The Danish Network for Community Pharmacy Practice Research and Development
2. Community Pharmacies in Denmark
3. Establishment and Structure of the Network
4. The Vision
5. How Does the Network Support its Members?
6. What Have We Learned So Far?
- The importance of establishing the project group with an allocated project manager to ensure support for the project;
- To ensure that the project yields valid data and robust results, it is important to involve both practitioners and researchers;
- When conducting a project with several community pharmacies participating, it is important to conduct a kick-off meeting with representatives from all participating pharmacies;
- Thorough instructions for the participants and follow up during data collection are important for a successful result;
- Participation in larger projects can enhance the sense of purpose, meaningfulness, and competency for many community pharmacy practitioners and pharmacy practice researchers;
- Participation in research and development projects results in useful knowledge to enhance the daily dialogue and counselling with customers at the pharmacy counter.
7. What Does the Future Hold for the Network?
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
|Project Title:||Triple Whammy—Safe Use of NSAIDs|
|Background:||It is well documented that the combination of diuretics and an ACE inhibitor (or angiotensin II receptor antagonist) with NSAIDs presents a risk of acute renal failure.|
The combination is known as triple whammy. The combination can result in a 31% increased risk of acute renal failure—the risk is doubled within the first 30 days of treatment with NSAIDs.
Together, the three drug groups, used alone or in combination, account for more than half of reported cases of drug-induced acute renal failure. Older adults are especially at risk as kidney function deteriorates with age.
As community pharmacy staff meet many patients every day, and possess knowledge about medication, there is a possibility that they can help these customers in their daily counselling, as well as those who may want to buy NSAIDs in retail in the future, without receiving counselling.
|Aim:||To quantify customers who use the triple whammy drug combination, including both customers who receive NSAIDs on prescription and customers who buy NSAIDs over the counter.|
To describe the awareness of the triple whammy effect among pharmacy staff and customers.
Introducing and implementing an information leaflet on the triple whammy effect, as part of the counselling to these customers.
|Design and methods:||Information about counselling of all patients who come to the pharmacy to buy any kind of NSAID, both prescription and OTC, will be registered by pharmacy staff. Data collection via digital survey.|
|Timeframe:||January 2020–May 2021|
|Dissemination plan:||Peer-reviewed paper, video presentations, articles in relevant Danish periodicals|
|Project manager:||Anne Mette Jørgensen, Pharmacist at Stege Pharmacy|
(Community pharmacy/researcher etc.)
|Which member of the steering committee do you wish to work with?|
- van Mil, J.W.F. Pharmaceutical care in community pharmacy: Practice and research in the Netherlands. Ann. Pharmacother. 2005, 39, 1720–1725. [Google Scholar] [CrossRef] [PubMed]
- Herborg, P.D.H. Safe and Effective Use of Medicines for Ethnic Minorities-A Pharmacist- Delivered Counseling Program That Improves Adherence. J. Pharm. Care Health Syst. 2015, 2, 2. [Google Scholar] [CrossRef][Green Version]
- Kjeldsen, L.J.; Bjerrum, L.; Dam, P.; Larsen, B.O.; Rossing, C.; Søndergaard, B.; Herborg, H. Safe and effective use of medicines for patients with type 2 diabetes-A randomized controlled trial of two interventions delivered by local pharmacies. Res. Soc. Adm. Pharm. 2015, 11, 47–62. [Google Scholar] [CrossRef] [PubMed]
- Herborg, H.; Soendergaard, B.; Froekjaer, B.; Fonnesbaek, L.; Jorgensen, T.; Hepler, C.D.; Grainger-Rousseau, T.J.; Ersboell, B.K. Improving drug therapy for patients with asthma—Part 1: Patient outcomes. J. Am. Pharm. Assoc. 2001, 41, 539–550. [Google Scholar] [CrossRef]
- Herborg, H.; Soendergaard, B.; Jorgensen, T.; Fonnesbaek, L.; Hepler, C.D.; Holst, H.; Froekjaer, B. Improving drug therapy for patients with asthma-part 2: Use of antiasthma medications. J. Am. Pharm. Assoc. 2001, 41, 551–559. [Google Scholar] [CrossRef]
- Hopp, T.R.; Klinke, B.O.; Sørensen, E.W.; Herborg, H. Roberts Implementation of cognitive pharmaceutical services in Danish community pharmacies—perceptions of strategists and practitioners. Int. J. Pharm. Pract. 2006, 14, 37–49. [Google Scholar] [CrossRef]
- Abrahamsen, B.; Burghle, A.H.; Rossing, C. Pharmaceutical care services available in Danish community pharmacies. Int. J. Clin. Pharm. 2020, 42, 315–320. [Google Scholar] [CrossRef]
- Koster, E.S.; Blom, L.; Philbert, D.; Rump, W.; Bouvy, M.L. The Utrecht Pharmacy Practice network for Education and Research: A network of community and hospital pharmacies in The Netherlands. Int. J. Clin. Pharm. 2014, 36, 669–674. [Google Scholar] [CrossRef] [PubMed]
- Marinac, J.S.; Kuo, G.M. Characterizing the American college of clinical pharmacy practice-based research network. Pharmacotherapy 2010, 30, 865. [Google Scholar] [CrossRef]
- Mott, D.A.; Chater, R. Collaborations to facilitate success of community pharmacy practice-based research networks. J. Am. Pharm. Assoc. 2008, 48, 153–162. [Google Scholar]
- Pruchnicki, M.C.; Rodis, J.L.; Beatty, S.J.; Clark, C.; McAuley, J.W.; Mehta, B.H.; Pedersen, C.A.; Protus, B.; Bennett, M.S. Practice-based research network as a research training model for community/ambulatory pharmacy residents. J. Am. Pharm. Assoc. 2008, 48, 191–202. [Google Scholar] [CrossRef]
- Lindsey, L.; Husband, A.; Steed, L.; Walton, R.; Todd, A. Helpful advice and hidden expertize: Pharmacy users’ experiences of community pharmacy accessibility. J. Public Health Engl. 2017, 39, 609–615. [Google Scholar] [CrossRef] [PubMed]
- Apotekerforeningen. Lægemidler i Danmark 2019–20. Available online: https://www.apotekerforeningen.dk/-/media/apotekerforeningen/stoerre_publikationer/laegemidler-i-danmark-2019-2020.pdf?la=da&hash=105F8904B093616CBFFB5342BAA1ABEBCB05C56E (accessed on 8 December 2020).
- Burghle, A.; Abrahamsen, B.; Lundby, C.; Rossing, C.; Hansen, R.N.; Nørgaard, L.S.; Pottegård, A. Customers’ information seeking behavior prior to community pharmacy visits: A community pharmacy survey. Res. Soc. Adm. Pharm. 2019, 16, 1442–1446. [Google Scholar] [CrossRef]
- Hansen, N.R.; Nørgaard, L.; Hedegaard, U.; Søndergaard, L.; Servilieri, K.; Bendixen, S.; Rossing, C. Integration of and visions for community pharmacy in primary health care in Denmark. Pharm. Pract. 2021, 19, 1–9. [Google Scholar]
- Danish Regions. Available online: https://www.regioner.dk/services/in-english (accessed on 9 June 2021).
- KL—Local Government Denmark. Available online: https://www.kl.dk/english/ (accessed on 9 June 2021).
- Danish Medicines Agency. Over-the-Counter Medicines. Available online: https://laegemiddelstyrelsen.dk/en/pharmacies/over-the-counter-medicines/ (accessed on 23 April 2021).
- Apotekerforeningen. Sammen Forebygger vi Bedst. Available online: https://www.apotekerforeningen.dk/-/media/apotekerforeningen/publikationer/apotekets-folder-sammen-forebygger-vi-bedst.pdf (accessed on 8 December 2020).
- Herborg, H.; Sørensen, E.W.; Frøkjaer, B. Pharmaceutical care in community pharmacies: Practice and research in Denmark. Ann. Pharmacother. 2007, 41, 681–689. [Google Scholar] [CrossRef] [PubMed]
- Benrimoj, S.I.; Feletto, E.; Wilson, L. Building Organisational Flexibility to Promote the Implementation of Primary Care Services in Community Pharmacy. 2015. Available online: https://6cpa.com.au/wp-content/uploads/Building-Organisation-Flexibility-to-Promote-the-Implementation-of-Primary-Care-Service-in-Community-Pharmacy-Final-Report.pdf (accessed on 28 August 2020).
- Danish Network for Community Pharmacy Practice Research and Development. Available online: https://www.pharmakon.dk/forskning/apoteksnetvaerk/ (accessed on 15 February 2021).
- Jørgensen, A.M.; Windsor, P.B.; Nørgaard, L.S.; Pottegaard, A.; Hansen, R.B. Patient Characteristics among Users of Proton Pumpinhibitors (PPI) in Danish Pharmacy Settings. 2019. Available online: https://linkinghub.elsevier.com/retrieve/pii/S155174111930854X (accessed on 10 June 2021).
- Reduktion i Langtidsbehandling Med Protonpumpe-Hæmmere (PPI). Available online: https://www.youtube.com/watch?v=JXrmwd6kF-c (accessed on 17 February 2021).
- Apotekskunders Informationssøgning før Apoteksbesøg. Available online: https://www.youtube.com/watch?v=Dp3nDcqlWzw (accessed on 17 February 2021).
- Stampe, G. Tværfagligt Samarbejde Mellem Apotek og Almen Praktiserende Læge. Available online: https://www.pharmakon.dk/media/1911/2018_specialeafhandling_gitte-stampe_final.pdf (accessed on 28 January 2021).
- Lundby, C.; Nielsen, A.V.; Bendixen, S.; Almarsdóttir, A.B.; Pottegård, A. Unavailable prescriptions at Danish community pharmacies: A descriptive study. Int. J. Clin. Pharm. 2019, 41, 672–676. [Google Scholar] [CrossRef]
- Nielsen, A.V. Help Please–My Prescription is Unavailable! Occurrence and Underlying Reasons for Unavailable Prescriptions and the Development of a Protocol for Dependent Pharmacist Repeat Prescribing at Danish Community Pharmacies. Available online: https://www.pharmakon.dk/media/1896/masters-thesis-anne-vejrum-nielsen-mwt233.pdf (accessed on 28 January 2021).
- Kutlu, Z. Danish Physicians’ and Pharmacists’ Knowledge, Attitude and Behavior on Antibiotics for Children under the Age of 15. Available online: https://www.pharmakon.dk/media/1907/speciale_zueleyha-kutlu.pdf (accessed on 28 January 2021).
- Pultz, K.; Rikke, N.H.; Rossing, R.C. Afprøvning af Medicinmøder Med Hjemmeplejen. Available online: https://www.pharmakon.dk/media/1417/rapport-v2-afproevning-af-medicinmoeder_web.pdf (accessed on 28 January 2021).
- Valentin, J. Evaluering af det Danske Netværk Indenfor Udvikling af Apotekspraksis. Available online: https://www.pharmakon.dk/media/1864/isa-evaluering-af-det-danske-netvaerk-indenfor-udvikling-af-apotekspraksis.pdf (accessed on 28 January 2021).
- Nørgaard, L.S.; Hansen, R.N.; Søndergaard, L.; Servilieri, K.M.; Bendixen, S.O. The Danish Network for Community Pharmacy Practice Research and Development. 2019. Available online: https://linkinghub.elsevier.com/retrieve/pii/S155174111930854X (accessed on 11 June 2021).
- Ayoub, W. Kommunikation Mellem Apotekspersonale og Ældre af Anden Etnisk Baggrund End Dansk. Available online: https://www.pharmakon.dk/media/1946/kort-rapport-kommunikation-mellem-apotekspersonale-og-aeldre-af-anden-e_.pdf (accessed on 28 January 2021).
- Kristiansen, S.; Nørgaard, L.S.; Paltoft, S. COVID-19-Seen through the Eyes of the Pharmacy Interns. 2020. Available online: https://pharmacyeducation.fip.org/pharmacyeducation/article/view/1157 (accessed on 11 June 2021).
- Elberg, M.D. The Pharmacy’s Experiences with Abuse of Over-the-Counter Medicines. Available online: https://www.pharmakon.dk/media/2210/martin-damm-elberg_162645_83913_hovedopgave_apotekets-erfaringer-med-misbrug-af-handkobslagemidler.pdf (accessed on 16 April 2021).
- Kaae, S.; Nørgaard, L.S.; Sporrong, S.K.; Almarsdottir, A.B.; Kofoed, M.; Daysh, R.F.; Jowkar, N. Patients’, Pharmacy Staff Members’, and Pharmacy Researchers’ Perceptions of Central Elements in Prescription Encounters at the Pharmacy Counter. Pharmacy 2019, 7, 84. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Fosgerau, C.F.; Kaae, S. Furthering patient-centered counseling: Exploring new aspects around pharmacists’ experiences in pharmacy encounters through video-stimulated recall interviewing. Res. Soc. Adm. Pharm. 2020, 17, 723–732. [Google Scholar] [CrossRef]
- Lech, L.V.J.; Husted, G.R.; Almarsdottír, A.B.; Andersen, T.R.H.; Rossing, C.; Nørgaard, L.S. Hospital and Community Pharmacists’ Views of and Perspectives on the Establishment of an Intraprofessional Collaboration in the Transition of Care for Newly Discharged Patients. Innov. Pharm. 2020, 11, 4. [Google Scholar] [CrossRef] [PubMed]
- Lech, L.V.; Husted, G.R.; Rossing, C.; Andersen, T.R.H.; Almarsdóttir, A.B.; Nørgaard, L.S. Establishing an inter-professional collaboration between hospital and community pharmacy pharmacists in Denmark. 2019. Available online: https://linkinghub.elsevier.com/retrieve/pii/S155174111930854X (accessed on 11 June 2021).
|Year||Project Title||Aim||Participants||Data Collection||Dissemination||Project Type||Conclusions|
|2017||Reduction in long-term treatment with proton pump inhibitors (PPIs)||To quantify the use of PPI for regular users to determine how many use it regularly and to examine how many have tried to discontinue their PPI-treatment||395 community pharmacy customers||Interviews||Poster at Nordic Social Pharmacy and Health Services Research Conference (NSPC) |
Video presentation 
|Development project||A large proportion of PPI users (80%) use their medicine continuously. The leaflet information was a useful tool to provide essential information to new users in addition to counceling at the community pharmacy counter.|
|2018||Customers’ information seeking behavior prior to community pharmacy visits: a community pharmacy survey||To quantify and describe customers’ information seeking behavior prior to community pharmacy visits, and to describe how pharmacy staff utilize information obtained by customers.||2623 community pharmacy customers||Survey||Burghle et al. |
Posters at international conferences: Pharmaceutical Care Network Europe (PCNE) and Nordic Social Pharmacy and Health Services Research Conference (NSPC)
Video presentation 
|Descriptive study||A total of 14.4% of customers had sought information prior to visiting the community pharmacy.|
The majority of customers had used reliable sources, and the information was used during pharmacy counselling.
|2018||Interdisciplinary collaboration between community pharmacy and general practitioner||To describe what characterizes the Danish pharmacies’ interdisciplinary collaboration with the general practitioner in the primary sector..||29 community pharmacy staff members||Survey||Master thesis report ||Descriptive study||The interdisciplinary collaboration between the pharmacy and the general practitioner in the primary sector was characterized by a high level of ‘trust’, ‘mutual professional respect’, and a clear ‘role distribution’.|
|2018||Unavailable prescriptions at Danish community pharmacies: A descriptive study||To describe the occurrence and reasons for unavailable prescriptions at Danish community pharmacies as well as the types of drugs involved||2765 prescriptions registered||Survey||Lundby et al. |
Master thesis by Anne Vejrum Nielsen 
|Descriptive study||Unavailable prescriptions occur in approximately 1% of all dispensing at Danish community pharmacies. Miscommunication between the patient and general practitioner seems to be the primary source of unavailable prescriptions.|
|2018||Danish physicians’ and pharmacists’ knowledge, attitude, and behavior regarding antibiotics for children under the age of 15||To describe the knowledge, attitudes, and actions of physicians and community pharmacists regarding antibiotics for children under the age of 15||8 interviews and 762 prescriptions registered||Semi-structured interviews and a cross-sectional survey||Master thesis report ||Descriptive and qualitative study||Physicians and pharmacists are aware of the appropriate use of antibiotics and antibiotic resistance. Physicians deviate from guidelines, though, when prescribing antibiotics in regard to choice of antibiotic type and dose.|
|2018||Roundtable between community pharmacy and homecare to support patient safety||To test roundtable meetings between community pharmacy and homecare staff regarding medication||Four community pharmacies and four municipalities||Surveys and online meeting minutes||Report by Pultz et al. |
Poster at Pharmaceutical Care network Europe (PCNE)
|Development project||The roundtables had a positive influence on quality and safety in medication management and are very relevant for the daily work in homecare. Additionally, homecare staff should be involved in planning the content of the roundtables and prioritizing topics.|
|2019||Evaluation of the Danish Network for Community Pharmacy Practice Research and Development||To explore the attitudes of community pharmacy staff on the Danish network for Community Pharmacy Practice Research and Development||41 community pharmacy staff||Survey||Report by Julie Valentin |
Posters at Nordic Social Pharmacy and Health Services Research Conference (NSPC)  and at FIP-congress 2018
|Descriptive study||Members of the network were generally satisfied with the management of the network. However, they had some suggestions for improvements e.g., and idea bank for their project ideas and a newsletter sent directly to their work e-mail regarding the status of the projects in the network.|
|2019||Communication between pharmacy staff and older migrants||To investigate the communication between older migrants and pharmacy staff at the community pharmacy counter||152 community pharmacy customers||Survey||Master thesis report ||Descriptive study||This pilot study indicates that older migrants with language barriers receive less and more basic medical information at the community pharmacy compared with customers who are Danish native speakers.|
|2020||COVID-19 at the University of Copenhagen’s internship pharmacies—spring semester 2020||To describe the experiences and reflections of pharmacy internship students from University of Copenhagen about the impact of COVID-19 on Danish community pharmacies||47 pharmacy internship students||Survey||Presentation at FIP virtual conference 2020 ||Qualitative study||The students gave, among other things, 12 suggestions for what they think could be maintained after the corona pandemic, e.g., meeting culture, social distancing, training in crisis preparedness.|
|2020||Experiences with abuse of over-the-counter medication in the community pharmacy||To describe Danish pharmacy pharmacists’ experience in regard to customers and their abuse of over-the-counter medicine||Seven sommunity pharmacists||Semi-structured interviews||Master thesis report ||Qualitative study||The pharmacists in this study all had experiences with customers abusing over-the-counter drugs. Pharmacy pharmacist experience abuse of over-the-counter drugs on a weekly basis. Identification of abuse takes place through identification of needs, and attempts are made to deal with it through counseling|
|2016||Improving counselling at the community pharmacy||To explore different ways to improve counselling at the community pharmacy||Pilot study:|
Two community pharmacies
Intervention study: 30 pharmacists and pharmacy technicians from community pharmacies
Focus group interviews
Observational and interview study
Test and survey
|Kaae et al. |
Fosgerau, Kaae 
|2017||The pharmacist as a bridge-builder in the transition of care at discharge||To to develop and test a cross-sectoral pharmacist-to-pharmacist service to optimize drug treatment and drug information at sector transitions||6 community pharmacists and clinical pharmacists from hospital||Focus group interviews|
Documentation of practice via survey
|Lech et al. |
Poster presentation at Nordic Social Pharmacy and Health Services Research Conference (NSPC) 
|Development project (PhD project)|
|2019||Quality of pregnancy prevention in women using teratogenic drugs||To explore patients’ and healthcare professionals’ knowledge about pregnancy prevention in women who use teratogenic drugs||103 patients||Survey||Ongoing||Descriptive study|
|2019||Scope and practice of re-prescribing in Danish community pharmacies||To explore practices for the re-prescribing service, with regard to providing input to community pharmacies, the Danish Health Authority, educators, and interest organizations in relation to the status, implementation, and development of the service.||125 re-prescribing situations registered||Survey||Ongoing||Descriptive study|
|2020||Data-driven dialogue on medical adherence in Danish community pharmacies with the help of Klikkit’s telehealth solution||To test the KlikKit technology to support patients at three selected pharmacies, and to assess how the overview of patients’ medication use can be included in a consultation about compliance||Ongoing||Focus group interviews||Ongoing||Development project|
|2020||Triple whammy effect—safe use of NSAIDs||To explore the number of customers who use the triple whammy combination, including both customers who receive NSAIDs on prescription and customers who buy NSAIDs over the counter. Furthermore, to disseminate awareness of the triple whammy effect among pharmacy staff and customers||Ongoing||Patient survey and documentation of practice|
Survey for the pharmacy staff
|2020||Narrative Medicine in pharmacy practice—a feasibility study||To develop a course in narrative medicine for community pharmacists and to investigate the feasibility of the course and the effect of the training on the empathic skills of pharmacists||Ongoing||Educational course in narrative medicine for pharmacists|
|2020||Drug shortages in community pharmacies||To explore the extent of drug shortages in Danish community pharmacies||Ongoing||Survey||Ongoing||Descriptive study|
|2020||Instruction of patients in using the positive expriatory pressure (PEP) device at the community pharmacy||To develop the service “Instruction in the use of PEP at community pharmacies in Aarhus”||Ongoing||Observations|
|2020||Customers’ wishes and attitudes towards the COVID-19 antibody test||To explore the customers’ motivations for taking the test at the community pharmacy, their expectations for the use of the results, and their attitude towards the price of the test||Ongoing||Survey||Ongoing||Development project|
|2021||Validation of Living with Medicines Questionnaire||To conduct a translation, cross-cultural adaptation and validation of a Danish version of the Living with Medicines Questionnaire||Ongoing||Translation and cross-cultural adaptation using forward and backward translation||Ongoing||Validation study|
|2021||Implementation of screening for streptococcus A at the pharmacy||To explore the attitudes of general practitioners and community pharmacits on implementing a test for streptococcus A at the community pharmacy||Ongoing||Interviews||Ongoing||Qualitative study|
|2021||The community pharmacy and cancer-related late effects||To explore how many current and former cancer patients with late effects come to the community pharmacies, their needs and wishes, and whether they are interested in receiving support from a community pharmacist to deal with cancer-related late complications||Ongoing||Survey||Ongoing||Descriptive study|
|2021||Patients’ perspectives on the deprescribing process||To explore the patient perspective in the deprescribing process. In addition, the project aims to describe the extent to which and how patients see role of the community pharmacy in the deprescribing process||Ongoing||Interviews||Ongoing||Qualitative study|
|2021||Use of pain medication in Denmark: A community pharmacy survey||To explore the use of analgesics among Danish community pharmacy customers||Ongoing||Survey||Ongoing||Descriptive study|
|2021||Is the patient information leaflet necessary?||To explore the use of the paper-based patient information leaflets in medication packages by community pharmacy customers vs. the use of digital alternatives||Ongoing||Survey||Ongoing||Descriptive study|
|2021||Sustainable conversion of community pharmacies and medicine use in Denmark in a Nordic perspective—a study of the role and perceptions of Danish community pharmacy staff||To examine the Danish community pharmacies in a sustainable context and to describe and understand the community pharmacies’ perception and role in the sustainable development of Danish community pharmacies and the sustainable transition of medicine use in Denmark||Ongoing||Survey|
|Ongoing||Descriptive and qualitative study|
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Burghle, A.; Hansen, R.N.; Nørgaard, L.S.; Hedegaard, U.; Bendixen, S.; Søndergaard, L.; Servilieri, K.; Hansen, J.; Rossing, C. The Danish Network for Community Pharmacy Practice Research and Development. Pharmacy 2021, 9, 114. https://doi.org/10.3390/pharmacy9020114
Burghle A, Hansen RN, Nørgaard LS, Hedegaard U, Bendixen S, Søndergaard L, Servilieri K, Hansen J, Rossing C. The Danish Network for Community Pharmacy Practice Research and Development. Pharmacy. 2021; 9(2):114. https://doi.org/10.3390/pharmacy9020114Chicago/Turabian Style
Burghle, Alaa, Rikke Nørgaard Hansen, Lotte Stig Nørgaard, Ulla Hedegaard, Susanne Bendixen, Lone Søndergaard, Kerly Servilieri, Julianne Hansen, and Charlotte Rossing. 2021. "The Danish Network for Community Pharmacy Practice Research and Development" Pharmacy 9, no. 2: 114. https://doi.org/10.3390/pharmacy9020114