引导药学专业本科生尽早树立执业药师意识

根据一项针对专业本科生的调研,就帮助药学本科生尽早树立执业药师意识进行了探讨,提出了通过更新药学教育观念、调整课程体系、改进教学方法和使用执业药师考试题型等措施,强化学生药学专业综合技能的培养,从而为提供高质量的药学服务奠定基础。     

临床药师在癌痛控制中的作用

癌痛治疗已经成为肿瘤内科治疗过程中较为棘手的问题,疼痛控制不佳往往会严重影响患者的生活质量。我院临床药师在癌痛控制工作中进行患者教育和疼痛评估,建立疼痛日记,为医生建议阿片类药物给药剂量,对不良反应进行监测并提出应对方案,将专业服务嵌入到临床医疗实践中,发挥了自己在癌痛控制中的作用。     

临床药师深入临床开展药学服务促进合理用药的探讨

目的探讨临床药师进入临床开展药学服务的必要性。方法临床药师通过参与临床用药实践,使药师能够应用自身的专业知识,服务于医生、护士、患者及家属。结果开展药学服务,参与临床药物治疗,提高患者的依从性,尽最大限度地发挥药物的疗效,真正地体现＂以患者为中心＂的药学服务理念。结论临床药师应在临床工作中不断地总结和探索,努力提高临床药师工作的社会价值,促进临床合理用药和医院药学的发展。     

临床药师对1例肾移植患者的药学服务

通过对我院泌尿外科1例肾移植患者的药学服务,介绍临床药师在药物相互作用、用法用量、不良反应等方面参与保障患者用药安全的工作。     

执业药师对基本药物可及性影响的探讨

基本药物供应链长,需经历遴选、生产、采购、使用等环节,才为患者所用。因此,自基本药物制度实施以来,可及性问题一直备受关注,而执业药师正是贯穿于此些环节中的重要人物。本文从执业药师的职能出发,探讨其在基本药物供应链的各个环节中所发挥的作用,对基本药物的可及性是否存在影响及如何影响,揭示了在保障基本药物可及性的过程中执业药师的重要作用。并根据现实与理想的差距,提出对执业药师价值体现的展望。     

临床药师对1例帕金森病合并巨幼红细胞性贫血患者的药学监护

专科临床药师结合临床治疗原则,分析、调整药物治疗方案,为1例帕金森病合并巨幼红细胞性贫血患者制定个体化用药计划并实施全程药学监护,优化药物治疗方案,有效开展药学监护,从而提高了药物治疗的安全性和有效性。     

落实药师人才发展规划加快药师人才队伍建设的思考

药师是我国新医改和医药卫生事业发展的急需紧缺专门人才,国家规划到2020年药师人才队伍达到85万。为落实该目标,本文结合药师队伍现状,探讨药师人才队伍发展策略,分析实现人才发展目标所需的配套政策与措施,为实现《国家中长期人才发展规划纲要》中药师队伍建设部分提供参考依据。     

Factors affecting community pharmacist work: A scoping review and thematic synthesis using role theory

Many community pharmacists ideologically support recent changes to their roles in primary healthcare. However, their antithetical resistance towards practice change could have systemic causes (i.e. role stresses), which may account for increased job dissatisfaction, burnout, and job turnover in the profession. Deeper comprehension was sought using a role theory framework.ObjectiveTo identify factors leading to role stresses and strain responses for community pharmacists, and to create a framework for community pharmacist role management.MethodPubMed, Scopus and Web of Science databases were searched for qualitative studies identifying community pharmacist role stress and strain using scoping review methodology from 1990 to 2019. Content and thematic analysis using the framework method was performed, and themes were reported using thematic synthesis.ResultsScreening of 10,880 records resulted in 33 studies identified, with 41 factors categorised into four domains: Interpersonal Interactions, Social Setting, Individual Attributes, and Extra-Role. All role stresses were present. Reported role strains suggest role system imbalance.ConclusionCommunity pharmacists are in a multifactorial transitional environment. Reported role stresses may be a function of past pharmacist roles and increased role expectations, amplified by many requisite interactions and individual pharmacist characteristics. Social science theories were found to be applicable to the community pharmacy setting.     

Protocol for a pilot and feasibility study of nurse practitioner-pharmacist telehealth collaboration to simplify complex medication regimens

IntroductionNew and flexible multidisciplinary workforce models are needed to address unnecessary medication regimen complexity in residential aged care facilities (RACFs). This study will investigate the feasibility of a nurse practitioner-pharmacist telehealth-based collaborative care model to simplify complex medication regimens.MethodsThis is a pragmatic, non-randomized pilot and feasibility study of up to 30 permanent residents from 4 RACFs in Western Australia. Simplification will be conducted in accordance with a validated 5-step implicit process. Nurse practitioners will identify residents potentially interested in and who may benefit from simplification, including any regulatory or safety imperatives that might preclude simplification. Medication regimens will be assessed by an off-site clinical pharmacist to identify opportunities for simplification in terms of drug–drug, drug–food, or drug–time interactions, and the availability of alternative formulations. The pharmacist will communicate simplification opportunities to nurse practitioners via video case conferencing. Nurse practitioners will then discuss simplification opportunities with the resident, caregiver and the health and care team, including any unintended consequences for the resident or RACF. The primary outcome measure will be feasibility (stakeholder acceptability, protocol adherence, recruitment and retention rates). Secondary outcomes include change in the number of medication administration times per day, medication and behavioral incidents, falls and fractures, hospitalization and mortality at 4 months.Ethics and disseminationEthical approval has been obtained from the Monash University Human Research Ethics Committee. Research findings will be disseminated through industry report, lay summaries, conference presentations and peer-reviewed publications.     

Economic impact of pharmaceutical services on polymedicated patients: A systematic review

BackgroundPolypharmacy is commonly related to poor drug adherence, decreased quality of life and inappropriate prescribing in eldery. Furthermore, this condition also leads to a higher utilization of health services resources, due to the increased risk of adverse drug events, length of stays in hospitals and readmissions rates after discharge.ObjectiveThis Systematic Review aimed to synthesize the current evidence that evaluates pharmaceutical services on polymedicated patients, from an economic perspective.MethodsSystematic searches were conducted in MEDLINE, SCOPUS and Cochrane Library databases to identify studies that were published until January 2021. Experimental and observational studies were included in this review, using strict inclusion/exclusion criteria and were assessed for quality using the following tools: RoB and ROBINS-I. Two independent reviewers selected the articles and extracted the data.Results3,662 articles were retrieved from the databases. After the screening, 18 studies were included: 9 experimental and 9 observational studies. The studies reported that the integration of the pharmacist as a member of the healthcare team provides an optimized use of pharmacotherapy to polymedicated patients and contributes to health promotion, providing reduction of spending on medication, reduction of expenses related to emergency care and hospitalizations and other medical expenses. The ECRs made cost-effectiveness or cost-benefit analysis, and most of the Non Randomized studies had statistically significant cost savings even considering the expenses of pharmaceutical assistance. Experimental studies reported a cost reduction varying between US$ 193 to US$ 4,966 per patient per year. Furthermore, observational studies estimated a cost reduction of varying from US$ 3 to US$ 2,505 per patient per year. The cost savings are related to decrease in emergency visits and hospitalizations, through pharmacist intervention (medication review and pharmacotherapy follow-up).ConclusionsConsidering the set of studies included, pharmaceutical care services directed to polymedicated patients may cooperate to save financial resources. Most of the interventions showed positive economic trends and also contributed to improving clinical parameters and quality of life. However, due to the majority of the studies having exploratory or qualitative methodology, it is essential to carry out more robust studies, based on full economic evaluation.