COMMUNITY PHARMACIST-PHYSICIAN COLLABORATION IN MANAGING POLYPHARMACY AND MULTIMORBIDITY IN POLAND AND PORTUGAL

Dear Editor,
I read the article published in your journal Health Problems of Civilization in the first issue of 2024 titled “Physicians-in-training attitudes towards the community pharmacist-physician collaboration and pharmaceutical care: a 2022 cross-sectional survey in Poland” by Wrześniewska-Wal et al. [1] with an exceptional interest. The authors studied a sample of 509 doctors undergoing specialization training in Poland and concluded that although the collaboration between physicians and pharmacists is important it is still limited in the context of Poland’s healthcare system [1].
Pharmacist-physician collaboration is fundamental in managing the increasing burden of chronic diseases, which often contribute to polypharmacy (five or more medications) for treatment. Polypharmacy is a matter of serious concern since it is linked with negative health outcomes [2].
Like in Poland, the Portuguese healthcare system faces the burden of chronic diseases with a high frequency of multimorbidity (two or more chronic health problems) in more than 70% of adult patients in the primary care setting [3]. In Portugal, the cooperation of primary care physicians and pharmacists is also scarce. But in my opinion, they should be working closely together to ensure the safe and effective use of medications, minimize adverse drug reactions, and optimize therapeutic outcomes to reduce polypharmacy as it was recognized by the physiciansin- training in the study by Wrześniewska-Wal et al. [1], especially when managing patients with multimorbidity. This cooperation is also important in the physicians’ daily work with medication review, identifying potential drug interactions, and in transmitting pharmacological information and advice (e.g. emergency oral contraception counseling [4]). In Portugal, a previously published qualitative study showed that pharmacists were considered by the elderly patients as having the role of professional help to reach to discuss the deprescription process [5].
The study by Wrześniewska-Wal et al. [1] also revealed that physicians lack knowledge about pharmacists’ responsibilities in Poland, this can be a factor that could hamper the collaboration between physicians and pharmacists in addressing issues like polypharmacy in patients with multimorbidity and should be studied in other countries with the aging population, such as Portugal.
Enhancing education and collaboration training may facilitate a better relationship between physicians and pharmacists to improve patient outcomes, particularly in managing complex polypharmacy regimens commonly associated with multimorbidity. Nonetheless, further studies are still needed to determine the clear role of pharmaceutical care in this setting, as pointed out by the literature [2].

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