Case Study – Germany | SIMPATHY project


Germany has one of the world’s most rapidly ageing populations. The impact on health care provision will be enormous. Multiple chronic morbidities are common among older citizens and multiple medications are needed to keep people’s health under control. However, such polypharmacy poses serious health risks if inadequately applied. Especially in Germany, where patients have direct access to GPs and specialists in primary care and consultation rates are traditionally high, medication tends to mount up with every medical appointment. Medication checks are not an explicit part of health insurance schemes. Health policymakers have become aware of the problem and are seeking solutions. This is where the regional training programme, ATHINA, comes in. Initiated by the Chamber of Pharmacists, ATHINA encourages and enables community pharmacists to perform medication reviews. So far, the role of pharmacists has been primarily to supply medications rather than taking an active part in patient care. The introduction of ATHINA has underlined pharmacists’ discontent with their currently under-utilized medical role. Already, within 2 years of its launch, 10% of all pharmacists in Lower Saxony have participated in this voluntary programme. Performing medication reviews in practice does, however, present challenges. There is a low demand from patients who have to pay for this service; reviews are based on patient statements and cannot utilize clinical data due to the lack of inter-connectedness of ICT-systems; medication analyses are time-consuming and interfere with the regular pharmacy workflow. Moreover, doctors also lay claim to medication checks and expect appropriate remuneration. ATHINA represents a crossroads in our healthcare system. To sustain and expand it, the specific role of pharmacists as partners in professional medical care needs to be politically established. Moreover, to make savings on the time required for the medication review, the long-awaited e-health law requires implementation, so that patient data can be shared between professions rather than repeatedly collected in isolation without reconciliation.