Jeroen van de Pol

13 General introduction 1 Figure 4: Costs of Dutch healthcare system over the years presented in billion Euros (left y-axis) and costs for healthcare per capita per year (right y-axis) [29]. Policymakers concomitantly realized that the provision of care needs to transition from secondary to primary care as much as possible. Due to this transition, more and more (complex) patients need to be treated within the primary care system. This shift is predominantly driven by financial motivators. Also, the utilization of the healthcare system by Dutch citizens is increasing with people paying more visits to general practitioners (GPs) office over the years, in part due to the ageing population [29]. This increases pressure on healthcare providers within the primary care system and especially the GP. Regarding pharmacotherapy, community pharmacists are key players within the primary care system capable of supporting general practitioners in handling and managing complex pharmacotherapy in patients. However, to facilitate community pharmacists to support prescribers, a revision of the current role and time-utilization of community pharmacists is probably needed to enable community pharmacists to better support GPs and patients by providing CPS. Although most care is being provided in the primary care system, the costs within the secondary care system are higher. However, the use of secondary care is not always necessary. This explains the necessity of shifting care provision from secondary care towards primary care [32]. But at the same time, policymakers state that the quality of care should be uphold (or even improved). A study in 2018 demonstrated that two-thirds of GPs experience the current workload as too high and are not able to finish the amount of work in the therefore available time. The majority also states to have a negative attitude regarding the workload