Pharmaceutical care in community pharmacies: Practice and research in Estonia

OBJECTIVE: To describe practice and research related to pharmaceutical care in Estonia following the country's restoration of independence from Russia in 1991, FINDINGS: The transition from a Soviet to a free market economy has impacted the healthcare and pharmacy systems in Estonia. Following independence, ownership of community pharmacies was transferred from the State government to Individual pharmacists. However, pharmacy ownership is no longer restricted to pharmacists and recent years have seen the emergence of large pharmacy chains. The number of community pharmacies in Estonia increased from 270 in 1992 to 523 in 2007. In addition to dispensing, Estonian pharmacies retain a focus on compounding of extemporaneous products and supply of herbal medications. Research into pharmaceutical care has addressed topics including pharmaceutical policy and the quality of pharmacy services provided at community pharmacies. DISCUSSION: There has been limited pressure to date from the governmental institutions and patient organizations to introduce extended pharmaceutical services. However, the trend toward providing health services in primary care will create greater responsibilities and new opportunities for community pharmacists. Recent inclusion of clinical pharmacy and interprofessional learning in the undergraduate pharmacy curriculum will help ensure ongoing development of the profession and high-quality pharmacy services in the future. CONCLUSIONS: Pharmaceutical care services in Estonian community pharmacies have become more patient-oriented over the past 17 years. However, community pharmacies continue to retain a focus on traditional roles.