Je apotheker kan meer. Hoe maken we dat mogelijk?

Cassandra
Krols

Je vaste medicatie is bijna op, maar je raakt niet op tijd bij de huisarts? Je hebt erge keelpijn, maar de huisartsenpraktijk in je buurt neemt geen nieuwe patiënten aan? In verschillende landen kan je voor zulke vragen ook bij de apotheker terecht voor de nodige hulp. Mijn vergelijking van twaalf landen toont wat België daarvan kan leren, en wat apothekers nodig hebben om die extra zorg verantwoord op te nemen.

We worden ouder en steeds meer mensen leven met chronische aandoeningen. Dat betekent vaker geneesmiddelen nemen, behandelingen opvolgen en vragen bespreken met een zorgverlener. Wie moeilijk een afspraak vindt bij de huisarts, voelt hoe belangrijk het is dat die zorg bereikbaar blijft.

Daarbij verdient een vertrouwd gezicht in de buurt meer aandacht: de apotheker. Je kan er doorgaans zonder afspraak binnenstappen. Apothekers beschikken over een brede kennis van geneesmiddelen en zien veel patiënten regelmatig terug. Dat biedt kansen om problemen te voorkomen, extra hulp te bieden waar nodig en mensen verder te begeleiden.

Als apotheker wilde ik weten hoe we die positie beter kunnen benutten. Welke zorgtaken nemen collega’s in andere landen op? Hoe werken zij samen met artsen? En wat moet er geregeld zijn om patiënten ook hier meer te kunnen bieden?

Wat elders al kan

In Canada kunnen apothekers, afhankelijk van de provincie en de geldende voorwaarden, bestaande voorschriften verlengen of aanpassen. Ze beoordelen daarbij of voortzetting van de behandeling verantwoord is.

Ook in België zorgt een ontbrekend herhaalvoorschrift voor frustratie aan de apotheekbalie. Tijdens mijn stage was dit een van de problemen die ik het vaakst tegenkwam. Patiënten gebruikten al jaren dezelfde medicatie, maar hadden geen nieuw voorschrift. Soms was de hernieuwing vergeten, soms konden ze niet tijdig bij hun arts terecht.

In Engeland startte Pharmacy First in 2024 met zeven afgebakende aandoeningen: bijholteontsteking (ontsteking van de slijmvliezen in de holtes rond de neus), keelpijn, oorpijn, geïnfecteerde insectenbeten, krentenbaard, gordelroos en ongecompliceerde urineweginfecties bij vrouwen. Apothekers kunnen daarvoor advies geven en, als dat medisch aangewezen is, bepaalde voorschriftplichtige geneesmiddelen verstrekken zonder voorafgaand voorschrift van een arts.

Daar gelden duidelijke grenzen voor. Apothekers moeten aantoonbaar bekwaam zijn en volgen waar nodig aanvullende opleiding, bijvoorbeeld in het onderzoeken van oren. Ze werken volgens vastgelegde richtlijnen, controleren of de patiënt in aanmerking komt en verwijzen zo nodig door. Voor patiënten kan dat een toegankelijkere weg naar hulp betekenen, terwijl bij de huisarts ruimte kan vrijkomen voor andere zorgvragen.

Twaalf landen onder de loep

Voor mijn masterproef aan de Universiteit Antwerpen verzamelde en analyseerde ik wetenschappelijke publicaties, beleidsdocumenten, rapporten en richtlijnen. Ik vergeleek twaalf landen, van Australië en Canada tot Japan en verschillende Europese landen. België bekeek ik daarnaast als referentie.

Ik ordende de informatie volgens veertien thema’s. Zo kon ik telkens dezelfde categorieën aan info verzamelen over onder meer bevoegdheden, betaling, opleiding en samenwerking. Dat leverde een vergelijkend overzicht op, met bronverwijzingen en een interactieve weergave waarin de informatie per land en thema kan worden bekeken.

Schermafbeelding van het interactieve landenoverzicht, met Denemarken geselecteerd en informatie over de bevoegdheden van apothekers.

Omdat die informatie verspreid zat over veel bronnen en talen, gebruikte ik artificiële intelligentie als hulpmiddel bij het zoeken, ordenen en vertalen. Ik controleerde de bronnen zelf op onder meer herkomst, relevantie en actualiteit. Ook de uiteindelijke selectie en interpretatie bleven mijn verantwoordelijkheid. Een aanvullende zoekronde via Google hielp om mogelijk gemiste recente documenten op te sporen.

Goede zorg vraagt overleg

De buitenlandse voorbeelden maken duidelijk hoeveel verschillende vormen een bredere apothekersrol kan aannemen. Tegelijk hangt veel af van de samenwerking met andere zorgverleners. Wie volgt de patiënt verder op? Wanneer is een onderzoek door de arts nodig? En weet de huisarts welke zorg iemand in de apotheek kreeg?

Bij de invoering van Pharmacy First benadrukte de Britse huisartsenorganisatie RCGP bijvoorbeeld dat de nodige digitale systemen en communicatievoorzieningen snel beschikbaar moesten zijn. Die aandacht voor informatie-uitwisseling sluit aan bij een terugkerende bevinding uit mijn onderzoek: extra taken vragen duidelijke afspraken tussen zorgverleners.

Neem iemand met een verminderde nierfunctie. Ontstekingsremmende pijnstillers zoals ibuprofen, die je zonder voorschrift kan krijgen, kunnen de nieren verder beschadigen en moeten dan vaak worden vermeden. Om dat risico te beoordelen, heeft de apotheker recente bloedwaarden nodig, zoals de eGFR: een maat voor hoe goed de nieren het bloed filteren. Toegang tot zulke gegevens helpt om verantwoord advies te geven en met de huisarts af te stemmen.

De nodige tijd en ruimte

Een andere belangrijke bevinding gaat over de haalbaarheid. In veel landen blijven de inkomsten van apotheken sterk verbonden met het afleveren van geneesmiddelen, terwijl bijkomende zorg tijd vraagt. Een uitgebreid gesprek, overleg met de huisarts en opvolging achteraf moeten ook kunnen worden betaald. 

Daar komt de werkdruk in de apotheek bij. Extra verantwoordelijkheden vragen voldoende personeel, passende opleiding en een werkverdeling die ruimte laat voor patiëntenzorg. Ook de inrichting moet mee evolueren. Veel apotheken zijn vooral ingericht om geneesmiddelen af te leveren. Voor uitgebreidere zorg is die indeling niet vanzelf geschikt. Daarvoor is een aparte, afgesloten consultatieruimte nodig, waar gesprekken en onderzoeken in alle privacy kunnen plaatsvinden. Dat kan een herinrichting vragen.

België heeft al stappen gezet, bijvoorbeeld met vaccinatie, de huisapotheker en medicatienazicht: een grondige beoordeling van iemands geneesmiddelengebruik. De internationale vergelijking biedt aanknopingspunten om daarop voort te bouwen. Daarbij moeten we per nieuwe dienst bekijken wat ze de patiënt kan opleveren en welke ondersteuning nodig is.

Mijn onderzoek levert geen kant-en-klaar buitenlands model op en bewijst niet welke aanpak de meeste gezondheidswinst geeft. Het maakt wel zichtbaar welke keuzes andere landen maken en welke voorwaarden telkens terugkomen. Dat helpt om gerichter te bepalen wat in België verder onderzocht en uitgewerkt kan worden.

De groeiende zorgvraag vraagt dat we de kennis van elke zorgverlener goed benutten. De apotheker kan daarin meer betekenen, dicht bij de mensen en in samenwerking met hun arts. De deur van de apotheek staat al open. Nu moet ook de organisatie van de zorg ruimte maken voor wat daar mogelijk is.

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Universiteit of Hogeschool
Universiteit Antwerpen
Thesis jaar
2026
Promotor(en) en begeleiders
Nina Hermans, Hans De Loof, Marleen Haems
Kernwoorden