Interface management of pharmacotherapy. Joint hospital and primary care drug recommendations

  • Linda Björkhem-Bergman
  • Eva Andersén-Karlsson
  • Richard Laing
  • Eduardo Diogene
  • Oyvind Melien
  • Malena Jirlow
  • Rickard E. Malmström
  • Sabine Vogler
  • Brian Godman
  • Lars L Gustafsson
Special Article



In September 2012 an interactive course on the “Interface Management of Pharmacotherapy” was organized by the Stockholm Drug and Therapeutics Committee in cooperation with Department of Clinical Pharmacology at Karolinska Institutet and at Karolinska University Hospital in Stockholm, Sweden, in collaboration with the WHO. The basis for the course was the “Stockholm model” for the rational use of medicines but also contained presentations about successful models in interface management of pharmacotherapy in other European countries.


The “Stockholm model” consists of 8 components: 1) Independent Drug and Therapeutics Committee with key role for respected drug experts with policy for “interest of conflicts”, 2) The “Wise List”, recommendations of medicines jointly for primary and hospital care, 3) Communication strategy with continuous medical education, 4) Systematic introduction of new expensive medicines, 5) E-pharmacological support at “point of care”, 6) Methods and tools for follow-up of medicines use, 7) Medicines policy strategy and 8) Operative resources.


The course highlighted the importance of efficient and targeted communication of drug recommendations building on trust among prescribers and patients for the guidelines to achieve high adherence. Trust is achieved by independent Drug and Therapeutics Committees with a key role for respected experts and a strict policy for “conflicts of interest”. Representations of GPs are also crucial for successful implementation, being the link between evidence based medicine and practice.


The successful models in Scotland and in Stockholm as well as the ongoing work in Catalonia were considered as examples of multifaceted approaches to improve the quality of medicine use across primary and hospital care.


Interface management Rational use of medicines Drug committees Pharmacoeconomics 



This work was in part supported by grants from the Karolinska Institutet, Sweden. No writing assistance was provided for this paper.

Financial disclosure

There are no conflicts of interest reported by any of the authors. However, Eva Andersén-Karlsson is chairman of the DTC in Stockholm County Council.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Linda Björkhem-Bergman
    • 1
    • 10
  • Eva Andersén-Karlsson
    • 2
  • Richard Laing
    • 3
  • Eduardo Diogene
    • 4
  • Oyvind Melien
    • 5
  • Malena Jirlow
    • 6
  • Rickard E. Malmström
    • 7
  • Sabine Vogler
    • 8
  • Brian Godman
    • 1
    • 9
  • Lars L Gustafsson
    • 1
  1. 1.Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska InstitutetKarolinska University Hospital HuddingeStockholmSweden
  2. 2.Drug and Therapeutics Committee, Unit of Medicine Support, Public Healthcare Services, Stockholm County Council and Department of Clinical Science and EducationKarolinska Institutet SödersjukhusetStockholmSweden
  3. 3.Department of Essential Medicines and Health ProductsWHO GenevaGenevaSwitzerland
  4. 4.Unit of Medicines Coordination and Strategy, Department of Health Care AffairsCatalan Institute of HealthBarcelonaSpain
  5. 5.Department of Medical Devices and Medicinal ProductsNorwegian Directorate of HealthOsloNorway
  6. 6.Unit of Medicine Support, Public Healthcare ServicesStockholm County CouncilStockholmSweden
  7. 7.Division of Clinical Pharmacology, Department of Medicine, Karolinska InstitutetKarolinska University Hospital SolnaStockholmSweden
  8. 8.WHO Collaborating Centre for Pharmaceutical Pricing and Reimbursement Policies, Department of Health EconomicsGesundheit Österreich GmbH (Austrian Health Institute)ViennaAustria
  9. 9.Strathclyde Institute of Pharmacy and Biomedical SciencesUniversity of StrathclydeGlasgowUK
  10. 10.Division of Clinical Pharmacology C1-68Karolinska University Hospital, Huddinge, Karolinska InstitutetStockholmSweden

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