Martine Kruijtbosch

13 I n t roduc t i on GENERAL INTRODUCTION Pharmacists’ professional role In the 1990s Hepler and Strand described pharmacists’ professional role as ‘pharmaceutical patient care’. 1,2 Pharmaceutical care does not only consist of applying scientific evidence. It also consists of acting in the best interest of the patient. Patients, being vulnerable in the context of their health problems, are dependent on the pharmacist’s knowledge about medicines and the risks associated with their use. 3 In this new professional role the pharmacist needs to connect and bridge his scientific knowledge of the medicine to the context and life of the patient who uses that medicine. The pharmacist is responsible to strive for an optimal health outcome of patients’ drug treatment. Responsible behaviour of the pharmacist and shared decision- making are important to achieve this outcome. 1,2 In addition, the pharmacist, both in primary and secondary care, has to collaborate and communicate with other health professionals. Cipolle and Strand 2 further defined the professional role of the pharmacist by four components which are equally applicable to the professional role in other health professions like medicine and nursing: (1) meeting social needs, (2) taking responsibility for patients’ health goals, (3) utilising a patient-centred approach, and (4) maintaining a therapeutic relationship. This implies that pharmacists can and will be held accountable by patients as well as by society to appropriately address patients’ medication related needs and concerns. 4 Hence pharmacists’ decisions should be transparent for both patients and other health professionals. Although the caring responsibilities of pharmacists were internationally recognised and promoted by the International Pharmaceutical Federation (FIP) and the WHO 5 , their level of implementation varies per country. Cultural differences in how the professional role is defined, implemented and supported may explain this. 6-8 Whereas in some countries the pharmaceutical care role has only recently been introduced in the primary health sector 9 , in other countries pharmacists may sometimes even prescribe in disease areas for which they have been accredited after specific training. 10 Dutch community pharmacists’ professional role In this thesis we will focus on the professional role of Dutch community pharmacists. In the Netherlands the pharmaceutical patient care philosophy was officially embraced by the Royal Dutch Pharmacists Association (KNMP) since 1996. 8,11 In 2007 community pharmacists’ role as ‘responsible’ care professionals was anchored in the law with the inclusion of community pharmacists in the Medical Treatment Agreement Act (WGBO). Hence, community pharmacists were recognised by Dutch society as health professionals along with physicians, nurses and other health professionals. The Dutch government’s vision in general is that pharmacists in their professional role work closely with physicians to support appropriate