There are 21 municipalities and citizens in Montenegro.

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2 There are 21 municipalities and citizens in Montenegro. Major number of citizens live in the capital city Podgorica and the number is citizens which represents 30 % of total number in whole Montenegro. There are 42 state pharmacies in Montenegro which are supplied by one state wholesale trade Montefarm, 170 private pharmacies and 43 private wholesale trades.

3 PODGORICA NIKŠIĆ BIJELO POLJE BAR HERCEG NOVI STATE SECTOR PRIVATE SECTOR 15 (23,08%) 3(42,86%) 1(11,11%) 6(33,33%) 3(16,67%) 50(76,92%) 7(57,14%) 8(89,89%) 12(66,67%) 15(83,33%) Table 1. Number of pharmacies in municipalities (central, northern, southern part of Montenegro) Larger representation of pharmacies per m2 is specific for Podgorica, therefore average of open pharmacies in a circle of 500 m are 4 pharmacies, whose mutually distance in some parts is from 10m to 200m (this specially refers to private sector).

4 Pharmaceutical services are done by licentiates pharmacists in other words licentiates pharmacist with appropriate specialisation and pharmaceutical technician with appropriate degree of sanitary avocation. Since 2012 Faculty of Pharmacy, University of Montenegro; I (first) generation of accomplished pharmacists with the title of doctors of pharmacy. Structure of employees of sanitary workers in state and private sector State sector: 107 licentiates pharmacists, 5 probationers on training period and 22 probationers pharmacists volunteers 219 pharmaceutical technicians i 43 probationers pharmaceutical technicians- volunteers Private sector : 226 licentiates pharmacists, 450 technicians (with probationers)

5 Activities of Chamber in the previous 2 years May, 2011 I Congress of pharmacists with international participation. February, 2012 Initiation of changes of Law o healthy protection in Montenegro Definition of Pharmaceuticals services, and also conditions for establishing organizational units of pharmaceuticals services (initiation for passing of Law on Pharmaceuticals services) Establisher of pharmacy have to be pharmacist, tightening of conditions for pharmacy establishing (employees, space, equipment, working time and respecting law regulations in reference to a question of obliged number of employees in pharmacies, defining membership in Chamber, a question of being mentor for probationers, defining conditions for issuance, restitution and subtraction of licences and increasing jurisdictions of Chamber referring to adopting attitudes and opinions referring to significant questions from pharmaceutical area and prescriptions that regulate it.

6 April, 2012 TAIEX APPLYING for study visit and getting guidelines for implementing DAP in pharmaceutical services The aim of visiting is implementation of good pharmaceutical practice and getting guidelines- references for passing Law on Pharmaceuticals services. September, 2012 Expert panel on theme Competences in pharmaceutical services where representatives of every sanitary institution of Montenegro assembled (Ministry of health, Sanitary inspection, Medical fund, Agency for medications and medical means of Montenegro, representatives of pharmaceutical companies, private and state sectorpharmacies ) where the project of Competence is adopted (since 2007, WHO and FIP recommended principles of Good Pharmaceutical practice as a standard in pharmacies) which is going to be implemented in pharmaceutical sector soon.

7 Oktober, 2012 INITIATION a question of compilation and production of medicaments I FAIR OF MEDICINE IN MONTENEGRO Became a member of FIP November, 2012 INITIATION changes of Regulation about closer conditions, lasting, a way of doing training period, passing an exam of competence, plan and procedure of practical work and training for probationerssanitary workers and sanitary collaborators with high education.

8 Faculty of Pharmacy, University of Montenegro was established as self-contained study program 2007/2008, when the first generation of students of pharmacy signed up. Since 2010 it has been transformed in Paculty of Pharmacy. A preferred reason for establishing Faculty of Pharmacy in Montenegro is deficit of pharmacists and education of cadre from territory of Montenegro. There is the only one Faculty of Pharmacy in Montenegro in Podgorica, where 20 students sign up per one year.

9 The first generation of students of Faculty of Pharmacy get their theoretical and practical practice in adequate equipped areas of related faculties: Medical, Natural Sciences and Metallurgy and Technology faculty. Teaching plan is tailored to new process of studying in accordance with Bologna Declaration. Study program is accredited and the process of reaccreditation is being done at the moment.

10 Some pharmacists from Montenegro realized their further perspective on this study program, therefore they continued further improvement as a doctoral studies. In order to do teaching competent subjects, the Faculty made a cooperation with Clinical center of Montenegro, Health facility Montefarm, pharmacies of Montenegro, CALIMS and High medical school.

11 Faculty of Pharmacy is a partner from region from south-east Europe and a candidate for participating in the project PHAR-EE TEMPUS IV 4 th Nancy University, France. The Faculty makes scientific and teaching cooperation with the Faculty of Pharmacy in Belgrade, and also a contract is made with the Faculty of Pharmacy in Ljubljana.

12 The first generation of accomplished pharmacists finished their studies in June 2012 and they got a Diploma- Doctors of Pharmacy, and they are probationers mostly in state pharmacies, and a small number of them is in private sector and pharmaceuticals companies. Competence = knowledge, skill, experience. Every day pharmacists are demanded to take responsibilities for timely providing safe, high-quality and rational therapy to patient in order to improve medical status of mentioned.

13 In order to fulfill conditions for providing quality pharmaceuticals medical protection, a pharmacist have to improve his existing knowledge and skills all the time which makes development of his own competences. During previous years International Pharmaceutical Federation FIP pays more and more attention to development program for evaluation and development of competences in pharmacy. In 2005 an eminent group of experts CoDEG (Competency Development and Evaluation Group) from Great Britain, developed a model for estimation and development of competences of pharmacists, General Level Framework GLF.

14 Pharmaceutical Chamber of Montenegro, after holding Expert panel, accepted, translated and validated the program of GLF document, where every single competence is relevant to pharmaceutical practice and existing law regulation of Montenegro. For the first time, pharmacists in Montenegro get some guidelines for pharmaceutical services.

15 November, 2012 The project of implementation of GLF model starts realizing in Montenegro, where initial circle is made of pharmacists from pharmacies from Montenegro, by model of self estimation and competences. Scientific and professional competences of pharmacists in accordance to this model are divided in 3 basic groups: 1.professional competences 2.competences of organization and ruling 3. personal and professional competences

16 Study worked only pharmacists from Podgorica. 27 pharmacists from state sector and 13 pharmacists from private sector was included. 1.professional competences -27 competences 2.competences of organization and ruling -32 competences 3. personal and professional competences - 42 competences

17 Graph1:Relathionship between competences

18 4,00 3,50 1. Estimation of patient and his sanitary needs 2. Advising patient about prevention and control of diseases, health promotion and ways of healthy living 3. Advising patient about safe and rational usage of medicaments 4. Recognising medical patient s usage, providing suitable advices and information 5. Regular, precise and appropriate selection of shapes, dose and packaging of medicament 3,00 2,50 2,00 6. Perceiving, estimation of importance and prevention of medicaments interaction with other medicaments, food or disease 7. Selecting equipment, methods of calculations procedure and substances necessary for medicament preparation 8. Making a medicament in accordance with regulations of good pharmacy practice 9. Precise medicament issuing prescribed on prescription or without prescription including detailed checking key parameters 10. Precise informing and reporting about deficit or non-standard medicaments to competent bodies 11. Checking and evaluating validity, clearness, accuracy and legality of prescription and other medical documentation 12. Precise issuing apparatus for medicament application and self-control 13. Recognising, documenting and solving medical mistakes and endangered patient s safety 1,50 1,00 0,50 0,00 Graph2: Analysis competences professional 14. Precise medicament labelling including giving necessary written information 15. Giving advices about proper keeping, period of usage and carrying over medicaments to patients 16. Adequate choice of shapes, contexture and concentration of medicament for self curing for smaller healthy needs of patient 17. Providing proper dose, shape, regime and a way of medicament usage, complete informing, documenting and getting feedback from patient individually 18. Providing optimal medicament packaging for patient safety 19. Using guidelines and proceedings in curing, using reference book and literature, medicine based on evidences 20. Following outcomes and influences of curing with medicament therapy 21. Recognizing, determining priorities and solving problems that can appear in medicament therapy 22. Applying first aid procedure and control care and concern for patient 23. Suitable documenting and reporting, registering unwished effects 24. Recognizing and understanding diagnosis based on objective and subjective measuring 25. Arrangement and making a decision together about proper medicament usage taking into consideration patient s attitudes 26. Documenting pharmaceutical interventions 27. Checking, revising, optimizing, supplementing relevant medical history of medicaments and history of disease

19 According to graphic 2, we can conclude the following : -Adequate choice of shapes, contexture and concentration of medicament for self curing for smaller healthy needs of patient is a competence that is always used by professional competences Checking, revising, optimizing, supplementing relevant medical history of medicaments and history of disease is a competence rarely used by professional competences

20 sometimes 2% usually 10% always 88% Graph3: Adequate choice of shapes, contexture and concentration of medicament for self curing for smaller healthy needs of patient( a pharmasist opinion)

21 100,00% 90,00% 80,00% 70,00% 60,00% 50,00% 40,00% 30,00% 20,00% 10,00% 0,00% never sometimes usually always never sometimes usually always State sector 0,00% 3,70% 11,11% 85,19% Private sector 0,00% 0,00% 7,69% 92,31% Graph4: Adequate choice of shapes, contexture and concentration of medicament for self curing for smaller healthy needs of patient( relationship between state and private sector)

22 always 13% never 40% usually 32% sometimes 15% Graph5: Checking, revising, optimizing, supplementing relevant medical history of medicaments and history of disease ( a pharmasist opinion)

23 100,00% 90,00% 80,00% 70,00% 60,00% 50,00% 40,00% 30,00% 20,00% 10,00% 0,00% never sometimes usually always State sector 51,85% 18,52% 14,81% 14,81% Private sector 15,38% 7,69% 69,23% 7,69% Graph6: Checking, revising, optimizing, supplementing relevant medical history of medicaments and history of disease ( relationship between state and private sector)

24 4,00 3,50 3,00 2,50 2,00 Precise, tailored, balanced and effective communication with patients, clients and their family members Competent, tailored, effective and affirmative communication with medical team members Two-way, clear, effective and affirmative communication with pharmaceutical team members Assertive communication with managerial structures 1,50 Sales skills 1,00 0,50 Responsibility for own professional training and competences 0,00 1-never, 2-sometimes, 3-usually, 4-always Implementing necessary procedures in the process of pharmacovigilance Graph7: Some personal and profesional competences(state sector)

25 3,00 2,50 2,00 1,50 1,00 0,50 Precise, tailored, balanced and effective communication with patients, clients and their family members Competent, tailored, effective and affirmative communication with medical team members Two-way, clear, effective and affirmative communication with pharmaceutical team members Assertive communication with managerial structures Sales skills 0,00 1-never, 2-sometimes, 3-usually, 4-always Responsibility for own professional training and competences Implementing necessary procedures in the process of pharmacovigilance Graph8: Some personal and profesional competences(private sector)

26 Precise, tailored, balanced and effective communication with patients, clients and their family members Competent, tailored, effective and affirmative communication with medical team members Two-way, clear, effective and affirmative communication with pharmaceutical team members Assertive communication with managerial structures Sales skills Responsibility for own professional training and competences Implementing necessary procedures in the process of pharmacovigilance 4,00 3,50 3,00 2,50 2,00 1,50 1,00 0,50 0,00 Private sector State sector Graph8: Relathionship between private and state sector for personal and profesional competences

27 Conclusion: The beginning of implementation of competences is difficult, but is a big step towards development of highquality pharmaceutical health protection in Montenegro, by which we struggle for recognizing the importance of pharmaceutical services in medical system, and all of that with the aim of improving quality of patient s life. Self-estimation of own work, a pharmatist recognize needs for continuous improvement of existing knowledge and skills.

28 THANK YOU FOR YOUR ATTENTION!!! Best regards from Montenegro