论医院药学服务的有效开展

目的：探讨对药学服务的性质,明确药学服务的涵义,促进我国医院药学服务工作的有效开展.方法：对与药学服务密切相关的各学科分别加以分析.结果：在我国目前特定的条件下,医院药学服务工作能否有效开展并不单单取决于临床药师,而是更多地取决于医院管理层对医院药学服务的认识程度和重视程度,取决于医院开展药学服务的管理体制和管理机制.结论：多学科支撑性是医院药学服务的基本特性,这一性质决定了医院药学服务的有效开展需要多种技术人才的通力协作.     

二级医院开展药学服务的实践与探索

目的探讨二级医院开展药学服务的模式。方法通过对我院药学服务现状的分析,根据实际情况提出提升我院药学服务能力的举措。结果我院药学服务现状还不尽人意,需要改进与提高。结论药学服务对"合理、安全、有效、经济用药"发挥重要作用,二级医院需从多方面提升药学服务工作质量。     

二级中医医院中药临床药学服务工作的建议

我国的临床药学工作在许多医院已开展,二级以上医院均设有临床药学室,参与临床合理用药工作,发挥了积极的作用,并收到显著效果。但中药临床药学至今未形成体系。目前大多数医院倾向于西药学,而对中药的合理用药研究比较少。影响中药疗效的因素较多,     

当前医院药学和医院药师定位的探讨

医院药学工作是当今我国医疗卫生事业的一个重组成部分,但因为该学科的形成只有二三十年,其性质和定义、内涵和外延、学科领域的界定、学术研究的范围,均需进一步完善。     

如何做合格的“专职”临床药师

在以患者为中心的药学服务阶段,结合我国临床药师的发展现况,认为培养专科临床药师切实可行,更利于我们药师和医院的同步发展,并探讨其工作主要任务和目标的六大方面,以及考核标准的六大方面;最终达到临床药师、医师、护师组成和谐团队,真正为患者提供最好的药学服务的观点。     

如何做合格的“专职”临床药师

在以患者为中心的药学服务阶段,结合我国临床药师的发展现况,认为培养专科临床药师切实可行,更利于我们药师和医院的同步发展,并探讨其工作主要任务和目标的六大方面,以及考核标准的六大方面;最终达到临床药师、医师、护师组成和谐团队,真正为患者提供最好的药学服务的观点。     

药学咨询服务在医院药房的开展探析

在当前我国医疗事业不断发展的形势下,面对严峻的社会医疗需求,提高医院内部医护服务水平是非常关键的。本文对于药学咨询服务的开展意义进行了分析和阐述,并且探讨了提高药学咨询服务在医院药房的开展水平的策略。     

基于优质护理服务的“病房管理年”活动实践及体会

从大庆油田总医院开展“病房管理年”活动的实施背景、对优质护理服务的重要性、具体实施方法以及活动取得的成效和体会等多个方面对开展活动的情况进行了阐述和分析，提出了开展“病房管理年”活动，能够促进医院各项工作的协调发展，为优质护理服务在医院的健康开展提供更大程度的保障和支持的观点，为推进优质护理服务在医院的持续深入开展提供参考。     

我国发展医院临床社会工作的意义与对策 ——基于美国临床社会工作的经验

随着医药卫生体制改革的不断深化,发展有效协作的医疗服务供给模式成为新趋势,因而凸显了在医疗机构中致力于提供咨询和协调服务的临床社会工作者的重要性。通过对美国临床社会工作内涵及其职责范围、重要性的分析,认为我国发展临床社会工作有利于改善医患关系、保障客户利益、提高医护人员工作福利和增加医院经济效益,建议我国从转变医疗服务供给理念、培养专业的社会工作者队伍和开展临床社会工作定量研究三个方面消除我国医院发展临床社会工作的障碍。     

二级中医医院中药房管理体会

中药房管理是医院药事管理的重要组成部分,中药房的管理质量将直接影响医院的声誉和经济效益.改善中药房的传统工作模式,加强药品管理,塑造良好药学服务,也是进一步提高医院整体服务水平的重要手段.中药房的管理包括中药饮片及中成药的购进、验收、存贮养护、申领、调配、中药汤剂煎煮及配送等方面,还包括临床用药指导,药学服务等内容[1].因此,在具体工作实践中要认真做好以下几点.     

The regional drug information service: a factor in health care?

Most regional health authorities throughout the United Kingdom have established drug information units to provide health service staff with a wide range of information about drugs and drug use. The units, which are staffed by drug information pharmacists, provide their service mainly by answering inquiries, although some disseminate information more positively through lectures and bulletins.An analysis of inquiries received by regional information units during 1976 showed that most were submitted by hospital doctors or pharmacists; comparatively few were received from general practitioners. Topics of inquiry included adverse effects of drugs, source of supply and identification, current treatment, dosage, route, precautions, and pharmaceutical problems such as stability or formulation of drug preparations. A more detailed analysis of the inquiries received by the North-western Regional Drug Information Service at Manchester over three years showed that the number of inquiries gradually increased and that more were received from general practitioners after a programme of lectures had been introduced to tell them about the service. The North-western service also received more requests from hospital pharmacists than other units, though many originated from clinicians.The regional drug information units consulted widely with clinical and other specialists in answering questions, but about a quarter of all inquiries were pharmaceutical, relating to stability and incompatibility. A multidisciplinary approach therefore seems necessary to provide a comprehensive and advisory drug information service.     

儿童巴特综合征药物治疗一例分析暨文献复习

目的:加强对儿童巴特综合征药物治疗的认识,探讨医院药学部门的处方点评模式。方法:分析我院2015年12月的1张巴特综合征患者处方的合理性,并复习相关文献。结果:本张处方初评时被判定为不合理处方,经过临床药师与临床医师的沟通和查阅相关文献,复评时将此处方改判为合理处方,证明了我院三级处方点评模式可以提高药师审查处方的能力,确保处方点评合理、公平。结论:表面上看用药不合理的处方并不一定是真正的不合理,要深入分析处方的内涵,才能对处方进行准确的判定。三级处方点评模式能促进药师学习掌握专业知识技能,提高判断处方的能力。     

Saskatchewan dial-access drug information service.

In September 1974 the colleges of pharmacy and medicine of the University of Saskatchewan began offering a drug information service to the pharmacists and physicians of Saskatchewan without charge. With the help of a radio-page system, calls are taken immediately by experienced pharmacists and pharmacologists. The cost of long-distance phone calls is borne by grants from the Saskatchewan medical and pharmaceutical associations. During the 1st year of operation 415 requests for information were received. Of 93 persons who called up to Feb. 28, 1975, 76% responded to an evaluation questionnaire; virtually all described the service as very valuable. The information received resulted in the alteration of drug therapy in one third of calls requesting information to assist in current treatment of a patient.     

北京市公立医院试点医事服务费调查

北京市在公立医院试点医药分开,取消药品加成、挂号费和诊疗费,收取医事服务费。对试点医院门诊调查发现,医院改变传统管理和经营模式,从关注创收转变为控制成本,从多开药转变为合理用药,门诊患者数量明显增多,多数患者对现行的医事服务费政策支持并感到满意。部分医院管理者认为采用医事服务费并取消药品加成没有真正切断医生和药品之间的利益关系,对医院和医护人员长期影响有待进一步观察。     

Perceptions and Attitudes of Egyptian Health Professionals and Policy-Makers towards Pharmaceutical Sales Representatives and Other Promotional Activities

BackgroundPharmaceutical promotion activities in low and middle-income countries are often neither regulated nor monitored. While Egypt has the highest population and per capita use of medicines in the Arab world, we know very little about pharmaceutical companies promotional activities in the country.AimTo explore and analyze the perceptions of physicians towards promotional and marketing activities of pharmaceutical companies among physicians and pharmacists in Egypt.MethodologyPerspectives of different healthcare system stakeholders were explored through semi-structured, in-depth interviews conducted in 2014 in Cairo, Egypt. Interviewees were chosen via purposive sampling and snowball technique. Each interview was recorded and transcribed. Then qualitative, thematic analysis was conducted with the help of NVIVO software.FindingsThe majority of physicians and pharmacists acknowledged exposure to pharmaceutical promotion. It was commonly believed that interaction with the pharmaceutical industry is necessary and both associated risks and benefits were acknowledged. The interviewed physicians considered themselves competent enough to minimize risks and maximize benefits to their prescribing habits. Views diverged on the extent and magnitude of the risks and benefits of pharmaceutical promotion, especially in regard to the influence on patients’ health.ConclusionsPharmaceutical promotion in Egypt is intensely directed at prescribers and dispensers. Physicians, pharmacists and policymakers expressed little skepticism to the influence of promotion towards their individual prescribing. Raising awareness of the pitfalls of pharmaceutical promotion is necessary, especially among the less experienced physicians.     

Intervention description is not enough: evidence from an in-depth multiple case study on the untold role and impact of context in randomised controlled trials of seven complex interventions

Background

Despite continual improvements in the management of acute coronary syndromes, adherence to guideline-based medications remains suboptimal. We aim to improve adherence with guideline-based therapy following acute coronary syndrome using an existing service that is provided by specifically trained pharmacists, called a Home Medicines Review. We have made two minor adjustments to target the focus of the existing service including an acute coronary syndrome specific referral letter and a training package for the pharmacists providing the service.

Methods/Design

We will be conducting a randomized controlled trial to compare the directed home medicines review service to usual care following acute coronary syndromes. All patients aged 18 to 80 years and with a working diagnosis of acute coronary syndrome, who are admitted to two public, acute care hospitals, will be screened for enrolment into the trial. Exclusion criteria will include: not being discharged home, documented cognitive decline, non-Medicare eligibility, and presence of a terminal malignancy. Randomization concealment and sequence generation will occur through a centrally-monitored computer program. Patients randomized to the control group will receive usual post-discharge care. Patients randomized to receive the intervention will be offered usual post-discharge care and a directed home medicines review at two months post-discharge. The study endpoints will be six and twelve months post-discharge. The primary outcome will be the proportion of patients who are adherent to a complete, guideline-based medication regimen. Secondary outcomes will include hospital readmission rates, length of hospital stays, changes in quality of life, smoking cessation rates, cardiac rehabilitation completion rates, and mortality.

Discussion

As the trial is closely based on an existing service, any improvements observed should be highly translatable into regular practice. Possible limitations to the success of the trial intervention include general practitioner approval of the intervention, general practitioner acceptance of pharmacists' recommendations, and pharmacists' ability to make appropriate recommendations. A detailed monitoring process will detect any barriers to the success of the trial. Given that poor medication persistence following acute coronary syndrome is a worldwide problem, the findings of our study may have international implications for the care of this patient group.

Trial registration

Australian New Zealand Clinical Trials Registry ACTRN12611000452998     

公立医院药事服务费收取标准的测算与敏感性分析

通过文献综述对药事服务费的相关概念进行了梳理。在此基础上,利用上海市宝山区5家综合性医院的财务会计报表和调查统计表数据,分别测算了弥补药品加成收入和弥补药事服务成本两种不同思路下的药事服务费,并对不同财政投入和医疗服务价格政策下的药事服务费收取标准进行了敏感性分析,为政府科学决策提供了理论依据。研究认为,取消药品加成、收取药事服务费是医改深入推进的必然趋势,药事服务费在不同经济发展程度的地区可有不同收费标准,但均要建立定期调整机制。