Antimicrobial stewardship

The overuse and misuse of antimicrobial agents has detrimental effects on patients, the health care system, and society. Inappropriate antimicrobial use contributes to the rising cost of health care, the emergence of multidrug resistant organisms, and adverse drug reactions. Antimicrobial stewardship programs provide standard, evidence-based approaches to encourage judicious use of antimicrobial agents. This review summarizes the goals of antimicrobial stewardship programs, the members needed to initiate and sustain them, antimicrobial stewardship strategies, barriers to?the implementation and maintenance of the programs, approaches to measure their effects, and the basic steps needed to initiate them.     

美国退伍军人药物目录遴选制度

本文对美国退伍军人目录制度兴起,药物目录遴选制度的发展以及药物目录遴选制度本身进行了阐述,在我国建设基层医疗卫生服务组织实现基本公共服务均等化的宏观背景下,对我国基本药物目录建设,特别是目录遴选制度建设,提供有益的建设思路。     

《千金要方》异文对校与研究

《千金要方》一书的古传本《孙真人千金方》与宋校本《备急千金要方》差异校大,通过两种不同版本的对校研究,能够探寻出《千金要方》真实的面貌,为《千金要方》的系统研究创造条件。同时也证明宋人在校订《千金要方》时对其医学资料确有过大幅度的改动,特别是增补了大量的医学内容,使今通行本《备急千金要方》与孙思邈原作已有显著不同。而《孙真人千金方》则保留了孙思貌著作的原貌,对《千金要方》的深入研究具有重要的学术意义。     

The effect of three-tier formulary adoption on medication continuation and spending among elderly retirees

OBJECTIVE: To assess the effect of three-tier formulary adoption on medication continuation and spending among elderly members of retiree health plans. DATA SOURCES: Pharmacy claims and enrollment data on elderly members of four retiree plans that adopted a three-tier formulary over the period July 1999 through December 2002 and two comparison plans that maintained a two-tier formulary during this period. STUDY DESIGN: We used a quasi-experimental design to compare the experience of enrollees in intervention and comparison plans. We used propensity score methods to match intervention and comparison users of each drug class and plan. We estimated repeated measures regression models for each class/plan combination for medication continuation and monthly plan, enrollee, and total spending. We estimated logit models of the probability of nonpersistent use, medication discontinuation, and medication changes. DATA COLLECTION/EXTRACTION METHODS: We used pharmacy claims to create person-level drug utilization and spending files for the year before and year after three-tier adoption. PRINCIPAL FINDINGS: Three-tier formulary adoption resulted in shifting of costs from plan to enrollee, with relatively small effects on medication continuation. Although implementation had little effect on continuation on average, a small minority of patients were more likely to have gaps in use and discontinue use relative to comparison patients. CONCLUSIONS: Moderate cost sharing increases from three-tier formulary adoption had little effect on medication continuation among elderly enrolled in retiree health plans with relatively generous drug coverage.     

基于数据挖掘的《普济方》治疗反酸用药规律研究

目的：利用数据挖掘方法对《普济方》中治疗反酸处方进行统计分析,从而为临床治疗反酸用药提供参考。方法：筛选《普济方》中用于治疗反酸的方剂,利用古今医案云平台V2.2.2、SPSS Statistics 26.0及SPSS Modeler 18.0软件对方药进行频次统计、关联分析、聚类分析,挖掘高频应用的中药、常用药对及药物组合。结果：纳入符合要求的方剂202首,共使用190种中药,其中频次≥20次的中药25味,排名前3位的是陈皮、生姜、肉桂;药性以温性、平性居多,药味以辛味、苦味为主,归经主要入脾经、胃经;关联规则分析得到18组药对;聚类分析得到4类药物组合。结论：《普济方》治疗反酸以恢复中焦气机升降为核心目标,重视对中焦的调补,采用益气健脾、燥湿化痰、疏肝行气、和胃降浊、温阳散寒等治法,多法并用,多脏同调,为临床治疗反酸提供参考。     

WHO儿童基本药物示范目录与我国基本药物目录中儿童用药的比较研究

目的:为我国制定儿童基本药物目录提供参考。方法:采用描述性的方法,对比我国《基本药物目录·基层医疗机构配备使用部分》(2009版)(以下简称"我国目录")中儿童用药与世界卫生组织(WHO)2010版《儿童基本药物示范目录》(以下简称"EMLc")中的药物,并比较2009版我国《基本药物处方集(化学药品和生物制品)》(以下简称"我国处方集")与WHO儿童示范处方集中药品的剂型、数量和项目,找出其中异同。结果:我国处方集在儿童用药的用法用量上未根据儿童年龄的不同进行分类指导,且我国目录中儿童用药虽然覆盖疾病范围较广,但仍缺乏适合儿童的剂型。结论:我国处方集和目录尚不能满足我国儿童的使用需要,建议建立适应我国国情的儿童基本药物目录及其配套处方集。     

The role of pharmacoeconomics in formulary decision making in different hospitals in Riyadh,Saudi Arabia

Objective

To assess the trend of using pharmacoeconomic information by Pharmacy and Therapeutics (P&T) committees when making formulary decisions.

Design

A cross-sectional study conducted in 2007, using structured survey questionnaires which were distributed to members of the P&T committees in 11 different hospitals in Riyadh, Saudi Arabia.

Results

A total of 100 survey questionnaires were sent to head of pharmacy departments of 11 different hospitals in Riyadh, Saudi Arabia. Out of these, 48 questionnaires were completed and returned. Of the total respondents participated in the study, 64.58% were medical doctors and 16.66% were pharmacists and 75% of the respondents said they have applied pharmacoeconomic evaluations in their decision making process. More than 80% of the respondents perceived that they had a fair knowledge of pharmacoeconomics. Approximately 80% of respondents expressed some degree of agreement that pharmacoeconomics should be applied as a decision making tool. The majority of decision-makers (95%) expressed the interest in attending workshops on pharmacoeconomics.

Conclusion

The study showed that pharmacoeconomics can play an important role in the P&T committee formulary decisions. However, more education to health care professionals and to hospital administrators should be conducted to facilitate the use of such a tool. Also, hospitals should recruit health care professionals with pharmacoeconomic expertise to manage limited health resources in the best way available.     

手机处方集药品供应动态查询系统的研发

目的：确保医、药、护工作人员随时随地掌握医院药品信息,提高医疗质量和药学服务水平。方法：结合医院药品处方集,充分利用医院局域网平台,采用嵌入式应用软件技术研发手机处方集药品供应动态查询系统。结果：该系统涉及药品涵盖院内所有品种,数据获取可定时更新,药物信息查询便捷,系统安全性考虑全面。结论：该系统开拓了高效快捷查询药品信息、掌握药品供应动态变化的新方式。     

《WHO示范处方集》对医疗机构处方集编写的启示

目的：介绍WHO示范处方集的历史、内容．阐述WHO示范处方集对医疗机构编写处方集的启示。方法：互联网及数据库文献检索．综合分析并评论。结果和结论：处方集包括前记部分、药物和药品信息部分、附录和索引;编写处方集包括几个步骤：选择编入处方集的药物,组织前记部分：编写正文：编写附录;完成草稿,回顾和完成内容修改。