Evolution of hospital clinical pharmacy services in Finland in the period 2017-2022: the third nationwide follow-up survey

Background and objectives: Pharmacists' involvement in patient care became more common in Finnish hospitals during the period of 2011-2016. The first national survey was conducted in 2011 and repeated using the same method in 2016. This development was in accordance with patient safety policy initiatives and European hospital pharmacy statements. This study aimed to conduct the third national follow-up survey on hospital clinical pharmacy services in Finland in 2022 and compare the results with those in 2016.

Methods: The study was conducted in 2022 as a national online survey targeting hospital pharmacies (n=22) and smaller-scale, independently operating medicine dispensaries (n=23). Descriptive statistics and qualitative content analysis were used for the data analysis.

Results: The response rate was 64% (n=29/45), accounting for 19/22 hospital pharmacies and 10/23 medicine dispensaries. Clinical pharmacy services were provided in 83% (n=24/29) of the responding units. The clinical pharmacy staff increased between 2017 and 2022 and services became more common, particularly at admission units (eg, emergency departments) and outpatient clinics. In some units (25%, n=6/24), services were also available in the evenings and in one unit during weekends. Similar to 2016, system-based medication safety risk management was also highlighted in this survey, and the first medication safety officer positions (n=8/24) were created. The most increased tasks were medication reviews and medication safety audits, while in 2016 the most increased task was medication reconciliation. Pharmacist participation in patient discharge had decreased. Despite the increasing prevalence of automation technology and pharmacy assistants, logistical tasks decreased only slightly.

Conclusions: Finnish hospital clinical pharmacy services have continued to expand in accordance with national and international guidelines, and have become increasingly concentrated on medication safety risk management. They currently engage in admission and outpatient units, but effort should also be put into discharge.