我国基层医疗机构药学服务现状及问题研究(三):药学服务开展现状分析

目的：通过调查分析了解我国基层医疗机构药学服务开展的基本情况，发现其中存在的问题并寻求改进措施。方法：以面对面访谈的形式发放调查表，对全国各地基层医疗机构开展药学服务的内容、医师药师对药学服务的态度、药学服务的需求以及患者的认可与满意度情况等进行统计、分析。结果：发药（91.1%）、患者用药咨询（90.0%）、处方审核（79.6%）和药品管理（78.7%）是基层医疗机构药师开展频率最高的药学服务工作；几乎所有的药师（98.7%）和医师（96.5%）都认为基层医疗机构需要药师提供药学服务，绝大多数医师（85.3%）会对药师的用药建议予以不同程度的采纳；大部分患者服药前会仔细阅读药品说明书（78.6%）和留意药品保质期（82.1%），约一半的患者会主动了解相关药物知识（55.6%）；患者在出现药物不良反应时咨询药师（13.7%）以及从药师处获取药物信息（11.0%）的比例偏低，接受药学服务相对不足；患者在医保报销比率（17.6%）、合理用药宣传（9.9%）和购药配药便利性（7.0%）方面的满意度相对欠缺。结论：我国基层医疗机构药学服务已有初步开展，具有一定的社会效益，但仍存在转变药师工作模式、提高药师与药学服务认可度以及满足患者更多服务需求等提升空间。     

美国药品成本管理策略对我国医疗机构药品费用控制启示

目的：为控制我国药品费用的不合理增长和促进医疗机构药学服务提供参考。方法：分析美国卫生系统药师协会制定的药品成本管理策略，对比我国医疗机构卫生现状，从而提出完善医疗机构药学工作，进行药品控费的建议。结果：美国药品成本管理策略建议医疗机构基于往年采购量（或金额）和使用量（或金额）开展药品预算管理；规范临床药师素质及临床药学服务质量的同时常态化开展交互治疗；成立药师参与临床治疗且获取医务人员支持的治疗小组；制定药品处方集并将成本较低、效果明显的药品纳入电子处方管理系统；建立药品使用替换制度，严格规范药品替换流程。结论：我国医疗机构可以开展药品预算研究来控制药品使用金额；通过提升临床药师技能来增强药师职业认知；加强药师医师沟通以明确两者职能分工；注重药师处方集制定并管控药品不合理使用；完善药品替换制度来规范药品使用管理。     

对二级医疗机构药师培训与药学服务能力现状的调研

目的：了解江苏省二级医疗机构药师培训与药学服务能力现状,分析影响因素并提出改进建议。方法：基于“知信行”（KAP）理论,设计“二级医疗机构药师培训与药学服务能力现状”调查问卷,以问卷星的形式,发放给省内部分二级医疗机构药师填写,回收后分析相关数据。结果：有208名药师参与调研。其中,具有本科学历者占72%,初、中级职称占85.58%,调剂岗位药师占75%。在药师培训方式中,70%以上为院内培训、参加学术会议和网络学习,院外进修仅占23.08%。36.06%的药师年培训1~2次。“知信行”问卷结果显示：知识得分较差;态度得分较好;行为得分一般。学历、职称及工作岗位对知识维度影响较大,差异具有统计学意义（P<0.05）。多元线性回归分析结果显示：学历、职称是知识维度的影响因素（P<0.05）;工作岗位是行为维度的影响因素（P<0.05）;性别是态度维度的影响因素（P<0.05）。结论：二级医疗机构药师业务培训有待加强,可根据岗位工作的需要,开展多层次、针对性强的教育培训,以提高药师的药学服务能力。     

广东省社区医务人员对临床药师及药学服务的认知及需求调查分析

目的：了解广东省社区医务人员对临床药师及药学服务的认知及需求,为开展社区药学服务提供参考。方法：以问卷调查形式,采用分层随机抽样法对广东省社区医务人员发放调查问卷,并对调查结果进行统计分析。结果：收回有效问卷564份,12.76%的社区医务人员十分了解临床药师工作;86.88%的社区医务人员遇到用药问题时希望得到临床药师的指导和帮助;95.39%的社区医务人员希望临床药师加入家庭医生团队,参与患者管理。社区医务人员希望提供的药学服务主要包括药品不良反应的识别及上报（90.43%）、开展用药咨询（89.01%）、参与个体化用药方案的制定（87.23%）和开展合理用药培训（84.75%）。多因素Logistic回归显示,地区（OR=0.367）、年龄（OR=1.793）、身份（OR=0.557）和遇到用药问题咨询药师（OR=3.361）,是社区医务人员对临床药师认知的主要影响因素。相关分析显示,社区医务人员对临床药师的认知水平与药学服务的需求具有明显正相关（P<0.01）。结论：社区医务人员对临床药师认知度较低,但对药学服务需求强烈,应通过加强宣传,推进临床药师制度建设等措施提升社区...     

湖北省321家二级以上医疗机构药学资源配置情况调查

摘要：目的:了解湖北省二级以上医疗机构药学资源配置的现状,为制定药师管理相关规定及提升药学服务质量提供参考,完善药学人员的合理配置提供依据。方法:对湖北省93家三级医疗机构和228家二级医疗机构药学部人员基本情况进行问卷调查,具体包含药学部门负责人及员工职称、学历及年龄分布情况,和是否具备相关部门,如门诊药房、中药饮片药房、临床药学室、制剂室、静脉用药集中调配中心等,将收集的数据输入Excel软件建立数据库进行统计分析,并提出建议。结果:总体上看,各级医疗机构药学技术人员占比无明显差异（P>0.05）,而三级医疗机构高学历、高职称的药学人员、临床药师显著多于二级（P<0.01）,尤其是青年药师（年龄≤30岁）比例,且相关硬件配套设施如临床药学室、制剂室、静脉用药集中调配中心、独立的住院部药房、独立的急诊药房等设施占比显著高于二级（P<0.01）。结论:二级以上医疗卫生机构药学专业技术人员数量不足,需要加强药学人力资源合理配置,提高药学人员学历、职称,优化年龄结构,尤其是二级医疗机构,急需加强青年药师及参与临床药师培训的数量,提高药师队伍素质,以促进医院药学事业的发展。     

西安市医疗机构临床药学工作开展现状调查

目的：调查西安市医疗机构临床药学工作开展状况,以促进临床药学工作的进一步发展。方法：分级分类抽取西安市24家二级以上医疗机构,对其临床药师现场进行问卷调查,内容包括医院基本信息、临床药师的基本情况、临床药学工作开展状况。结果：被调研医疗机构全职临床药师占60.2%,平均每位临床药师服务床位数为133.1±53.8（床/人）。各医疗机构中主要开展的临床药学工作有用药干预（95.8%）、药学咨询（91.7%）、细菌耐药监测（41.7%）、治疗药物监测（20.8%）。临床药师进行了查房（96.6%）、药品不良反应监测（95.8%）、合理用药培训（84.8%）、患者用药教育（80.5%）、重点患者药学监护（78.0%）、特殊管理药品药学监护（47.5%）、实习生和进修人员培训（61.9%）、疑难危重患者会诊（56.8%）、科研工作（42.4%）等临床药学工作。每天药学服务时间多为1~2 h（68.6%的临床药师）。三级医院、二级医院每日查房频次大于等于一次的分别为34.1%,3.5%。参与会诊的临床药师有67.1%认为"医师会参考临床药师提供的用药信息"。3.4%的临床药师认为"ADR监测工作开展很好且临床很支持"。三级医院临床药师更重视查房、ADR监测和科研工作（P<0.05）,二级医院临床药师与护士沟通较多（P<0.05）。结论：西安市各级医疗机构临床药学工作已经普遍开展,但开展情况有差异,三级医院查房频次、ADR监测和科研工作重视程度较高,二级医院与护士沟通较多。     

重大突发性公共卫生事件下临床药学服务在贵州省医疗救治体系中的应用现状研究

目的：调查临床药学服务在贵州省医疗救治体系中的开展现状,为未来在重大突发性公共卫生事件中最大化发挥临床药学服务效能提供相关建议。方法：通过三甲医院药学部门负责人个人深入访谈及10家三甲医院的药师、医师和住院患者实地问卷调查,对贵州省临床药学服务的开展现状进行调研。结果：本次调查的药师主要以大专/本科学历、拥有初级职称的青年女性为主;药师对临床药学服务的了解度与药师的学历（P=0.002）以及是否参与过临床药学服务培训（P=0.004）之间密切相关;医师对重大突发事件应急预案的了解度高于药师（P=0.024）;参与过重大突发事件的药师比未参与过的在日常药学服务上涉及更多的用药监测（P=0.027）和治疗方案制定（P=0.014）服务;参与过重大突发事件的药师比未参与过的更肯定自我地位（P=0.032）和临床药学服务能力（P=0.031）;62.7%的医师表示与药师的整体合作情况较好,78.0%的患者表示对临床药学服务不太了解,89.0%的患者对药师提供的临床药学服务表示满意但对其信任度较低。结论：三甲医院药师在自我认识、相关知识能力水平、临床药学服务种类提供和公众认知度方面有待提升;建议完善药学教育结构,丰富药事咨询服务形式,健全药品供应协调机制,加强安全用药与不良反应监测以及应急科普宣传工作。     

湖北省494家医疗机构临床药学发展及临床药师培训现状调研

目的：调查湖北省各级医疗机构中临床药学发展及临床药师培养现状。方法：基于湖北省临床药师培训管理中心平台,由湖北省卫生健康委员会向全省各市、州及部省属医疗机构下发调查问卷,内容包括医院基本信息及情况、药学部门情况、专职临床药师情况、师资带教药师情况及临床药学工作情况。结果：共收到全省494家医疗机构有效调查问卷,其中三级医疗机构75家（15.18%）,二级137家（27.73%）,一级282家（57.09%）。不同级别医疗机构之间临床药学发展及临床药师培养情况存在较大差异。其中,三级、二级、一级医疗机构药学专业技术人员分别占比4.18%,4.76%,6.96%,均小于8%,且临床药师的数量短缺。开展临床药学工作困难的原因主要集中在科室人员不足、缺乏医院资金支持及缺少医院政策支持等方面。结论：各级医疗机构要根据功能定位加大药学人员配备和培养力度,强化临床药师配备与培养,合理运用信息化手段,以进一步提升医疗机构开展高质量药学服务的能力和水平。     

苏州地区14家医疗机构医师对国家药品集中采购政策的认知现状及药学需求调查研究

目的 通过苏州地区14家医疗机构医师对国家药品集中采购政策(以下简称“集采政策”)的认知现状及药学服务需求的调研，了解集采政策推进情况，更好地发挥药学服务的作用，促进药学服务转型。方法 2021年5—7月采用问卷星调查的方式，调研苏州地区14家医疗机构医师对集采政策知晓情况、评价情况、用药行为及药学需求。对各个问题的回答情况进行汇总和描述性分析，应用SPSS 25.0统计软件进行数据分析。结果 共计调研1 134份问卷，有效回收1 005份。知晓情况：知晓集采政策的医师有826人，知晓率为82.19%。医疗机构等级、专业职称、学历、集采政策培训次数对集采政策知晓情况差异有统计学意义(P<0.05)。医疗机构等级越高、专业职称越高、学历越高、集采政策培训次数越多的医师知晓率越高。评价情况：知晓集采政策的医师中，有61.26%的医师对国家集中采购药品(以下简称“集采药品”)治疗效果满意，69.49%的医师对集采药品安全性满意。不同学历、集采药品培训次数对集采药品的评价差异有统计学意义(P<0.05)，其中专科学历的医师对集采药品满意度较高；参与集采政策培训次数越多，对集采药品评...     

我国社区药店药师参与儿童非处方药药学服务现状调研

目的 提升我国社区药店药师儿童非处方药药学服务水平。方法 通过查阅万方医学网、中国知网、中华医学期刊全文数据库、PubMed数据库中国内外文献并咨询9位专家（国内部分医院药学部主任等）设计调查问卷，随机发放至我国31个省/自治区/直辖市（未纳入台湾省）的社区药店药师，调研其对儿童常用6类非处方药（解热镇痛药、感冒药、化痰止咳药、消化系统用药、抗组胺药、维生素与微量元素补充剂）的认知及其药学服务开展情况，分析调查结果及存在的问题。结果 共发放3 518份调查问卷，均有效回收，涉及药师3 518人。“非常清楚”6类药物的适应证、注意事项、配伍禁忌、用法用量、适宜剂型的药师占比多在30%～40%之间；推荐用药前，能询问患儿症状、年龄、过敏史的药师占70%～81%，会提示药品用法用量及药品不良反应的药师占65%～72%。结论 社区药店药师对儿童常用6类非处方药的各方面认知及药学服务开展水平均有待提高。应有的放矢设计儿童非处方药知识培训计划，提高社区药店药师该类药的药学服务水平，发展和完善我国社区药店服务体系。     

重庆市39家医疗机构临床药学服务发展现状的调查研究

目的:了解重庆市等级医疗机构临床药学工作的开展状况,探讨优化我市临床药学服务的方法。方法:采用问卷调查的方式,按照地域、医疗机构级别,兼顾综合与专科医院,选取重庆市50家样本医疗机构(包括15家三级医院、25家二级医院和10家一级医院),对其临床药师队伍及临床药学工作开展状况等进行调查,并对结果进行统计分析,找到共性问题并提出相关建议。结果与结论:共回收45份调查问卷,回收率90%,其中合格问卷39份,合格率86.67%。39家医疗机构中设置临床药学部门的有32家(82.05%)、临床药师培训基地医院有4家(10.26%)。39家医疗机构均配有专职药师,共计239人,平均每家医疗机构6.13人从事临床药学工作,其中专职临床药师4.5人/家,多数医疗机构专职临床药师为2~5人(25家);临床药师主要参与工作的临床科室占比排序前5位依次为呼吸科、心血管科、内分泌科、重症医学科(ICU)、肿瘤科,大部分临床药师(16家,42.11%)在临床的工作时间占比为>50%~≤80%;在开展的临床药学项目方面,以开展药品不良反应监测、合理用药知识宣传、处方医嘱点评、查房、会诊、编辑出版药讯的医疗机构数量较高(28~37家,>70.00%)。28家(78.95%)暂未开展治疗药物监测项目;39家(100%)医疗机构均开展了患者用药教育工作,以宣传栏(30家,78.95%)、科普讲座(28家、73.68%)和用药教育表(28家、73.68%)的形式较多,用药教育内容以注意事项(39家,100%)、用法用量(37家,97.37%)、不良反应(36家、94.74%)为主;29家医院开展了临床药学科研工作(73.68%),以合理用药研究(28家,73.68%)为主;5家(12.82%)医疗机构开设了联合药学门诊、2家(5.12%)开设了独立药学门诊,其余均未开设药学门诊(26家,66.67%)。本次调查发现药学服务存在科室病区床位覆盖不全、药学部门科研基础薄弱等问题。建议国家和地方卫生健康委员会可采取加强多层次临床药学人才梯队建设、探索培养驻科临床药师、评选和建设重庆市临床药学重点专科、建立临床药师激励机制等方式,各级医疗机构可采取多途径加快临床药师培养、增加药师门诊宣传、改变病区工作模式、培养特色专科临床药师、完善继续教育途径及路径、增强科研实力等方式提高临床药学服务水平。     

我国基层医疗机构药学服务现状及问题研究(一):研究简介及药学服务基本条件分析

目的:通过调查分析了解我国基层医疗机构药学服务基本条件及相关概况,为相关政策制定提供参考。方法:以面对面访谈的形式调研,对全国各地基层医疗机构的诊疗服务、硬件水平、人员配置、药物配备等情况进行统计、分析。结果:99.1%的基层医疗机构承担常见病、多发病首诊职能;基层医疗机构设置科目最多的是预防保健科(72.8%);88.4%的基层医疗机构配备药品专用储存柜;医师以男性居多(60.7%),药师以女性居多(70.3%);75.9%的基层医疗机构只配备基本药物;86.2%的医师和85.7%的药师期望增加人员待遇;40.4%的慢性病患者希望增加医保报销药品种类,28.7%的使用抗生素患者希望基层医疗机构提供更多的用药指导。结论:我国基层医疗机构硬件水平、人员配置、软件设备等方面亟待改善,社会各界应给予重视,政策制定应向提供经费和提升人员素质等方面倾斜。     

Knowledge and awareness of adverse drug reactions and pharmacovigilance practices among healthcare professionals in Al-Madinah Al-Munawwarah,Kingdom of Saudi Arabia

Adverse Drug Reactions (ADRs) are scantly reported with poor contribution by healthcare professionals worldwide and in particular in developing countries. The aim of this study was to assess the knowledge and awareness of adverse drug reactions (ADRs) reporting and pharmacovigilance system among healthcare professionals in Al-Madinah Al-Munawwarah hospitals, Kingdom of Saudi Arabia. A questionnaire was designed addressing; awareness of ADRs, knowledge of pharmacovigilance system, availability of ADRs reporting system, patient counseling about ADRs and documentation of ADRs. The questionnaire was distributed to randomly selected healthcare professionals (n = 585) such as physicians, pharmacists, nurses and pharmacists’ technicians of hospitals. Completed questionnaires were collected and data were analyzed. Data were expressed in number as well as percentage. Of the 585 questionnaires circulated, a total of 384 healthcare professionals responded. Healthcare professional categories involved in the study were 148 physicians, 37 pharmacists, 158 nurses and 41 pharmacist technicians. The percent of the respondents who accepted to enroll in the study was 65.64%. Most of the respondents were unable to correctly define the pharmacovigilance term, but they were aware of ADRs. The awareness among healthcare professionals of the national pharmacovigilance system was 39.6%. Pharmacists had a good knowledge of pharmacovigilance and ADRs terminology and showed a more positive attitude to report ADRs. A greater number of the healthcare professionals were aware of ADRs reporting, but practically it is not implemented in hospitals. Most hospitals had follow-up documentation systems, but did not include ADRs reporting. There was no distinct pharmacovigilance system in place. Our study has demonstrated a lack of knowledge and awareness of pharmacovigilance and ADRs reporting among healthcare professionals in hospitals. The poor knowledge of ADRs reporting emphasized the urgent need to implement the appropriate strategies to improve the awareness of pharmacovigilance practices and ADRs reporting in Al-Madinah Al-Munawwarah hospitals.     

中西结合药师门诊服务模式的探索与分析

目的通过设立中西结合的药师综合门诊,为患者和群众提供个体化药学服务,探索分析中医院药学服务转型模式。方法设立中西结合药师综合门诊,建立规范的药师接诊制度和流程,收集统计开诊以来接诊病例资料,分析咨询人群、咨询内容和满意度调查结果。结果患者和群众对药师门诊的知晓率较低,就诊率和复诊率(11.03%)低;136例就诊病例中,就诊人群以45岁以上中老年人(67.64%)居多,以女性(56.62%)居多;群众对药学服务内容需求涉及面较广,以第一服务需求为用药教育(32.35%)和慢病用药管理(30.15%)为主,其次为涉及中药方面(20.59%)的内容;主动提出药物精简或处方重整的仅6例(4.41%)。结论中药师参与药师门诊工作,可以与西药师优势互补,在一定程度上促进临床合理使用中药,降低中药药源性疾病的风险;开设中西结合综合药师门诊能为群众提供满意的药学服务,提高用药依从性,提升药物治疗效果和患者满意度。但出诊药师的专业水平有待进一步提升,接诊服务流程有待进一步规范和标准化。     

Comparative usefulness of MEDLINE searches performed by a drug information pharmacist and by medical librarians

The usefulness of MEDLINE searches conducted by a drug information pharmacist who had received online training was compared with the usefulness of searches conducted by medical librarians. Searches for literature pertinent to select drug information requests received at a university drug consultation service during a three-month period were conducted independently by the pharmacist and one of three reference librarians. The three librarians had received extensive online search training and were experienced in conducting MEDLINE searches; the pharmacist was trained by a fourth experienced librarian-searcher using National Library of Medicine (NLM) training materials. For each drug information request, the pharmacist and the librarian searched two MEDLINE files on the NLM service. The printouts generated by the two searchers were evaluated by two drug information pharmacists in terms of how useful each list of citations would be in enabling the drug information pharmacists to answer the related question. The majority of printouts in 48 sets of searches were judged to be useful. Of the 96 possible "best search" votes (two votes for each of the 48 sets of printouts), the pharmacist's searches received 34 votes, the librarians' searches received 28 votes, and there were 34 tie votes. The numbers of useful primary and alternate citations were found to be the best predictors of whether a given printout would receive the "best search" rating. MEDLINE searches performed by a drug information pharmacist with online training, in response to drug information requests, were judged by drug information pharmacists to be as useful as searches performed by librarians.     

A Canadian Survey of Pharmacist Participation during Cardiopulmonary Resuscitation

Background:The participation of pharmacists on cardiopulmonary resuscitation (CPR) teams has been associated with improvements in patient outcomes secondary to lower rates of adverse drug events and higher rates of compliance with guidelines for advanced cardiac life support (ACLS). The degree to which Canadian pharmacists participate on CPR teams and the services they provide have not previously been assessed.Objectives:To measure the frequency of pharmacists’ involvement on CPR teams in Canadian health care delivery organizations, to characterize the services provided by these pharmacists, to identify positive predictors of participation, and, for health care delivery organizations without pharmacists on CPR teams, to determine the reasons for the lack of involvement.Methods:An electronic survey was distributed to key informants in Canadian health care delivery organizations. The survey consisted of questions about characteristics of the health care delivery organizations, pharmacists’ participation and role on the CPR team, training, and barriers to implementation. The primary outcome was the percentage of health care delivery organizations with pharmacists participating on CPR teams in at least one centre within the organization. The secondary outcomes were pharmacists’ activities, training, and reasons for not participating on CPR teams.Results:Forty-three of 99 key informants responded to the survey. Twenty-nine respondents (67%) indicated that their organization had a CPR team, and 10 (23%) indicated participation by pharmacists on a CPR team. Roles reported to be performed by pharmacists during CPR events were provision of drug information, preparation and administration of medications, record-keeping, and chest compressions. Training for these pharmacists was variable: ACLS training for 4 (40%) of the 10 organizations with pharmacist participation, in-house training for 3 (30%), and no training for 2 (20%); one respondent (10%) did not report the level of training. Reasons for not having pharmacists on CPR teams included inconsistent coverage, lack of training, and staff shortages.Conclusions:This study characterized current pharmacist participation on CPR teams in Canadian health care delivery organizations. As evidence arises showing the impact of this practice on patient outcomes, pharmacist participation on CPR teams may become more common.     

我国医院药师在医疗机构中的定位与作用

目的:明确新医改形势下我国医院药师在医疗机构中的定位与作用。方法:介绍我国现有药师的分类并分析探讨其职责和定位。结果与结论:我国现有药师按专业不同可分为药师、中药师和临床药师;按职称职务可分为药士、药师、主管药师、副主任药师和主任药师;按是否注册可分为药师和执业药师。他们主要在医院药剂科、研究所、制药企业的研究部门、药检所以及药品的生产和流通等部门从事相关工作。医院药师在医疗机构中具有独立性、辅助性、经济性和结构上的立体性。在新医改政策下,医院药师并不是要放弃传统的医院药学工作,而是要增加临床药学的工作内容,使医院药师的队伍不断壮大,功能更加完善。传统的医院药学工作和现代的临床药学工作是相互促进、相互支撑的,都是医疗工作中不可或缺的组成部分,只有在做好传统医院药师本职工作的基础上来开展临床药学活动,才是医院药师正确的发展之道。     

Pharmacists’ and physicians’ perception and exposure to drug promotion: A Saudi study

Introduction

Drug promotion has to contribute to a more rational use of drugs. Concerns arise if promotion negatively influences prescribing/dispensing pattern. It is warranted to assess exposure and attitudes to, and acceptance of, drug promotion among pharmacists and physicians.

Methodology

Adopting a randomized, multiple site and cross-sectional survey study, questionnaires (n = 250) were completed by physicians and pharmacists to investigate the exposure, acceptance or skepticism of Saudi physicians/pharmacists to drug promotion as well as their perception of the appropriateness of gifts and to check if they had any teaching/training about dealing with medical representatives (MRs) and Pharma promotion.

Results

Significantly more pharmacists than physicians (32% vs. 23%; p < 0.05) reported being taught or educated about the ethics of drug promotion. The experience level was significantly associated with the teaching or training that the physicians and pharmacists received. Conference registration fees and drug samples were the most appropriate promotional gift for the physicians (67% and 66%, respectively; p < 0.01) whereas for pharmacists, the drug sample was considered the most suitable donation (79%). More pharmacists perceived drug companies as a useful way to gain knowledge about drugs than physicians (75% vs. 65%; p < 0.01). A higher proportion of both groups were accepting drug promotion than those skeptical about it.

Conclusion

The majority of physicians or pharmacists participating in this study have received gifts from pharmaceutical companies. The drug samples and printed educational materials are the most widely accepted gifts. Recent graduates and those with few years of experience had higher teaching/training than experienced physicians and pharmacists in pharmaceutical promotion ethics and tactics to deal with MRs. On the other hand, experienced healthcare team were more approached and targeted by pharmaceutical companies and MRs. It is highly recommended to implement courses/discussion groups on the ethical interaction between healthcare professionals and pharmaceutical companies in the curriculum of both pharmacy and medicine. Updating the physicians and pharmacists after graduation, as part of continued medical/pharmacy education, will eventually improve the healthcare professionals’ capability to act to the patients’ welfare.