我国二级医院临床药学服务现状及问题研究(二):临床药学服务开展现状分析
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摘要
目的收集我国二级医院临床药学服务开展现状相关数据,剖析临床药学服务现存问题,并提供相关政策建议。方法采用面对面访谈形式收集二级医院临床药师对自身工作情况的认知、医师对临床药师工作情况的认知和患者对临床药师工作认知等信息,并通过描述性统计分析相关数据。结果被调查的临床药师、医师和患者中,52. 8%的临床药师认为所在医院临床药师工作开展顺利,但仍有35. 8%的临床药师认为所在医院临床药师的配置情况不合理; 42. 0%的医师基本了解临床药师的工作,对临床药师提出的用药建议或给药方案的态度主要为部分采纳(82. 5%);多数的患者不太了解但听说过临床药学服务工作(39. 7%)。结论我国二级医院临床药师的工作开展情况、配置情况和与医师患者之间的了解度有待改善。
OBJECTIVE To collect relevant data on the development of clinical pharmaceutical services in secondary hospitals in China and analyze the existing problems of clinical pharmaceutical services and provide relevant policy suggestions. METHODS A face-to-face interview survey was conducted to collect data on the secondary hospital clinical pharmacists' perception of their own work,physicians' knowledge of clinical pharmacists' work and patient's attitude toward clinical pharmacists' work,et al which was analyzed with descriptive statistics tools. RESULTS Among the clinical pharmacists,physicians,and patients surveyed,52. 8% of clinical pharmacists think that the clinical pharmacists in the hospital work smoothly,but 35. 8% of clinical pharmacists think the configuration of clinical pharmacists in the hospital is unreasonable; 42. 0% of the doctors had a basic understanding of the work of clinical pharmacists; the attitude of the clinical pharmacists on medication recommendations or dosing regimens was mainly partly adopted( 82. 5%).Most of the patients did not understand but had heard of clinical pharmacy services( 39. 7%). CONCLUSION The work and assignment of clinical pharmacists,understandings between clinical pharmacists and physician,patients of secondary hospitals in China require further improvement.
OBJECTIVE To collect relevant data on the development of clinical pharmaceutical services in secondary hospitals in China and analyze the existing problems of clinical pharmaceutical services and provide relevant policy suggestions. METHODS A face-to-face interview survey was conducted to collect data on the secondary hospital clinical pharmacists' perception of their own work,physicians' knowledge of clinical pharmacists' work and patient's attitude toward clinical pharmacists' work,et al which was analyzed with descriptive statistics tools. RESULTS Among the clinical pharmacists,physicians,and patients surveyed,52. 8% of clinical pharmacists think that the clinical pharmacists in the hospital work smoothly,but 35. 8% of clinical pharmacists think the configuration of clinical pharmacists in the hospital is unreasonable; 42. 0% of the doctors had a basic understanding of the work of clinical pharmacists; the attitude of the clinical pharmacists on medication recommendations or dosing regimens was mainly partly adopted( 82. 5%).Most of the patients did not understand but had heard of clinical pharmacy services( 39. 7%). CONCLUSION The work and assignment of clinical pharmacists,understandings between clinical pharmacists and physician,patients of secondary hospitals in China require further improvement.
引文
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[30] SU L,TANG Y. The basic elements of clinical pharmacists should be defined in the clinical treatment team[J]. J China Pharm(中国药房),2010,21(30):2794-2795.
[31] XU P. Exploration on the differences of training process for clinical pharmacist and work patterns between China and the United States[J]. Chin Hosp(中国医院),2015,19(10):48-50.
[32] XIAO L W,WANG H C. Present situation and countermeasures of clinical pharmacists in dimethyl hospitals[J]. Chin J Hosp Pharm(中国医院药学杂志),2018,38(1):100-103.
[33] KEITHM O,SYLVIA A D,OLIVIA V N,et al. American clinical pharmacy education and practice[J]. J China Pharm(中国药房),2016,27(2):145-149.
[34] YAN Y,ZHANG J Y,LIU J,et al. The enlightenment of the development of the laws and regulations of clinical pharmacists in the United[J]. China Pharm(中国药师),2016,19(11):2128-2130.
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[36] ZHU Z,SHANG N. Overview of changes in the practice flow of pharmaceutical care in the United States[J]. China Pharm(中国药师),2015,18(9):1571-1573.
[2] YEE G C,HAAS C E. Standards of practice for clinical pharmacists:the time has come[J]. Pharmacotherapy,2015,34(8):769-770.
[3] FENG A M. Improve the management of drug distribution in ward and improve the level of pharmaceutical service[J]. Chin J Clin Rat Drug Use(临床合理用药杂志),2014,19(4):79-80.
[4] XUAN L I,PENG W X,TANG H M,et al. Analysis of service status and strategies of pharmacy in China[J]. China Health Industry(中国卫生产业),2017,14(30):190-191.
[5] YUAN S W. Analysis of services status of our country's clinical pharmacy and its countermeasures[J]. Anti-Infect Pharm,2016,13(3):494-496.
[6] SUN Y,HUANG C L,ZHANG M H,et al. Restricted factors of hospital clinical pharmaceutical care capability and discussion of improved countermeasures[J]. Pharm Care Res(药学服务与研究),2016,16(5):369-374.
[7] PAN C Q,LI X Y,WANG L W,et al. Establishment of the clinical pharmacist working model based on the total quality management in hospital[J]. Chin J Hosp Adm(中华医院管理杂志),2016,32(3):191-194.
[8] DESEN L I,WANG Y,SHUISHENG W U. Thinking and suggestion on positioning of clinical TCM pharmacists and the cultivation of post service ability[J]. J China Pharm(中国药房),2017,28(36):5170-5173.
[9] LIU D,ZHANG C,GUI L,et al. Survey of current situation of clinical pharmacy in hospitals above classⅡin Hubei Province[J]. Chin J Pharmacoepidemiol(药物流行病学杂志),2011,20(4):186-188.
[10] YANG Z,WANG Z,WEI J I. An investigation into present clinical pharmacy work in 55 hospitals[J]. Pharm Care Res(药学服务与研究),2002,2(1):17-19.
[11] HU M,JIANG X H,WU Y P,et al. Survey on hospital pharmaceutical care in China and the status quo of clinical pharmacy practice(part 2):survey on status quo of clinical pharmacy practice[J]. J China Pharm(中国药房),2009,20(13):1030-1032.
[12] ZHOU Y,YANG Y,MENG L,et al. Investigation of the development of clinical pharmacy in 28 hospitals of Jiangsu Province[J]. J China Pharm(中国药房),2017,28(24):3341-3346.
[13] LIANG L,ZHANG J,WANG Y,et al. Investigation on development of clinical pharmaceutical care of medical institutions in Xi'an[J]. Chin J Hosp Pharm(中国医院药学杂志),2017,37(17):1747-1752.
[14] TING X W,WANG B,WANG Y. Investigation of the evaluation of physicians for clinical pharmaceutical care in 5 third grade class a hospitals in Beijing[J]. J China Pharm(中国药房),2016,27(36):5066-5068.
[15] LIU Z,CHEN K,YAN T,et al. Investigation of clinical pharmacy work conditions of 4 third-level first class hospital in Guangxi Yulin[J]. J China Pharm(中国药房),2017,28(3):308-311.
[16] HOU S,WANG Z,SHI W,et al. Investigation and study on the competence required of clinical pharmacist in PIVAS of 63 thirdgrade class a hospitals in China[J]. J China Pharm(中国药房),2017,28(6):725-729.
[17] AMERICAN COLLEGE OF CLINICAL PHARMACY,HAMMOND R W,SCHWARTZ A H,et al. Collaborative drug therapy management by pharmacists—2003[J]. Pharmacotherapy:J Human Pharm Drug Ther,2003,23(9):1210-1225.
[18] CHU S,XING X. Reflections on the current development status of China's clinical pharmacists[J]. Chin Pharm Aff(中国药事),2014,28(11):1261-1264.
[19] LI X,PENG W X,YE Y Q,et al. A brief discussion on relationship between clinical pharmacists and multi personnel[J].Eval Anal Drug-Use Hosp China(中国医院用药评价与分析),2016,16(s1):227-228.
[20] CUMMING J M. Health services coverage regulation:an evaluation of policy options for New Zealand[D]. Victoria University of Wellington,2003.
[21] AYALEW M B,TAYE K,ASFAW D,et al. Patients'/clients'expectation toward and satisfaction from pharmacy services[J]. J Res Pharm Pract,2017,6(1):21-26.
[22] MARTIN M T,FABER D M. Patient satisfaction with the clinical pharmacist and prescribers during hepatitis C virus management[J]. J Clin Pharm Ther,2016,41(6):645-649.
[23] GALT K. Using patient expectations and satisfaction data to design a new pharmacy service model in a primary care clinic[J]. J Managed Care Pharm Jmcp,1997,3(5):531-540.
[24] LI H W,HUANG Q,LIU Y,et al. Clinical pharmacist pharmacy services for patients with chronic obstructive pulmonary disease cost impact and satisfaction[J]. Anti-Infect Pharm(抗感染药学),2017,14(7):1323-1324,1340.
[25] SY L,LI W F,TAN Q Q,et al. Study on the correlation between analgesia effect and satisfaction degree of pain management in perioperative period of pharmacy service[J]. Strait Pharm J(海峡药学),2017,29(6):69-71.
[26] XI X Y,YAO D N,HUANG Y K,et al. National survey on clinical pharmacy services of second-level hospitals in China:Part 1. introduction of survey and basic conditions of clinical pharmacy service provision[J]. Chin Pharm J(中国药学杂志),2018,53(23):2058-2064.
[27] ZHU J. An overview of the American clinical pharmacist system[J]. Beijing J Trad Chin Med(北京中医药),2008,27(6):469-470.
[28] FAN H W,XIANG Q,REN G H,et al. Evaluation and systematic review of working mode of clinical pharmacists in China[J].Clin Med J(临床药物治疗杂志),2016,14(4):23-29.
[29] XIAO J Y,CUI X L,LIU Y,et al. Responsibility and mission of clinical pharmacists given by new medical reform[J]. Chin J Clin Pharm(中国临床药理学杂志),2017,33(11):1042-1044.
[30] SU L,TANG Y. The basic elements of clinical pharmacists should be defined in the clinical treatment team[J]. J China Pharm(中国药房),2010,21(30):2794-2795.
[31] XU P. Exploration on the differences of training process for clinical pharmacist and work patterns between China and the United States[J]. Chin Hosp(中国医院),2015,19(10):48-50.
[32] XIAO L W,WANG H C. Present situation and countermeasures of clinical pharmacists in dimethyl hospitals[J]. Chin J Hosp Pharm(中国医院药学杂志),2018,38(1):100-103.
[33] KEITHM O,SYLVIA A D,OLIVIA V N,et al. American clinical pharmacy education and practice[J]. J China Pharm(中国药房),2016,27(2):145-149.
[34] YAN Y,ZHANG J Y,LIU J,et al. The enlightenment of the development of the laws and regulations of clinical pharmacists in the United[J]. China Pharm(中国药师),2016,19(11):2128-2130.
[35] HALL M N,KRUSE J. Allies in family medicine advocacy:the patient-centered primary care collaborative[J]. Annals Family Med,2010,8(1):89.
[36] ZHU Z,SHANG N. Overview of changes in the practice flow of pharmaceutical care in the United States[J]. China Pharm(中国药师),2015,18(9):1571-1573.