructure for compounding and production also demonstrated maturity, with widespread use of risk assessments and adherence to traceability standards.
Must Read: Streamlining Hospital Pharmacist Interventions via Risk-Based CDSS
The profession’s ability to maintain these standards amidst pandemic-related disruptions and the implementation of FMD reflects strong operational resilience. Pharmacists were highly involved in managing SARS-CoV-2 vaccine storage and distribution, despite experiencing shortages in protective equipment and capacity constraints. These functions, central to patient care, continue to be reliably executed by hospital pharmacists across Europe.
Clinical Pharmacy and Research: Limited Progress
While foundational operations have advanced, clinical pharmacy services and research activities remain underdeveloped in many European countries. Fewer than 60% of respondents reported consistent pharmacist involvement in medication reviews, reconciliation or documenting interventions. For example, only 33% indicated that pharmacists routinely entered all medicines onto a patient’s medical record on admission and only 44% confirmed medicine reconciliation on entry. Patient-facing services such as counselling also showed weak results, despite pharmacists being well positioned to offer medication information in accessible terms.
Similarly, research engagement remains limited. Only 40% of pharmacists reported involvement in hospital pharmacy practice research. Barriers cited included lack of capacity, limited prioritisation by managers and insufficient capability within teams. Some countries still lack visibility for the clinical pharmacist role, and prescribing rights are not uniformly recognised. Consequently, pharmacists are underutilised in multidisciplinary care teams, which reduces the overall impact of pharmacy expertise on patient outcomes.
Systemic Barriers and the Role of Sustainability
Capacity and capability emerged as persistent obstacles to advancing new roles. Many hospital pharmacies operate with inadequate staffing relative to bed numbers. In addition, the administrative burden imposed by FMD verification, often leading to false alarms, further reduces time for clinical activities. While core responsibilities are prioritised, expanding into more proactive or research-oriented roles becomes difficult under these pressures.
Sustainability also remains a concern. While 59% of respondents supported greater organisational focus on sustainability, 43% were unsure whether they had the empowerment or resources to initiate changes. Pharmacists generally lacked access to Immunisation Information Systems, limiting their ability to track vaccine histories or contribute to wider public health strategies. There is a growing recognition that sustainability should be integrated at both systemic and individual levels, with structured support and innovation pathways needed to empower staff.
The 2022/23 EAHP investigation underscores both the strength and inertia within the hospital pharmacy sector. Traditional roles have been sustained and even improved, demonstrating the profession’s operational dependability. However, clinical pharmacy, research and sustainability remain underdeveloped in many regions. To address this imbalance, investment in workforce capacity, capability-building and advocacy is essential. Promoting awareness of clinical roles, enhancing education and encouraging visibility are crucial to unlocking the full potential of hospital pharmacists in improving patient care across Europe.
Source: European Journal of Hospital Pharmacy
Image Credit: iStock
