某基层医院2012年门诊药学服务情况分析

目的:通过总结2012年某基层医院门诊药学服务工作,阐述基层药师在合理用药中的价值。方法:汇总分析2012年某院门诊药师发药时向患者进行用药教育的情况和药物咨询案例。结果:2012年药师讲课培训6次,提供药物咨询86例,发药时为患者提供用药教育126人次。结论:基层药师应积极提供药学服务,并在发药的同时向患者提供药学服务,确保用药安全。     

新西兰现行的药师注册及考试介绍

目的：为完善中国执业药师注册和考试提供参：等。方法：通过对新西兰药学会（PCNZ）和新西兰药师协会（PSNZ）等网站相关内容的翻译整理,以及国内外相关文献的查阅进行综合分析,并提出完善中国执业药师注册和考试的建议。结果与结论：新西兰的执业药师注册和考试有章可循,药师作用得以体现,其实习药师模式、考试形式和内容以及能力审查这三点特别值得学习。建议中国药师应以针对性的实习为基础,加强实习药师的监督和考核,确保实习经验的获取;考试形式多样化,注重考查药师的药学服务能力,考试内容中增加临床及医学等内容;建立患者申诉机制,增加能力审查来确保药师执业过程中的服务质量,提升药师业务水平。     

医药职业教育在社区药学服务人才培养上的作用

药品的特殊性决定了用药安全问题不可忽视。通过调查和走访社区、医药公司和医院,了解当前社区居民特别是老年人家庭用药缺乏安全指导的现状,存在严重的安全隐患,尤其在老龄化的中国,需要大量经过职业培养的专业的药学服务人员(下称社区药师)对用药者进行近距离指导。     

Depressed patients’ preferences for education about medications by pharmacists in Kuwait

Objective

To assess patients’ opinion toward receiving written or specialized verbal pharmacists’ interventions and to determine the effect of these interventions on patients’ medication knowledge.

Methods

150 newly diagnosed patients with unipolar depression and initiated with a single antidepressant were randomized into 3 groups: control, leaflet and counselling, and interviewed at initiation and after 6–8 weeks of treatment at the outpatient department of the Psychiatric Hospital in Kuwait.

Results

50% of respondents asserted that clinicians did not give them sufficient information while 90% favoured the idea of receiving further information about therapy. Forty seven percent of participants failed to return for the second follow-up appointment. The drop-out rate was 66% in the control, 42% in the Leaflet and only 34% in the counselling groups (P = 0.004). A broad support for receiving leaflets and drug counselling (97%) was found among attendees. Moreover, 94% of the counselling and 79% of the leaflets group affirmed that they received adequate information compared to 47% of the control (P = 0.001). Counselling was found to be significantly associated with a much higher recall of medicine name (OR = 9.6, P = 0.01), how to manage missed doses (OR = 8.9, P = 0.007), and correct use of medication (OR = 31.3, P < 0.001). Leaflet use was less strongly associated than counselling and was statistically significant for recall regarding correct use of medication (OR = 8.4, P = 0.009).

Conclusion

Pharmacists in a psychiatric institution can play an important role in satisfying patient demands for specialized information about their medications. Patients with depression appear very eager to receive additional drug information with modest difference between the written and the verbal counselling interventions. Patients looked at the two interventions in a very positive manner and no difference was observed between patients in the leaflets and in the counselling group with regards to how helpful, sufficient, supportive and reassuring was the educational material. However, both interventions were more informative than the control in conveying elemental drug information to patients.

Practice Implications

In contrast with the lack of enthusiasm that some clinicians express, the affirmativeness that was expressed by patients towards receiving written or verbal specialized educational interventions by pharmacists may support the psychiatric hospital pharmacists’ stands in providing them for all patients which may aid in improving patients compliance and probably treatment outcome.     

The availability of pharmacists with Additional Prescribing Authorization in relation to the distribution of vulnerable populations - A cross-sectional study

BackgroundFor vulnerable patients- such as immigrants or those with low income- to benefit from pharmacists’ advanced services, such as independent prescribing, pharmacists must be accessible to these populations.ObjectivesThis research examines the geographical relationship between Alberta pharmacists with Additional Prescribing Authorization (APA) and a neighbourhood's proportion of vulnerable populations.MethodsPublicly available data were extracted from the Alberta College of Pharmacy website for active registered pharmacists' primary location of practice and APA status. Pharmacists with APA were grouped depending on the postal codes of their main self-reported place of practice. These postal codes were converted to geospatial locations and then linked to aggregated dissemination area's (ADA's) income and immigrant quintiles. The mean number of APA pharmacists per ADA was compared using analysis of variance (ANOVA) between income and immigrant quintiles. The number of APA pharmacists per ADA in the highest and lowest income and immigrant quintiles was compared using negative binomial regression model.ResultsThe records of 3,742 pharmacists with 1,054 unique postal codes of practice sites were included in the study and were linked to unique ADAs (N = 527). Almost one half of all ADAs in Alberta (47.6%, n = 251) had no APA pharmacist. Income quintiles of ADAs were associated with the mean number of APA pharmacists (p < 0.001), with high income areas estimated to have 0.44 more APA pharmacists (p = 0.01). Similarly, areas with the highest quintile of recent immigrants were estimated to have 0.66 more APA pharmacists than other ADAs (p < 0.01).ConclusionsA sizable proportion of the Alberta population still does not have access to a pharmacist with APA, and those with APA seem to concentrate in areas with higher income and higher proportions of the population who are immigrants. Future research should examine the utilization of expanded scope of practice in relation to the distribution of vulnerable populations.     

Barriers to the use of patient safety information sources by community pharmacies

BackgroundWhen patient safety information is communicated across a regulatory jurisdiction or country, the potential to enhance the safety of community pharmacy practice is significant. While there currently exists a number of sources for patient safety information (e.g., websites, safety bulletins, online tools), knowledge of the barriers that may inhibit the use of such information sources within community pharmacies is limited.ObjectiveThis research explores community pharmacy manager use of Canadian patient safety information sources and the barriers that may limit the use of such sources.MethodsA qualitative research study design using semi-structured interviews was conducted with 15 community pharmacy managers in the Halifax Regional Municipality of Nova Scotia, Canada. The study explored how pharmacists access and engage a variety of information sources, including corporate intranets, websites, and tools provided by third party data base repositories. Interview data were analyzed using thematic analysis.ResultsFive general barriers were identified: lack of time to access information sources and its contents; too many sources of available information; too much information not relevant to community pharmacy practice; complexity navigating online information sources; and lack of community pharmacy involvement in source design.ConclusionWhile pharmacies do use safety information sources to enhance practice safety, their ability to incorporate this information is inhibited by their general lack of time available to access and read safety information, lack of knowledge about where to get this information, and lack of tailored information for the community pharmacy context. Future initiatives should address increasing information awareness of available sources, consolidating and reducing information overload of such sources, and packaging information to better fit with pharmacists’ needs.     

Adopting global tools for the advancement of pharmacy practice and workforce in Saudi Arabia

BackgroundThe continuing expansion of the pharmacist’s role necessitates continuous evaluation of current practice to identify strategies for improvements. The International Pharmaceutical Federation (FIP) has developed tools to support stakeholders in identifying development needs and planning advancement strategies. The aim of this research was to utilise the FIP Global Competency Framework, version 2 (GbCF v2), and FIP Development Goals (DGs) to evaluate competencies related to pharmacy practice in Saudi Arabia, and to understand the strategies needed to develop and improve the current practice.MethodsThe study involved four phases. Phase 1 involved translation of the FIP GbCF v2 into the Arabic language. Phase 2 was a consensus panel validation to establish the initial relevance of the competencies to current practice. Phase 3 included a national survey distributed to all registered pharmacists in Saudi Arabia. The final phase was conducted through mapping ‘not relevant’ competencies to FIP DGs to identify priorities.ResultsThe translation phase yielded a bilingual framework that could be utilized by pharmacists in Saudi Arabia. The initial validation phase identified 61 behavioral statements (from 124 in the GbCF v2) as ‘highly relevant’ or ‘relevant’ to pharmacy practice. Findings from the national survey identified a list of ‘not relevant’ competencies that could highlight gaps in current practice. The final mapping phase generated a list of three FIP DG priorities: DG5 (competency development), DG8 (working with others) and DG11 (impact and outcomes).ConclusionThe study indicated that competencies in the GbCF v2 were relevant to pharmacists practicing in the country. However, some competencies were perceived as ‘not relevant’ to current practice and these highlighted gaps in the current practice that need attention. Mapping ‘not relevant’ competencies to FIP DGs should be used as a starting point towards developing strategies, systems, and protocols to advance pharmacy practice in Saudi Arabia.     

Factors influencing the implementation of clinical pharmacy services for hospitalized patients: A mixed-methods systematic review

BackgroundDespite the evidence of benefits, clinical pharmacy services (CPS) are not uniformly implemented across healthcare institutions. Understanding the influencing factors and identifying the domains in which they act is the first step to a successful implementation.ObjectiveTo identify the factors that affect the implementation of CPS for inpatients and to categorize them.MethodsCochrane Library, Embase, CINAHL, IPA, Medline/PubMed, and Lilacs databases were researched up until January 2018. The search strategy was developed using text words or MESH terms related to the following four domains: “clinical pharmacy,” “influencing factors,” “implementation,” and “hospital.” Two reviewers selected original research articles that reported the factors influencing the implementation of CPS in hospitals, extracted data, and assessed the quality of the studies. After framework synthesis and categorization of the factors, a diagrammatic approach was used to present the results.ResultsFifty-three factors were identified in the 21 studies that were included in this review. The most cited influencing factors were uniformly distributed across the following four domains: Attitudinal, POlitical, TEChnical and Administrative (APOTECA domains). However, in terms of level (pharmacist, healthcare team, patient, institution, and national organization), the “pharmacist” group had the highest concentration of factors. “Clinical skills and knowledge” was the most frequently cited implementation factor, followed by “time to implement CPS.”ConclusionOur findings showed the multifactorial nature of CPS implementation process. We suggest that factors from all four APOTECA domains need to be fully considered and strategies need to be addressed for all five groups of interest to successfully implement CPS in hospitals. Future studies on the influence of implementation stages, interrelationships of implementing factors, and strategies to overcome barriers could accelerate the successful adoption of these services.RegistrationPROSPERO register CRD42016050140.