title: A review of countries' pharmacist-patient communication legal requirements on prescription medications and alignment with practice: Comparison of Nordic countries.
abstract: BACKGROUND
  Pharmacist-patient communication around prescription medications can optimize treatment outcomes. Society's expectations of pharmacist-patient communication around medications can be expressed in legislation, economic incentives, and authority control. In this study, the Nordic countries of Denmark, Finland, Iceland, Norway and Sweden provide the legislative examples and can be used as a platform to discuss how society's expectations, professional visions, and practice are aligning.
  
  
  OBJECTIVE
  The overall aim of this study was to describe society's expectations of pharmacist-patient communication around medications as expressed by the state in Nordic legislation, economic incentives and authority control. Additionally, this study describes how the states govern Nordic pharmacists in different pharmacy systems.
  
  
  METHODS
  A legal review was performed using online legislative databases. Regulating authorities were contacted to gather supplementary information. Thereafter, a qualitative document analysis was conducted.
  
  
  RESULTS
  The Nordic countries regulate staff-patient communication by using broad laws. The legislation's main focus during dispensing is information on the use of medications, but also generic substitution and pricing. Pharmacies should have internal routines for this in place. Pharmacists' obligation to keep a journal on advice given during dispensing is ambiguously regulated. The economic incentives for communication on prescription medication during dispensing are included in the general pharmacy mark-up. Today's authority control focuses on the pharmacy management and appears to primarily evaluate structure indicators of communication, for example, if there is a routine method of counseling available.
  
  
  CONCLUSIONS
  Various countries throughout the world differ in their requirements for pharmacy staff to communicate on the use of medicines during dispensing. The Nordic countries all require such communication, which aligns with professional visions. Regardless of the pharmacy system, the states let the employer and pharmacy professions carry out it in practice with apparently little state involvement, thus showing trust in the profession and employers. However, since Nordic communication studies show deviation from the legislation, there are reasons to reevaluate and discuss the legislation, the economic incentives and the control system.
authors.affiliation: School of Pharmacy, Section of Social Pharmacy, Research Group Pharma-Safe, University of Oslo, P.O. Box 1068, Blindern, 0316 Oslo, Norway. Electronic address: karin.svensberg@farmasi.uio.no.
authors.forename: Karin
authors.initials: K
authors.lastname: Svensberg
authors.affiliation: Department of Pharmacy, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen, Denmark.
authors.forename: Sofia Kälvemark
authors.initials: SK
authors.lastname: Sporrong
authors.affiliation: School of Pharmacy, Section of Social Pharmacy, Research Group Pharma-Safe, University of Oslo, P.O. Box 1068, Blindern, 0316 Oslo, Norway.
authors.forename: Ingunn
authors.initials: I
authors.lastname: Björnsdottir
mesh_terms: D003142:Communication; D003157:Community Pharmacy Services / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D003376:Counseling / Q000331:legislation & jurisprudence / Q000379:methods; D016208:Databases, Factual; D006801:Humans; D010353:Patient Education as Topic / Q000331:legislation & jurisprudence / Q000379:methods; D010595:Pharmacists / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D055553:Prescription Drugs / Q000627:therapeutic use; D024382:Professional Role; D011369:Professional-Patient Relations; D012537:Scandinavian and Nordic Countries
chemical_list: D055553:Prescription Drugs
keywords: Communication; Community pharmacy; Legislation; Nordic countries; Pharmacy policy