SPEECH BY THE HON. LOUIS DEGUARA, MINISTER OF HEALTH, ON THE OCCASION OF THE 2ND SPRING CONFERENCE ON CLINICAL PHARMACY: ?PHARMACY PRACTICE TO MEET PATIENTS? NEEDS?

Excellency, Hon. Colleagues, Rector Manificus, Distinguished guests, Ladies and Gentlemen.

It is my pleasure as Minister of Health to welcome the European Society of Clinical Pharmacy to Malta. Your choice of venue for this conference is most appropriate as Malta has a long established tradition in the health care field.

This historical church was built by the Knights of St. John who were renowned wordwide as hospitaliers. In 1575, not far from here, the knights finished building a new hospital which was structurally magnificent when compared to those existing at the time but more important it was innovative in terms of the provision of healthcare to patients.

It was at this hospital, better known as the Holy Infirmary, that Grand Master Jean de la Cassier decreed that pharmacists should participate in patient care at the bedside. This must surely have been one of the very first attempts at introducing the concept of the clinical pharmacist in Europe. It also made a lot of sense considering that since 1450, the practice of the profession at the time had been closely and almost exclusively related to hospital pharmacy. This trend lasted well up to 1900 by which time community services started evolving.

Since the mid fourteen century, Malta enjoyed one of the most advanced systems of pharmaceutical practice in Europe. Codes of behaviour, rules regarding the importation of drugs, the dispensing of drugs and constant surveillance existed in Malta before other European countries took up similar measures. This in spite of the fact that the first local course in pharmacy is believed to have started in 1676.

The term Clinical Pharmacy was officially coined some thirty years ago and it was not much later that attempts were made at introducing the concept locally. In fact in 1972 the first ward rounds with pharmacists forming part of a team were introduced.

Since then several other attempts were made but I must admit that it is only today that we can really claim to be on the doorstep of establishing clinical pharmacy practice in our hospitals on a sound basis.

By coincidence, our principles describing the activities of the clinical pharmacist match those of your association. I therefore cannot do better then quote the activities of the clinical pharmacist as listed in the short but highly enlightening booklet of your association.

These include:

Analysing therapies, advising health care practitioners on the correctness of drug therapy and providing pharmaceutical care to patients both at the hospital and at the community level.

Selection of drugs and defining "drug formularies" or "limited lists of drugs" in collaboration with hospital doctors, general practitioners and decision makers.

Seeking information and critically evaluating medical literature, organising information services for both the health care practitioners and the patients.

Formulation and preparation of medicinal products and devices according to acceptable standards to meet the specific needs of patients.

Drug use studies, pharmaco-epidemiology outcome research, pharmacovigilance and vigilance in medicinal devices, collecting data on drug therapies, their costs and patient outcomes through structured and scientific methods.

Pharmacokinetics and therapeutic drug monitoring by studying the kinetics of drugs and optimising the dosage.

Planning, evaluating and participating in clinical trials.

Using the results of clinical trials and outcome studies to determine cost effectiveness evaluations.

Dispensing and administration of medicinal products and devices, studying and developing systems for the dispensing and administration of medicinal products and devices, that can guarantee a higher security in administration, a reduction of expenditure and a reduction in medication errors.

Most of these areas will be discussed in the topic chosen for this conference, namely Pharmacy Practice to Meet Patient's Needs.

And with this, may I welcome you again to our islands and to our hospitals especially those of you who this morning embarked on the first clinical course carried out by your association.

It is a great pleasure and an honour to host this ambitious programme in our health care system.

Thank you all.