Pharmaceutical care in community pharmacies:: Practice and research in Denmark

OBJECTIVE: To review the current status of Danish community pharmacy in both practice and research and discuss future trends. FINDINGS: Denmark has a social welfare system that provides health care, social services, and pensions to its population. Medical care and surgery are free. Prescription medicines are reimbursed by an average of 56%. Community pharmacies are privately owned, but the health authorities regulate drug prices and the number of pharmacies. At present, Denmark has 322 pharmacies, corresponding to 1 pharmacy per 16 700 inhabitants. All pharmacies provide prescription and over-the-counter products, advice about medicine use, dose dispensing, generic substitutions, and administration of individual reimbursement registers. Except for very simple processes, compounding is centralized at 3 pharmacies. Many pharmacies offer measurement of blood glucose, blood pressure, and cholesterol, and 60% offer inhalation counseling, a reimbursed service. Research in pharmacy practice is well established and conducted primarily at universities and at Pharmakon A/S, which is owned by the Danish Pharmaceutical Association. DISCUSSION: Extended services in clinical pharmacy are priorities for all Danish pharmacy organizations. Reimbursement is sought at the national level, as well as from payers in the new local authority structures in Denmark. The trend in research focuses on collaborative health care, on developing and documenting the value of community pharmacy services, and on optimizing services and strengthening implementation. CONCLUSIONS: Denmark has few, but large, community pharmacies and a long tradition of research and development resulting in several well-documented cognitive and clinical services. However, few services are reimbursed and implementation is still a challenge.