Rebekah J Moles, Lee Vermeulen, Jonathan Penm, Marianne Ivey
In 2008, the International Pharmaceutical Federation (FIP) hosted the Global Conference on the Future of Hospital Pharmacy in Basel, Switzerland. The result of this historic meeting was the release of 75 consensus statements reflecting a unified vision of hospital pharmacy practice, known as the Basel statements.1 In 2014, hospital pharmacy practitioners and leaders undertook an extensive revision of the Basel statements, to ensure that they remained current and applicable to practice. The revision process involved 3 phases: a global online survey, review through an online forum, and a “World Café” workshop.
In the first phase, a survey was sent to hospital pharmacy stakeholders in late 2013 and early 2014. Participants were asked to comment on each statement by agreeing with the statement as written, suggesting that it be deleted, or suggesting that it required changes in wording. In the latter situation, respondents had the option of suggesting revised language. Respondents could also suggest new statements not included in the original 75. A total of 334 survey responses were received from 62 countries. Fourteen of the statements were judged by more than 10% of respondents as requiring revision or deletion, and these statements were rigorously discussed at a face-to-face meeting of the Hospital Pharmacy Section executive in late March 2014. Following initial revisions by the executive, the statements were further scrutinized in a global online forum. During this phase, individuals from 28 countries, representing all 6 of the World Health Organization regions, made recommendations. This process culminated in additional concepts being flagged for inclusion, such as the role of technology assessment, the responsibility of hospital pharmacy for the integrity of outsourced sterile products, and the development of specialty practice. In the final phase, 80 participants from 20 countries participated in a “World Café” workshop at the FIP congress in Bangkok in 2014. At the end of the workshop, participants voted on the statements, a process that resulted in the final 65 revised Basel statements, listed under the same 6 main themes as the original statements: procurement, influence on prescribing, preparation and delivery of medicines, medicines administration, monitoring medication, and human resources and training. A set of overarching statements are also available. In September 2015, the revised Basel statements (available online at www.fip.org/basel-statements) were launched for the world to use.
So, you might ask, what has changed? For those who were already on the road to adopting the original statements, the good news is that you can keep going: despite the fact that there are fewer statements, the essence of their content remains intact. In fact, the decrease in the number of statements is mainly due to the recognition and elimination of overlap. However, some new concepts have also been added, specifically to deal with managing the environmental effects of pharmaceuticals, advances in information technology, and the use of electronic health records. Furthermore, terms used by the FIP, such as “responsible use of medicines”, are reflected in the new statements. Finally, the wording changes aim to simplify the statements, making them clearer and more easily applicable across countries.
With this reassurance about the appropriateness of the changes, you might reflect that having this set of statements is all well and good, but you still might question whether they are really relevant. Similarly, you might wonder how they can be used. The executive of the FIP Hospital Pharmacy Section believes that these statements provide a roadmap for hospital pharmacy practice, as they are truly global and reflective of ideal standards. Since their inception in 2008, the Basel statements have been used by hospital pharmacy organizations in various countries and by individual hospitals to change or monitor practice. Some institutions may even be able to use the statements to “leverage” political infrastructure to support the adoption of more pharmacy services.
This issue of the Canadian Journal of Hospital Pharmacy (CJHP) includes a scoping review of how the Basel statements have been used in research.2 For their review, the authors identified 14 published studies: 4 reporting adaptation of the statements to the European environment, 6 focusing on use of the statements in monitoring current practice, and 4 exploring barriers to and facilitators of implementation of particular statements. Although much of the research to date has occurred in the Western Pacific Region and in Europe, the scoping review also showcases a longitudinal study from a hospital in Uganda, described in a previous CJHP article.3 The authors of that earlier report highlighted improvements in implementation of the statements over time. It would appear that the impetus for change was an increasing awareness of the statements, along with the willingness of pharmacy staff to strive to improve services on the basis of the statements.3 These observations would therefore suggest that the more these statements are disseminated, read, reflected upon, and monitored, the more likely it is that there will be relatively rapid changes in the provision of hospital pharmacy services around the globe. It is therefore the responsibility of all hospital pharmacists to read the statements and to pass them along to colleagues.
Hospital practitioners from developed countries like our own (Australia and the United States), which have ways of doing things similar to those in Canada, may find it easy to gloss over the Basel consensus statements, to think that the statements are not needed, that existing practice is fine, and that they themselves are doing things to the best of their ability with the resources available. Nonetheless, we urge you to take a closer look at these statements, to find some that you might not be following as well as you could, and to reflect on how you might be able to make a change at your workplace. Conversely, if you are already doing something really well, with full adherence to one of the statements, why not let other institutions and other practitioners, including those in other countries, know how you went about getting your pharmacy service to that level of performance? To spread the word even further, we also recommend that pharmacy organizations program discussions of their successes in using various Basel statements. As members of the FIP Hospital Pharmacy Section executive, we truly believe that these statements are relevant for all and that they will maximize the value hospital pharmacists bring to the well-being of their patients. We encourage you to review the statements and take steps to make them a reality in your place of work!
1. The Basel Statements on the future of hospital pharmacy. Am J Health Syst Pharm. 2009;66(3):S61–6.
2. Penm J, Chaar B, Moles RJ. Use of the International Pharmaceutical Federation’s Basel statements to assess and advance hospital pharmacy practice: a scoping review. Can J Hosp Pharm. 2016;69(2):131–7.
3. Poh J, Vaillancourt R, Lamarre D, Oyela J. Use of the 2008 Basel consensus statements to assess, realign, and monitor pharmacy practice at a tertiary care hospital in northern Uganda: illustrative case study. Can J Hosp Pharm. 2013;66(5):318–27. 
Competing interests: All of the authors are members of the executive of the Hospital Pharmacy Section of the International Pharmaceutical Federation. No other competing interests were declared.
Canadian Journal of Hospital Pharmacy, VOLUME 69, NUMBER 2, March-April 2016