Nicole Brandt
The following is a three-part series written by Nicole Brandt, PharmD, MBA, BCGP, FASCP, executive director of the Peter Lamy Center on Drug Therapy and Aging and a professor in the Department of Practice, Sciences, and Health Outcomes Research at the University of Maryland School of Pharmacy who spent three weeks in Helsinki, Finland, in January as part of the Fulbright Specialist Program.
Part 1: Expanding Collaborations in Finland to Improve Medication Use and Safety for Older Adults
Last year, I was fortunate enough to receive funding from the Fulbright Finland Foundation to continue my aging work as part of my role as executive director of the Peter Lamy Center for Drug Therapy and Aging at the University of Maryland School of Pharmacy.
I must admit that when awarded this amazing opportunity, I was not fully aware of the rich history and connections that it would afford me. I have been so impressed by the hospitality of so many, but especially professor Marja Airaksinen, Clinical Pharmacy Group, Division of Pharmacology and Pharmacotherapy, faculty of pharmacy, University of Helsinki.
The primary objectives of this Fulbright specialist program are:
- Create new strategies that foster competencies in interprofessional collaboration in geriatric care, particularly in managing older adults’ medications.
- In partnership with key stakeholders, develop an actionable co-designed demonstration that uses the framework/model to increase the knowledge, skills, and integration within the interprofessional team to contribute to person-centered medication use management across care settings. (This occurred during a brainstorming meeting and workshop series, where seminars and active engagement occurred to develop strategic goals and research areas between HUS— the largest provider of specialized health care in Finland —and the University of Helsinki.)
- Increase patients’, clinicians’, and other stakeholders’ awareness of pharmacists’ competencies and potential role(s) to improve medication use and safety in older adults.
During a visit to Lahti, we met with Anni Wartiainen at the Päijät-Häme Hos. We learned about efforts across care settings to improve medication reconciliation and reviews in home care, assisted living, and nursing homes.
Part 2: ‘Oppia ikä kaikki’ — The Finnish Version of ‘Live and Learn’
In Finland, the saying “Oppia ikä kaikki” suggests you keep learning new things all your life through experience. I can honestly admit that I have experienced and learned so much that I struggled to condense it into this second post. Despite the cold temperatures, limited daylight, and snow, the people here warm the heart and truly make Finland one of the happiest places to live.
Dr. Sirkka-Liisa Kivelä, professor emeritus at the University of Turku and professor of geriatric pharmacotherapy at the University of Helsinki, opened her home to faculty, students, and practitioners to gather ideas on how to increase collaboration to truly engage the older adult’s perspective on “what matters.” She has focused her research on epidemiological longitudinal studies on depression, falls, and the use of drugs and prevention of falls in the aged.
The Myllypuro Senior Centre and Day Care Unit, led by Mari Saivanen, hosted our Aging in Place faculty meeting to establish a site for interprofessional learning.
I spent the weekend in Vaasa, Finland, visiting family, learning how to make Finnish pulla, interviewing our 86-year-old uncle about the role of community pharmacists and social services, and visiting the Finnish Centre for Client and Patient Safety.
Throughout the second week, I visited a local community pharmacist who shared her workflow, provided a day full of seminars on age-friendly efforts, deprescribing, and antipsychotic medication use in nursing homes, and lessons shared with global implications and collaboration.
An additional experience was meeting a visionary leader, Dr. Pirjo Laitinen-Parkkonen, medical director and director of research, development, and innovation, Well-Being Services, County of Keski-Uusimaa, Finland. The vision is that Finland will be a model for client and patient safety in 2026 — eliminating all avoidable harm. Based on my experiences thus far, there are many strengths to make this attainable, but it will take leveraging strong partnerships and relationships. I look forward to the continued opportunities to support and learn in these efforts.
Part 3: Together Shaping the Future (#FulbrightFinland75)
For those who know me, I am all about creating an agenda, a plan, and a timeline to meet objectives. In my first reflection, I outlined objectives to help chart my journey during my time in Finland. The second entry indexed learnings and lessons focusing on health care policies and opportunities for collaboration. This third installment allows me to verbalize my takeaways and appreciation.
I really appreciated Minna Lindgren meeting me for coffee to talk about her advocacy work focusing on caregivers for persons with dementia. She was awarded an honorary doctorate at the University of Helsinki in May 2023 as an author and journalist, among other amazing dignitaries such as C. Alan Lyles, ScD, MPH, BSP ’80, professor in the School of Public and International Affairs and the School of Health and Human Services at the University of Baltimore. Minna’s books get at important age-related topics in a creative and thought-provoking way.
During the last week of my fellowship, the weather in Helsinki was quite treacherous with fluctuating temperatures leading to very icy conditions. Fortunately, we were provided hiking spikes for our shoes during the outdoor excursions. These conditions did not affect our productivity or ability to meet, whether in person or via Zoom. The worst day afforded time to collaborate on the recommendations and next steps for our work.
I met with other Fulbright awardees to learn more about the program’s 75-year history, as well as received my Fulbright pin from Terhi Mölsä, chief executive officer at the Fulbright Finland Foundation.
We held two virtual seminars to discuss community pharmacies as part of primary care in the United States, challenges in community pharmacists’ work duties, availability of workforce, potential solutions to challenges, aging in place, and how to improve medication safety and outcomes for older Finns.
Reflections from a Three-Week Fulbright Specialist Visit in Finland
As I return from my 21 days in Finland working with and learning from fellow professionals, community members, and trainees, I am very grateful for this occasion to reflect and focus. This experience has re-energized my battery, but more importantly it reinforced the importance of taking time to connect with others to shape the future together.
There are many to thank, but I want to give a special thanks to professors Marja Airaksinen and Alan Lyles for their mentorship and friendship, which made this journey possible, and to the Fulbright Finland team for their support. I am looking forward to the work and collaboration that will ensue after this effort to make Finland a more “age-friendly” country, leveraging the role of pharmacists as part of the interprofessional team, and increasing the participation of older adults and those who care for them.
