This book is being updated at a time of financial crisis leading to downward pressure on healthcare budgets. This means that pharmacists have to be even smarter at demonstrating their value for money and providing the evidence to underpin that. The value of clinical pharmacy services in terms of saving lives and saving money has been demonstrated, yet such services remain patchy in parts of central and eastern Europe. By contrast, many developing countries, particularly in Asia, are rapidly developing their clinical pharmacy with strong support from their health ministries.

The increased pressure of limited resources will continue to shape the way pharmacy is practised. Innovation continues to run ahead of our ability to fund new developments, and demands from an increasingly informed public who have ready access to medical information add to this pressure. Add to this the pressure to reduce our carbon footprint, and we have some challenges ahead.

These realities have created a fertile environment for the growth of evidence-based practice. Developments offering to identify effective interventions and providing the possibility of eliminating those activities which are ineffective or even harmful is clearly attractive to many, particularly those who purchase healthcare in some way or another. There is a further attraction in the belief that eliminating useless interventions will somehow free up resources for new developments. This is probably wishful thinking. However, other professionals regard the whole evidence-based movement as a threat to their right to practice.

The rapid unstoppable development of information technology has greatly facilitated the evidence-based healthcare movement. The rise of apps for tablets and smartphones makes information available at the fingertips. In 2012, some 250 000 medically related apps were downloaded worldwide. The internet provides worldwide and almost instant access across continents to high-quality evidence, good quality guidelines and protocols for treatment at little …