新型冠状病毒肺炎疫情下大型三甲医院急诊药房防控策略

目的探讨新型冠状病毒肺炎(简称新冠肺炎)疫情下医院急诊药房的防控策略,为医院急诊药房面对类似突发公共卫生事件时的防控提供参考,安全地为临床提供有效的药学服务。方法新冠肺炎疫情期间,医院急诊药房从清洁卫生、日常工作流程改进、人员防控及相关物资调配4个方面整体完善防控策略,并观察防控效果。结果疫情期间,急诊药房在保证在岗药师人员安全的前提下,为发热门诊、急诊患者提供了安全、有效的药学服务。结论面对突发公共卫生事件,作为提供药事服务的主体,急诊药房制订合理的防控策略,在岗人员团结一心,理性应战,有助于取得抗疫的最终胜利。     

Recommendations and guidance for providing pharmaceutical care services during COVID-19 pandemic: A China perspective

BackgroundThe novel coronavirus pneumonia (COVID-19), which was first detected in Wuhan City, has now became a pandemic that affecting patients around the world. Particularly, the community patient population are at high risk of infection and are facing potential failure of proper medication use during the pandemic.ObjectiveTo discuss community pharmacists’ role and the content of pharmaceutical care (PC) during the novel coronavirus pandemic to promote effective prevention and control and safe drug use of the community patient population.MethodCollect and summarize the experience Chinese community pharmacies gained from providing pharmacy services during the COVID-19 outbreak, and taking patients' PC needs into consideration, analyze and discuss the methods and strategies that community pharmacies and pharmacists shall use to provide PC during the pandemic.ResultsCommunity pharmacy management teams shall support PC services by providing adequate supply of COVID-19 related medications and preventative products, following environment regulations, and providing sufficient staff trainings. Pharmacists shall use various approaches to provide PC services in drug dispensing, consulting and referrals, chronic disease management, safe use of infusions, patient education, home care guidance and psychological support to promote the COVID-19 pandemic control and ensure safe medication use of community patients during the pandemic.ConclusionPC services in communities during the COVID-19 shall possess different properties due to disease characteristics and related change in patients' need. Community pharmacies shall work as a strong supporter of patient's medication and protective equipment supply. Community pharmacists shall be prepared to provide skilled and effective PC services for community patient population to ensure medication safety and promote the overall COVID-19 pandemic control.     

公共卫生事件中医疗机构中药制剂应急管理探讨

目的 回顾与总结新型冠状病毒肺炎疫情下医疗机构中药制剂应急管理措施,为进一步改进和完善我国应对突发公共卫生事件中药品应急管理体系建设提供参考。方法 结合本次新型冠状病毒肺炎疫情中各省医疗机构中药制剂应急管理工作实践,梳理开展医疗机构中药制剂应急管理工作流程,探讨突发公共卫生事件中医疗机构中药制剂管理策略及措施。结果 目前,19个省份发布新型冠状病毒肺炎防控用医疗机构中药制剂应急管理文件,25个省份完成百余种医疗机构中药制剂备案审批并投入临床使用。结论 建立完善的药品应急管理体系,可以提高监管效率,协调指导相关工作有序进行,进一步提高突发公共卫生事件应对能力。     

Hospital pharmacists’ pharmaceutical care for hospitalized patients with COVID-19: Recommendations and guidance from clinical experience

ObjectiveTo discuss hospital pharmacists’ role in providing pharmaceutical care for hospitalized patients with COVID-19 to promote patient care and management during the pandemic.MethodBased on the method of evidence-based pharmacy, clinical evidence of therapeutical drugs for COVID-19 were retrieved and summarized. Based on clinical experience Chinese hospital pharmacists gained from providing pharmaceutical care services during COVID-19 pandemic, taking COVID-19 hospitalized patients’ needs into consideration, the methods and strategies hospital pharmacists shall use to provide pharmaceutical care were analyzed and summarized.ResultsHospital pharmacists shall support pharmaceutical care services by participating in making evidence-based decisions for medication, monitoring and evaluation of medication safety and efficacy, providing strengthened care for special population and patients with combined underlying diseases, monitoring and management of convalescent plasma therapy, providing emotional counselling and psychological support, and providing scientific information about COVID-19 vaccines.ConclusionThe need of pharmaceutical care services in COVID-19 hospitalized patients during this pandemic was quite distinguished from the past. Hospital pharmacists shall join the collaborative multidisciplinary team to improve COVID-19 patients’ outcome and reduce mortality, and to facilitate the pandemic control.     

Provision of clinical pharmacy services during the COVID-19 pandemic: Experiences of pharmacists from 16 European countries

BackgroundThe pharmacy profession has an important role in the frontline healthcare response to COVID-19 across all settings.ObjectiveThis study sought to explore the views and experiences of clinical pharmacists in relation to the provision of clinical pharmacy services during COVID-19.MethodsSemi-structured qualitative interviews were conducted with pharmacists working in clinical roles in healthcare settings across Europe. Participants were recruited through professional organisations of clinical and hospitals pharmacists combined with a snowballing technique. The Pharmacy Emergency Preparedness and Response Framework and Disaster Preparedness Framework for pharmacy services were used to generate data which were analysed using the thematic framework method.ResultsTwenty-two participants from 16 European countries described a range of measures to protect patients, public and healthcare staff against virus transmission including developing and disseminating educational materials. Most described their involvement in aspects of evidence provision such as facilitating clinical trials, gathering and appraising evidence and disseminating clinical information. Many hospital-based pharmacists were reassigned to new roles such as intensive care. Routine clinical services were extensively interrupted and remote forms of communication were used. Most were motivated by a strong sense of professionalism to continue delivering services. A number of facilitators and barriers to prevention, preparedness and response actions were identified which related to uptake of new roles, recognition of pharmacists roles in the healthcare team, information gathering, communication with patients and healthcare professionals, and provision of routine clinical services.ConclusionsParticipants in this multinational qualitative study described a range of service adaptations and adoption of novel roles to prevent and mitigate the public health impact of the pandemic. The study findings may help to inform governments, public health agencies and healthcare systems in harnessing ongoing service provision and adapt to any future interruptions.     

新型冠状病毒肺炎防控期间临床药师的药学服务策略

目的探讨新型冠状病毒肺炎(简称新冠肺炎)疫情期间医疗机构的药学服务策略,以充分发挥临床药师的协同作用,为医护人员与患者提供专业的药学服务。方法总结医院临床药师针对疫情、结合工作实际制订的临床药学工作模式与经验。结果临床药师对确诊/疑似新冠肺炎患者开展分层标准化药学监护,重点监护特殊人群与合并基础疾病患者,并以处方审核与药物重整、会诊、治疗药物浓度监测和不良反应监控上报为切入点开展药学服务;对于非新冠肺炎患者,充分利用网络工具开展线上咨询与药品供应,编写发布相关科普文章与书籍;另外,还积极开展临床药学与循证研究,为制订药物治疗方案提供依据。结论新冠肺炎防控期间临床药师调整药学工作模式,开展药学服务与科研,对于保证患者治疗的有效性、安全性及促进临床合理用药具有积极意义。     

COVID-19普通型患者药物治疗管理模式的建立与实践

目的 梳理总结药师在COVID-19普通型患者药物治疗管理过程中的作用，为疫情特殊时期的医院药学工作提供参考。方法 根据实际工作情况，结合文献查阅，阐述COVID-19疫情防控时期临床药师为普通型患者提供药物治疗管理的具体实践和探索。结果 临床药师积极参与COVID-19普通型患者的诊治医疗活动，展开药物治疗管理，充分做好药物治疗分析，及时识别各类药物不良反应、药物相互作用等，参与多学科协作诊疗讨论，提供药物信息，为患者提供科学、合理和个体化的给药方案。结论 面对突发疫情事件，临床药师充分利用信息系统，及时调整药学工作应对策略，发挥药学特长，保障患者安全合理用药。     

互联网药学服务研究现状和热点的可视化分析

目的 分析国内外互联网药学服务的研究现状和热点,为进一步开展互联网药学服务提供参考。方法 检索中国知网、万方数据库、PubMed和Web of Science核心合集数据库自建库至2021年发表的有关互联网药学服务研究的文献,采用BICOMB 2.02软件对纳入的中英文文献分别进行提取和统计,并生成高频关键词的词篇矩阵和共现矩阵;利用NetDraw 2.089软件对共现矩阵进行社会网络分析,绘制社会网络图,并利用Ucinet 6.212软件对网络进行中心度分析;利用gCLUTO 1.0软件对词篇矩阵进行聚类分析。结果 最终纳入关于互联网药学服务研究的中文文献159篇,互联网药学概念最早出现于2000年;英文文献纳入62篇,相关研究最早发表于1999年;发文量最多的中英文期刊分别是《中国药房》和Journal of Medical Internet Research;确定了当前关于互联网药学服务研究的6个主题:互联网药学服务在社区慢病患者中工作模式的研究、移动互联网平台在药学咨询服务中的研究、云药房(网上药店)互联网药学服务研究、新型冠状病毒肺炎疫情期间互联网药学服务模式研究、互联网药学实践在药师或临床药师继续教育培训体系中的应用研究、互联网药学服务的发展对药师的影响研究。结论 该研究全面深入分析了互联网药学服务的发展现状和研究热点,新型冠状病毒肺炎疫情催化加速了互联网药学服务的发展,在疫情防控新形势和国家各项政策支持下,伴随着"互联网+医疗健康"的发展,互联网药学服务也将蓬勃发展。     

新型冠状病毒肺炎疫情期间医院门诊药房防控管理实践

目的加强医院门诊药房应对新型冠状病毒肺炎(COVID-19)疫情的防控管理措施。方法根据医院相关规定和要求,在保障患者和药师安全的基础上,结合门诊药房疫情防控实践,梳理具体处置措施。结果在疫情防控期间,医院门诊药房通过成立督导小组,向员工普及COVID-19相关知识,窗口运行精细化管理,开展互联网+药品配送服务等措施,至今已服务20万余人次,无员工感染及疑似感染新型冠状病毒。结论医院门诊药房在COVID-19疫情期间的防控管理措施,可提升患者和员工疫情期间的安全,保障门诊药房的正常运转。     

临床药师绩效考核制度的构建

目的 建立新医改背景下医院临床药师的绩效考核制度,激励和挖掘临床药师潜能,强化竞争与责任意识,提高临床药学工作成绩。方法 以工作量为核心,创新性、效益性、推广性工作为导向,工作质量、时效性和成果并重的原则,制定考核制度与明细。结果 结合临床药学实际情况,制定了覆盖日常工作、牵头工作、科研服务、工作态度、对外交流与学术辐射、教学工作、临床问题挖掘与创新性工作、科研成果、学术任职与个人荣誉、医德医风的临床药师工作量化方案,并建立了科学可行的考核方法、分值细则和计算方法。结论 本研究建立的临床药师考核制度客观可行,达到了临床药师的绩效考核目的,对提高临床药学管理水平和药学服务质量均具有重大意义。     

Expanded roles of community pharmacists in COVID-19: A scoping literature review

BackgroundCoronavirus disease 2019 (COVID-19) has affected the world health care system adversely, but it has also brought out innovative roles for health care professionals to cater to growing health care needs. Community pharmacists provide community pharmacy services and can play a vital role in fighting the pandemic by taking on novel roles that complement their pre-existing roles.ObjectivesThis study aimed to provide a scoping review of current and emerging literature about the novel roles adopted by community pharmacists during the COVID-19 pandemic.MethodsOnline databases such as Google Scholar and PubMed were searched systematically using the keywords “COVID-19,” “pharmacist,” and “community.” Articles were selected based on availability of full text in English language, with time limit from December 1, 2019, to October 31, 2021; case reports, cross-sectional studies, literature reviews, qualitative studies, and systematic reviews were included, whereas commentary reviews and editorials were excluded from the search methodology. An independent review of the articles was conducted for inclusion based on relatability to study subject; those chosen were screened for references to find additional gray literature. Findings were arranged in themes, and the results were organized accordingly.ResultsNovel roles for community pharmacists were found in relation to maintenance of drug-supply chains, delivery of telepharmacy and telehealth services, provision of ambulatory pharmacy services, use of digital software to coordinate medication delivery for patients with chronic conditions, dispelling of misinformation, and roles in research and clinical trials. Roles in a post-COVID world regarding immunization of population and involvement in lifting lockdown strictures alongside other stakeholders were also explored.ConclusionAlthough COVID-19 has challenged the health care system, it has also provided an opportunity for development of novel and innovative roles that can ultimately have profound consequences for the health care system. Community pharmacists, despite facing multiple challenges in the community, should be facilitated to adapt with these new roles, which can be beneficial in achieving mass immunization and better health care in a post-COVID world.     

Psychological impact of the COVID-19 outbreak in community pharmacists: A longitudinal study

BackgroundCoronavirus disease 2019 (COVID-19) has negatively affected the mental health of frontline health care workers, including pharmacists.ObjectivesThe aim of this longitudinal study was to assess the psychological impact of the COVID-19 outbreak in French owner community pharmacists.MethodsWe conducted a postal-based survey to assess the psychological difficulties of the COVID-19 outbreak in French owner community pharmacists based on 3 psychologically validated self-report questionnaires: Perceived Stress Scale (PSS), Impact of Event Scale-revised (IES-R), and Maslach Burnout Inventory. The baseline assessment was during the first sanitary lockdown period and the second one 5 months later.ResultsThe sample consists of 135 owner community pharmacists. At follow-up, 67 answered the questionnaires (response rate: 49.6%). The mean scores of the PSS and IES-R significantly decreased (P = 0.002). Fifteen pharmacists reported significant posttraumatic stress symptoms (23.1%) at baseline and 11 at follow-up (16.4%, P = 0.02). Age and sex were not significantly associated with persistent posttraumatic stress or burnout symptoms.ConclusionThis is the first longitudinal study that showed the psychological impact of owner community pharmacists as health care workers dealing with their community’s COVID-19 outbreak. Based on validated self-report questionnaires, stress, posttraumatic stress, and burnout symptoms decreased during follow-up. It is necessary to continue monitoring psychological difficulties for health care workers, especially during consecutive waves of the COVID-19 outbreak.     

Response to the first wave of the COVID-19 pandemic in the community pharmacy of a University Center for Primary Care and Public Health

BackgroundPharmacists played a key role during the coronavirus disease 2019 (COVID-19) pandemic: they contributed to preventing transmission and to maintaining continuity of primary care.ObjectivesTo present the contributions of a Swiss pharmacy of an academic outpatient care department (Unisanté) to the prevention of COVID-19 transmission and the precautionary measures plan implemented as well as to evaluate the impact of Swiss semicontainment on its pharmacy services.MethodsContributions to COVID-19 transmission prevention and the precautionary measures plan are described. The impact on pharmacy services was measured by quantitative comparison before, during and after semicontainment.ResultsThe pharmacy supplied protective equipment to the population and to liberal healthcare professionals and provided COVID-19 recommendations to patients and community pharmacies. The precautionary measures plan implemented required a reorganization of the premises, facilities, staff operation and pharmacy services. Semicontainment had a strong impact on pharmacy services; however, clinical bonds with patients and other healthcare professionals were maintained. Unseen negative impacts may exist and need to be investigated.ConclusionsAlthough innovative solutions remain to be developed to guarantee continuous and secure remote communication with patients, this pandemic was an opportunity to demonstrate the versatility, benefit and importance of community pharmacy services.     

The “affected” pharmacist and the “business as usual” pharmacist: Exploring the experiences of pharmacists during COVID-19 through cluster analysis

BackgroundThe global coronavirus disease 2019 (COVID-19) pandemic has necessitated considerable changes in the delivery of pharmacy services, with pharmacists experiencing increasing demands and a high rate of burnout. The ability to categorize pharmacists based on their burnout risk and associated factors could be used to tailor burnout interventions.ObjectiveThis study aimed to identify subgroups (profiles) of pharmacists and use these profiles to describe interventions tailored to improve pharmacist’s well-being.MethodsA survey was disseminated to pharmacists working in Australia during April and June 2020. The survey measured demographics, burnout, and psychosocial factors associated with working during COVID-19. A two-step cluster analysis was used to categorize pharmacists based on burnout and other variables.ResultsA total of 647 survey responses contained data that were used for analysis. Participants were mostly female (75.7%) and working full time (65.2%). The final cluster analysis yielded an acceptable two-cluster model describing 2 very different pharmacist experiences, using 10 variables. Cluster 2 (representing 53.1% of participants) describes the “affected” pharmacist, who has a high degree of burnout, works in community pharmacy, experiences incivility, is less likely to report sufficient precautionary measures in their workplace, and has had an increase in workload and overtime. In contrast, cluster 1 (representing 46.9% of participants) describes the profile of a “business as usual” hospital pharmacist with the opposite experiences.Interventions focused on the “affected” pharmacist such as financial support to employ specialized staff and equitable access to personal protective equipment should be available to community pharmacists, to reduce the risk to these frontline workers.ConclusionThe use of cluster analysis has identified 2 distinct profiles of pharmacists working during COVID-19. The “affected” pharmacist warrants targeted interventions to address the high burnout experienced in this group.     

临床药师参与COVID-19患儿抗病毒治疗的药学监护

目的通过参与新型冠状病毒肺炎(COVID-19)患儿的药物治疗实践,探讨临床药师参与COVID-19患儿的治疗和开展药学监护的方法。方法临床药师运用药学专业知识和最新的临床研究证据,参与和协助临床调整治疗方案,并对患儿家属进行用药教育。结果临床药师积极参与COVID-19患儿治疗过程的药学监护,及时发现患儿的药物治疗问题,提出合理化建议,并取得明显成效。结论临床药师参与COVID-19患儿药物治疗方案的制订,找到了融入临床治疗团队的切入点,将理论知识和临床实践相结合,优化药物治疗方案,既可提高临床药物治疗水平,又能提高患儿用药的安全性、有效性。     

Impact of the COVID-19 epidemic on the provision of pharmaceutical care in community pharmacies

BackgroundCommunity pharmacists and their teams are easy accessible healthcare providers with an important role in primary care. As a consequence of the COVID-19 epidemic, (pharmaceutical) care and specifically communication between patients and healthcare providers is compromised.ObjectiveTo describe the impact of the COVID-19 epidemic on the provision of pharmaceutical care in the Netherlands.MethodsA cross-sectional study with an online questionnaire was sent to community pharmacies in the Netherlands. The questionnaire covered the following main topics: changes in pharmacy setting and logistic procedures, communication about medication and baseline characteristics.ResultsPharmacies implemented hygiene measures and minimized direct patient-provider contact, e.g. by delivering medication at home to a wider range of patients (47.0%), temporarily not conducting medication reviews (55.8%) and only performing inhalation instructions via telephone (22.3%). Only a small number of pharmacies used telepharmacy, such as video calling during patient education and counseling. A total of 76.7% of the participants expressed concerns towards the pharmaceutical care for vulnerable patients.ConclusionsOur results show considerable impact of the COVID-19 epidemic on both logistic procedures and services regarding patient education and counseling. Pharmacies should be stimulated to implement telepharmacy or remote service to optimally support patients during the COVID-19 epidemic.     

The experiences of the community pharmacy team in supporting people with dementia and family carers with medication management during the COVID-19 pandemic

BackgroundThe novel coronavirus COVID-19 pandemic has changed the lives of people across the globe in significant and long-lasting ways. People with dementia were significantly and disproportionally affected at the height of the pandemic in England. Community pharmacies in England continued to operate during the pandemic but had to adjust the way they provided key healthcare services. The impact of these changes on the provision of medication services to people with dementia is underexplored.ObjectiveTo explore the experiences of the community pharmacy team in supporting people with dementia and their family carers with the management of medications during the COVID-19 pandemic.MethodsAn interpretivist/constructivist research paradigm was used; semi-structured one-to-one telephone interviews were conducted with any member of the community pharmacy team who had been involved in providing medication services to people with dementia in England before and during the COVID-19 pandemic. Recruitment took place between July and August 2020. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis.ResultsFourteen participants were interviewed with equal numbers of qualified pharmacists and non-pharmacist staff. Participants were in their role for an average of 4.5 years. The analysis of interviews generated three themes: 1) key interactions curtailed due to COVID-19 restrictions, 2) utilising resources within and outside of the pharmacy to provide tailored services for people with dementia, and 3) the interplay between professional duty and personal values underpinned decisions to provide medication services.ConclusionsThe study provided a unique and important first insights to our understanding of how the community pharmacy team in England supported people with dementia and their family carers during the COVID-19 pandemic. These insights provide opportunities for reflection by individuals, healthcare teams, healthcare organisations, policy makers and the public, in an international context, to enable long-term planning, investment and implementation of strategies beyond the current pandemic.