药店实施哮喘患者药学服务干预的效果评价——Meta分析

目的评价药店实施哮喘患者药学服务干预的效果。方法检索中国期刊网、AcademicSearchPremier(ASP)、Blackwell、Elsevier、JohnWiley等数据库1999年～2006年3月国内、外发表的相关文献,选择以用药咨询、健康教育等为干预措施的随机对照试验,由2位评价者对文献进行筛查。采用ReviewManager4·2软件对符合条件的文献进行Meta分析。结果共有4项试验纳入本研究,哮喘患者样本1298例,异质性分析结果X2=1·28(P=0·73),采用固定效应模型进行统计学分析。与对照组比较,药学服务干预组最大呼气流速改善更明显,合并后的SMD值为0·19,95%的置信区间为0·08～0·30(P=0·0006)。结论开展以用药咨询、健康教育等为主要内容的药学服务可改善哮喘患者的症状,提示在药店开展哮喘药学服务干预项目是一种有效的疾病管理模式。     

Do pharmacists’ reports of adverse drug reactions reflect patients’ concerns?

Aim: The aim of the present study was to investigate whether the concerns patients express to a Drug Information Line about possible adverse drug reactions (ADRs) they have experienced, are sufficiently reflected by the ADR reports submitted by pharmacists to the Netherlands Pharmacovigilance Centre Lareb with regard to the type of ADRs and the drug groups involved.Methods: ADR-related questions patients addressed to the Dutch Drugs Information Line were compared with the ADR reports pharmacists sent in to Lareb in the same period. The similarities and differences between the characteristics of the suspected ADRs and the kinds of drugs mentioned were investigated, as well as the severity of the reported ADRs. To compare the two data sets and to establish whether significant differences were present, a logistic regression analysis was conducted on the reported drugs and ADRs.Results: Analysis of the content of the phone calls yielded 1168 (14.6%) calls concerning possible experienced ADRs. The suspected ADRs pharmacists reported to the Netherlands Pharmacovigilance Centre Lareb in the same period included 1734 reports. There were only slight differences between the queries patients put to the Drug Information Line regarding possible adverse drug reactions and the reports on suspected ADRs pharmacists submitted to the pharmacovigilance centre. With respect to possible ADRs in the psychiatric spectrum and ADRs associated with the use of antidepressants, there seems to be a deficiency in the reporting by pharmacists.Conclusion: The ADRs pharmacists report to the national pharmacovigilance centre reflect patients concerns about ADRs they experience in relation to the medication they are taking.     

基于处方管理办法强化我疗区药事管理

目的:规范处方管理,促进合理用药。方法:贯彻落实《处方管理办法》,充分发挥我疗养区药事管理委员会作用,强化药事管理,建立长效监督机制。结果与结论:通过建立三级监督管理制度等一系列新举措,我疗养区药事管理成效显著,但仍存在一些不足之处有待进一步完善     

浅谈疗养院的药学服务模式

目的 由当前医疗体制改革引发疗养院药剂科的管理尤其是疗养院开展药学服务的模式必须转变.方法 对疗养院开展药学服务的意义、优势、特色及目标进行了具体分析.结果 疗养院药学服务模式的转变是形势所迫,疗养院的药学服务应当有自己的特色.结论 疗养院的药学服务要贴近疗养员,疗养院的药师要融入疗养、康复、治疗的大环境.     

临床药师的工作经验及体会

临床药学在医院药学工作中是极其重要的，我国医院药师的任务正逐渐发生根本性的变化。医院药学部门要建立“以病人为中心”的药学管理摸式，开展以合理用药为核心的临床药学服务。临床药师除了要做好用药咨询工作外，还要坚持深入临床、参与用药全过程，真正实现促进和指导临床合理用药，以及做好临床药学服务相关的科研工作。总结临床药师的工作经验及体会，坚持下临床是进行临床药学服务的重点，临床药师的工作应得到其他医疗人员的理解和帮助以及国家相关法律法规的支持。     

Interdisciplinary Care Team with Pharmacist in a Community-based HIV Clinic

Background

Human immunodeficiency virus (HIV) infection presents a significant burden, especially in the Washington, DC area. Literature is limited in describing the role of pharmacists in the outpatient clinic setting to provide patient-centered pharmaceutical care for patients with HIV.

Gender Differences in Trajectories of Lower Extremity Function in Older Adults: Findings From the International Mobility in Aging Study

ObjectivesWe examined the lower extremity function trajectories of older men and women over 4 years and baseline predictors of these trajectories.DesignLongitudinal analysis of an international cohort study.Settings and participantsOlder adults from the International Mobility in Aging Study (IMIAS) aged between 65 and 74 years at baseline.MeasuresPhysical performance of the lower extremities was measured in 2012, with follow-ups in 2014 and in 2016, using the Short Physical Performance Battery (SPPB). Group-based trajectory analysis of physical performance by gender was performed. Multinomial logistic regression was used to derive relative risk ratios with 95% confidence intervals between the physical performance trajectories and the potential baseline predictors in men and women separately.ResultsThree physical performance trajectories were identified in men and women: high-stable (30.0% vs 35.5%), gradual functional decline (63.1% vs 54.3%), and rapid functional decline (6.9% vs 10.2%). Common baseline characteristics associated with memberships in the gradual functional decline and rapid functional decline trajectory groups in men and women were age, single marital status, and multiple chronic conditions (>3). Among men, depression was a strong predictor of the membership in the rapid functional decline trajectory group. Women in the rapid functional decline trajectory group were more likely to be obese, with feminine and undifferentiated gender roles, and have poor self-rated health at baseline.Conclusions/ImplicationsThere are gender differences in the physical performance trajectories and related factors among older adults. Programs aiming at preventing or slowing functional decline in old age should be sensitive to gender.