18th EAHP Congress in Paris: Improving patient outcomes—a shared responsibility
- Received 22 March 2013
- Accepted 25 March 2013
‘The early bird catches the worm’ as the saying goes, and for this Congress it meant that those who arrived early avoided travel disruption due to wintry weather. Long delays, closed airports and traffic accidents created difficulties for many attendees. However nearly everyone persevered, and on the last day the Chairman of the Scientific Committee Prof Dr Cees Neef was able to announce that over 3300 people had managed to attend, a number only slightly lower than last year's record.
The largest event for hospital pharmacists in Europe, the European Association of Hospital Pharmacists (EAHP)'s Annual Congress is now limited by its success to venues that can accommodate this popular gathering. The Palais des Congrès in Paris was one such excellent venue. In addition to the main programme and a large exhibition area, 16 industry-sponsored satellite seminars were accommodated. As the host country was France, delicious food was beautifully presented at break times.
The EAHP is as ever deeply grateful to its sponsors, Amgen, Bayer, and Pfizer and all other industry stakeholders. An educational grant from Amgen was used to hold the first Synergy satellite. ‘Biosimilars—do not look in the mirror’ was designed to deliver the highest quality of educational content. The main conclusion reached by Dr Hans Ebbers was that biosimilars have arrived! The EU biosimilarity exercise has demonstrated that products are highly similar and therapeutically equivalent. Thus far, no safety issues have arisen for biosimilars marketed in the EU; monoclonal antibodies will be the next challenge.
The excellent relations EAHP have built up with the industry mean that Association finances and the future of the Congress are secure, despite the economic slowdown. The fruits of continuing dialogue with other associations were also to be seen at this year's Congress. Inter-sector communication means that hospital pharmacists have friends who are also lobbying the EU about issues of mutual concern. Leaders of several associations were invited to attend the Congress, and met to plan future actions while they were together. These included the European Industrial Pharmacists’ Group, the European Society of Oncology Pharmacists, the European Public Health Alliance, the Union Européen des Médecins Specialistes, and of course the International Pharmaceutical Federation (FIP). All the representatives praised a different aspect of the Congress, first-timers being amazed at the vitality, numbers and good connections of hospital pharmacists.
Another ‘first’ this year was a seminar for pharmacy students. There is a growing partnership between the EAHP and the European Pharmaceutical Students’ Association (EPSA). Facilitated by David Preece, who is doing a year's internship in the EAHP Brussels office, speakers discussed their career to date and focused on the attractions of working in hospital pharmacy. Dr Marianne Ivey, the first keynote speaker, joined the session, explaining the need to put the patient at the centre of the approach. This theme was taken up by many in the Congress.
Working in multidisciplinary teams
The keynote lectures are intended to bring to life the congress theme as a whole, each from a different perspective. Keynote 2, which put over the necessity of the multidisciplinary approach, received particularly high praise. Dr Fiona Reynolds is a multi-talented paediatric intensive care specialist who has published research on human factors and teamwork in emergency situations, while at the same time working on mathematical modelling of healthcare demand and capacity with her programmer husband. Explaining first what teamwork might mean in a hospital setting, and how a physician, pharmacist, nurse, physical therapist, chaplain, and occupational therapist might all be needed to help a patient recover, she pointed out that different skill sets can offer checks and balances. A doctor might be a patient-centred risk taker, while a pharmacist might be more cautious and see a bigger picture. Effective team building takes a long time and requires frequent contact. It is particularly difficult in hospitals, where the team constantly changes. All members must understand the role and contribution of other members, and communication must be open and non-recriminatory. Hundreds of excess deaths when this does not happen are a chilling reminder that we need to get this right. Dr Reynolds went on to show how they set about improving the culture of teamwork in Birmingham Children's Hospital and her paediatric intensive care unit.
The third keynote lecture dealt with similar themes of culture change. Prof Dr Norbert Pateisky of Austria made the audience cry and laugh while explaining the difference between quality (easy to measure) and safety (very difficult to measure). Drawing on the lessons learned in the aircraft industry, he explained why a checklist works for pilots but not senior doctors and why hierarchy is an enemy of a safety culture. It seems that safety results from complicated interactions: hospital-wide standardisation but at the same time good interpersonal relations between all members of each team.
The three keynote presentations framed, as intended, the more focused seminars. In ‘Medicines across the interface—who is responsible?’ Dr Julie Rouprêt-Serzec and Professor Jean-Hugues Dalle from Paris described setting up a pharmacist advice service for children treated for haematological malignant disease before leaving hospital. Professor Anthony Sinclair, Director of Pharmacy at Birmingham Children's Hospital, described the difficulties faced by a large and rapidly-growing number of complex cases treated as outpatients. Both hospitals had financial constraints and both had responded by putting the patient first and slowly building up the care they are able to provide.
In ‘Team challenges in cancer—from cytotoxics to supportive care’ the speakers were Professor Jørn Herrstedt, a professor of clinical oncology from Denmark, and João Oliveira of the Lisbon Regional Oncology Centre, Portugal. Professor Herrstedt humorously outlined why supportive care is necessary for cancer patients, recommending that hospital pharmacists join the Multinational Association of Supportive Care in Cancer. Pharmacists would be familiar with two sets of problems: the side effects of chemotherapy with curative intent and those of palliative care in dying patients. He strongly urged pharmacists to be more proactive in introducing systems to restrain doctors from pursuing overambitious treatment objectives regardless of cost or minimal gains in life expectancy. Mr Oliveira likewise urged hospital pharmacists to redesign patient pathways and control costs.
Both of these seminars were well attended and overran the time slot due to audience interest.
The organisers’ opinions
In brief interviews for the EJHP, Scientific Committee Chairman Cees Neef and EAHP President Roberto Frontini both expressed satisfaction with this year's Congress. The high level of attendance was a compliment to the organising committee. Professor Neef was also pleased to hear praise for the high standard of presenters this year. The committee tries to raise the standard year by year, as more pharmacists and physicians succeed in mastering English to the extent of becoming world players.
Dr Frontini thought the theme had worked well. The different sessions had gone well and he had heard many stakeholder discussions outside the sessions, so felt the Congress had been very successful.
Valuing the work of individual hospital pharmacists
One of the great successes of the Congress has been to interest hospital pharmacists in doing original research. This has led to more and more posters being submitted, up from 262 in 2010 to 950 in 2013! Introducing the poster prizes at the end of the Congress, EAHP President Professor Frontini explained that this gave the Scientific Committee a lot of work to review them all. While appreciating the hard work that went into them, they felt they had to reject some of the least well-expressed abstracts and posters. Therefore, this year they asked three experienced writers to teach good scientific practice when creating scientific questions and choosing study methodology. The workshop also outlined the structure of a high-quality scientific abstract.
Professor Frontini then announced this year's winners. In reverse order, third place (€250) was awarded to S Alaqeel and colleague from Saudi Arabia for ‘Dispensing practice in Saudi community pharmacy’. Second prize of €500 went to DN Wigg and colleague from England for ‘Insulin: improving prescribing safety’. Collecting first prize of €750 on behalf of herself and three colleagues was TRH Nielsen of Denmark with ‘Pharmacy optimisation of the medication process during admission to hospital: a multicentre, randomised controlled trial’.
As usual at the end of the Congress, two host country pharmacists who joined the Organising Committee to prepare for this congress, Dr Guillaume Hache and Dr Nicholas Janus, were thanked for their hard work, as were EAHP staff members. It takes 2 years to prepare a Congress, so work is already well under way for the 19th EAHP Congress in 2014, which will be held in ever-popular Barcelona. The theme will be ‘The innovative hospital pharmacist—imagination, skills and organisation’.
To listen to podcasts recorded with some of the key speakers at the 18th EAHP Congress, please visit ejhp.bmj.com
Competing interests None.
Provenance and peer review Commissioned; internally peer reviewed.