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??OBJECTIVE To analyze the adjustment of therapeutic regimen and pharmaceutical care for a patient with AIDS accompanied by a variety of opportunistic infection, and to explore the work pattern of pharmacists in the clinical practice. METHODS According to the patient??s condition and clinical guidelines to disease, reasonable suggestions for rational drug use were put forward, and adverse drug reactions were also monitored by the pharmacists during the treatment. RESULTS With adjustment of therapeutic regimen and pharmaceutical care, clinical pharmacists optimized the treatment program and solved clinical programs. CONCLUSION Through participating clinical practice, pharmacists improve the safety and effectives.     

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??OBJECTIVE To explore the role of clinical pharmacists in safety management of long-term administration of oral targeted drugs by establishing a team for management of adverse reactions and providing pharmaceutical care. METHODS Inpatients receiving oral gefitinib (250 mg QD) were enrolled in the study between January 2014 and December 2014. Clinical pharmacists provided education and instruction to patients on how to deal with adverse effects during gefitinib treatment. After the discharge, the clinical pharmacists supplied regular follow-up for patients. Finally, a survey of patients?? awareness of targeted drugs was conducted after the pharmaceutical care. RESULTS The pharmaceutical care could attenuate the severity of adverse reactions. It also improved patient acceptance and understanding of targeted drugs and reduced the adverse reactions. CONCLUSION Provision of regular follow-up and strengthened patient education by pharmacists can pre-manage the adverse drug reactions of long-term oral targeted drugs treatment, achieve patient self-management and improve their medication compliance and quality of life.     

冠心病住院患者健康教育需求的调查与分析

目的了解冠心病住院患者健康教育需求的现状,以便采取个体化健康教育,提高患者的生活质量,也为医院针对性地进行健康教育提供依据。方法对136例冠心病住院患者进行健康教育需求的问卷调查。结果冠心病住院患者对健康教育有普遍需求,了解治疗方案与效果占强烈需求首位。住院次数不同的患者对健康教育需求侧重点不同。冠心病住院患者对健康教育形式的需求中首位是医护口头宣教。结论冠心病住院患者的健康知识缺乏,希望得到检查治疗、康复指导等健康教育,护士应有针对性、有计划性地对冠心病住院患者实施阶段性、个性化的健康教育,才能满足患者的健康需求,全面提高生活质量。     

心内科临床药师参与冠心病慢病管理的实践和体会

目的通过系统研究,探讨心内科临床药师在冠心病合理与规范用药中的作用。方法通过对比研究的方法,比较接受临床药师用药教育组与未接受临床药师用药教育组在合理用药各项对比指标中的差异,对冠心病认知情况、对药物适应症了解情况、对用法用量掌握情况、对注意事项了解程度、用药依从性、生活方式改变程度、ADR发生后的应对程度进行统计学分析,以考察是否有显著性差异。结果以上各组对比数据接受心病科临床药师教育组明显优于未接受心病科临床药师用药教育组,2组差异具有统计学意义(P<0.05)。结论说明临床药师在慢病管理工作中意义显著。     

我国医疗机构药师参与慢病管理的现状调查分析

目的 通过调查医疗机构药师参与慢病管理的现状,客观分析影响因素,为建立合理的慢病管理队伍和药师未来发展方向提供指导。方法 针对全国范围内各级医疗机构药师,设计调查问卷,问卷主体分为3部分内容,分别为基本信息、慢病管理药学服务的开展情况,以及影响药师参与慢病管理的因素。结果 共发放400份调查问卷,回收391份,问卷回收率97.8%。参与调查的医院药师来自全国28个省份,男性113名、女性278名,年龄以31～45岁为主(51.7%,n=202);其中234名来自三级医院(占59.6%),以大学本科(49.4%,n=199)和硕士研究生(34.0%,n=133)为主。参与调查的药师中有204人(52.2%)曾经或正在参与慢病管理。286名药师(73.1%)所在医疗机构设有慢病管理专区。药师参与慢病管理以全职(16.6%,n=65)和兼职(49.6%,n=194)为主。药师参与慢病管理的方式多样,面对面(上门随访)(n=307, 78.5%),电话随访(n=247, 63.2%),短信或微信随访(n=186, 47.6%)。现阶段药师可以完全做到处方审核与调剂(51.2%,n=200)、不良反应监测与指导(37.1%,n=145)、用药咨询与指导(31.2%,n=122),用药依从性教育(23.0%,n=90)。目前影响药师参与慢病管的影响因素包括缺乏提供慢病管理药学服务的资源(77.5%,n=303),患者对药师缺乏信任(67.3%,n=263),缺乏规范化的慢病管理药学服务规范(61.9%,n=242),药师服务费用问题(56.0%,n=219)。结论 药师团队目前已逐步开展或加入慢病管理的队伍,参与此项工作的态度积极,参与的广度有待进一步提高。客观的政策条件也限制了药师的发挥空间(例如:药师收费问题)。政府和医院需要对药师队伍加强专业培训,完善政策支持,让药师未来更好的参与慢病管理。     

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??OBJECTIVE To explore standardized pharmaceutical care service mode from establishment of process for pregnancy combined with hypothyroidism or hyperthyroidism. METHODS According to evidence-based medicine, relevant regulations and clinical practice, the pharmaceutical care process was established and tried out based on the clinical pharmacists?? daily work. We used METHODS of pharmaceutical care classification and standard record forms to carry out the systematic, real-time and continuous medical supervision work for patients. RESULTS Pharmaceutical care was performed on forty-two patients with hypothyroidism or hyperthyroidism in accordance with this procedure. Clinical pharmacists participated in the optimization of drug treatment regimens, intervened with irrational use of drugs, and advised on drug adverse reactions. CONCLUSION The practice of pharmaceutical care process is beneficial for clinical pharmacists to carry out pharmaceutical service in depth and ensure the safety of drug use. Standardization can promote this procedure in the industry field, as well as promote the improvement and homogenization of professional skill level and pharmacy service ability of clinical pharmacists in gynecology and obstetrics.     

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??OBJECTIVE To discuss the drug therapy in a patient with in-stent restenosis, and explore the work forms of pharmacists in the department of cardiology. METHODS Two causes for in-stent restenosis were summarized by pharmacists, which the patient was noncompliance or poor quality of drugs. Then pharmacists gave feasible suggestions to improve drug therapy by searching literatures and consulting patients. RESULTS After regular administration of aspirin in our hospital, the symptoms improved and laboratory test showed poor. The outcome of follow-up in 5^th month is normal. CONCLUSION Pharmacists identify adverse events and help physicians to make individual drug therapy to ensure patient safety, effectiveness and economy.     

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??OBJECTIVE To evaluate the efficacy of medication reconciliation (MR) service provided by clinical pharmacist for chronic kidney disease(CKD).METHODS Patients with CKD administered in department of nephrology between Dec, 2017 and Mar. Total of 2018 who met the inclusion criteria were given MR service, and the newest Pharmaceutical Care Network Europe (PCNE) V8.02 classification scheme was constructed for drug related problems (DRP) to analysis and summary.RESULTS MR was conducted 48 times (accounted for 80%) on 60 patients during the study period. Total of 59 medication DRP were identified. The most common DRP was treatment effectiveness (accounted for 84.75%), there were 54 causes (accounted for 76.06%) were prescribing in 71 causes, all the causes were classified as likely to cause level 1 harm (accounted for 84.75%), clinical pharmacists made 145 interventions, 102 (70.34%) of these were completely accepted and implement.CONCLUSION DRPs are common in CKD patients, clinical pharmacists should provide MR for CKD patients, and conducted as routine work.     

基于核心能力模型的妇产科临床药师培训大纲的构建

目的 构建适合妇产科需求的临床药师岗位培训大纲。方法 基于文献检索和医院药师核心能力模型,构建函询表;采用德尔菲法对16名专家进行函询,确定妇产科临床药师岗位核心能力要素和培训内容体系,并对指标的重要性进行赋值,建立妇产科临床药师培训大纲。结果 两轮函询的专家积极系数均别为93.75%,专家权威系数为0.77。经过2轮函询,确定包含6个一级指标和17个二级指标的核心岗位要素,以及34项培训内容的指标体系。结论 本研究采用的方法科学,专家积极性高,内容合理,对于为妇产科临床药师的岗位培训和人员考核提供了科学依据。     

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??OBJECTIVE To understand the prevalence of chronic diseases and the demands of pharmaceutical care in the ederly, and to explore the content and mode of pharmaceutical care for elderly people.METHODS A questionnaire survey was conducted in 1 262 people over 60 years old, and the data were processed by SPSS.RESULTS Respondents?? prevalence rate of chronic diseases was as high as 95.2%, the top three chronic diseases was hypertension,bone hyperplasia/osteoporosis and coronary heart disease.The respondents?? cognition and evaluation of pharmacists and pharmaceutical care needed to be improved, their pharmaceutical care needs mainly concentrated in the popularization education of medication particularity,the detailed explanation of drug instructions and the coping measures to common adverse drug reactions; lectures,face-to-face communication,pamphlets were more acceptable for the elderly to carry out pharmaceutical care.CONCLUSION The health status of the elderly is not optimistic, and they generally have an urgent need for pharmaceutical care. Pharmacists should improve their ability, to carry out various pharmaceutical care to meet the needs of the elderly.