中医临床诊疗指南制修订现状调研、分析与工作建议

背景 2014年底,国家中医药管理局政策法规与监督司开展中医临床诊疗指南制修订工作,对中医13个专科领域的240项中医临床诊疗指南项目进行制修订,中华中医药学会承担本部分工作。目的 为了解中医领域临床诊疗指南制修订现状,从方法学角度对项目组工作中存在的问题进行分析并给出建议,本项目组对中华中医药学会中医临床诊疗指南制修订项目组进行调研。方法 2020年6—12月,以中华中医药学会中医临床诊疗指南制修订项目组为调研对象,每个项目组人员填写一份问卷,汇集项目组整体意见。采用问卷星电子问卷,通过中华中医药学会工作文件的方式下发通知至各项目组进行调查,网络端收取调查结果。围绕调研主题,问卷内容包括5大方面：对中医临床诊疗指南的认识、指南制修订程序和方法学应用、指南制修订工作重点问题和关键环节、指南实施推广和应用情况、指南制修订工作情况整体调研。问卷为半结构化设计,共30个结构化问题、4个开放性问题。调研完成后对结果进行数据汇总与描述性分析。结果 本调研最终收回有效问卷198份,调研结果提示,在对中医临床诊疗指南的认识上,大多数项目组（94.45%,187/198）认为本领域内依然需要更多的中医...     

教育心理学和教学效益相关性的研究

本研究在罗马尼亚Oradea大学医药学院进行，始于1998年，结束于2003年。研究的出发点为该学院的学生们提出不少的教师，包括一些国内外知名的学者和医生，因缺乏教育心理学知识，不能很好地理解学生，组织教学和传授知识。因此，本研究设置了问卷调查，学院向教员开设了教育心理学课程(1998年10月～1999年7月)，与学生和教师座谈，统计并比较学生的考试成绩，特别地跟踪研究全国年度(1999年～2003年)医学证书汇考结果。研究结果客观地证实了教育心理学能够提高学习(工作)效益和成果，因为教育心理学知识使得教师(和医师)更好地与学生(或病人)沟通、理解和组织、合作。     

Relational continuity of care in community pharmacy: A systematic review

Relational continuity of care (COC) is becoming an important concept related to improving healthcare quality, reducing medical costs and increasing patient satisfaction with primary care. While community pharmacy (CP) has a considerable role in primary care, there are few reports dedicated to the role of relational COC in CP. This study reviewed the existing evidence of relational COC in CP and its effect on patients. PubMed, Embase, CINAHL, Cochrane Library CENTRAL and Google Scholar were used to search for relevant studies from the date of database inception through to January 2021, which were appraised according to eligibility criteria. There were no limitations on the primary outcome or language. Case reports and studies without control groups were excluded. The Newcastle–Ottawa quality assessment scale was used to assess the quality of the studies. Database searches identified 13 records. Relational COC measures in the included studies were grouped in three kinds; pharmacy-visiting pattern, Continuity of Care Index and loyalty. The assessed outcomes were medication adherence behaviour (e.g., the proportion of days covered, medication possession ratio), adverse drug reactions, potentially inappropriate drug prescribing and clinical outcomes. The odds of patients adhering to their medication regimen were about 1.1~2.5 times higher among those who consistently visited a single pharmacy compared to patients visiting multiple pharmacies. Additionally, the care provision with a high level of relational continuity could lower inappropriate drug use by 21~32 per cent and the use of other costly services by 12~29 per cent. This study suggests that a high degree of relational COC in CP could improve safe use of medications among patients. Future research is needed to employ more rigorous methods to reduce heterogeneity and to measure effects on clinical outcomes.     

静脉用药调配中心干预不合理医嘱的效益分析

目的对静脉用药调配中心(pharmacy intravenous admixture services,PIVAS)干预临床不合理用药产生的经济效益、社会效益、人力资源效益进行分析,促进临床合理、安全、经济用药。方法采用回顾性分析方法,调取2018年10月1-31日山东大学齐鲁医院PIVAS接收的全部静脉用药医嘱及对不合理用药医嘱的干预结果,分析PIVAS干预不合理用药医嘱产生的药品资源、人力资源节约情况。结果2018年10月1-31日PIVAS药师共审核用药医嘱412782组,其中不合理医嘱1967组,占0.417%,包括不规范、不适宜及超常医嘱等类型。通过PIVAS药师干预不合理用药医嘱,及时纠正医师用药医嘱错误,节约了药品资源及护理工时。结论PIVAS进行用药医嘱审核对于保障患者临床合理用药具有积极意义,有利于节约医疗资源。     

Examining community pharmacists’ intention to provide pharmacist-driven vaccination services: A structural equation modelling

BackgroundThe evidence of pharmacists' current involvement in vaccination services in low- and middle-income countries (LMICs) is uncertain. This study would be a first step to develop vaccination services by investigating community pharmacists’ intention to be involved in PDV services not just during COVID-19 pandemic but also during standard service provision in Turkey which can be taken as an example across LMICs.ObjectiveConsidering the efforts to empower community pharmacists in service provision, the goal of the present study was to develop a structural equation model to explain the “Pharmacist-Driven Vaccination Service Intention Model (PDV-SIM)” by using the theory of planned behavior (TPB).MethodsBased on the constructs of TPB, a measurement tool was developed. Sub-factors of PDV service intention was determined by conducting exploratory factor analysis (EFA). In the second step, confirmatory factor analysis (CFA) was conducted to prove the theoretical structure of the tool. Finally, a model explaining the relationship between observed variables, latent constructs from TPB was developed by SEM analysis.ResultsIn the proposed PDV-SIM, patient related attitude toward PDV services, attitude toward negative consequences of PDV services, and subjective norm about PDV services had an impact on the behavioral intention of community pharmacists. Nevertheless, professional development attitude toward PDV services and perceived behavioral control were not evaluated as determinants of the behavioral intention.ConclusionResults of this study revealed that TPB is appropriate for modelling PDV service intention of community pharmacists. This model can be utilized as a guide to potential pharmacy regulatory bodies and policy makers in their efforts to enable community pharmacists as vaccinators across LMICs.     

基层医院如何开展临床药学工作

临床药学是现代药学的重要组成部分,临床药学工作在各级医院开展极不平衡,特别是基层医院开展较差。本文论述了在基层医院应从人才的选择入手开展临床药学工作。     

药事管理学科科研问题及对策浅析

分析当前我国药事管理学科科研中存在的问题和原因。提出发展科研的思路与方法。     

建设我国药学职业道德规范的思考

探讨建设我国药学职业道德规范的思路；阐释和分析建设药学职业道德规范应明确的基本概念及药学职业道德规范的基本内容；建设我国药学职业道德规范，需明确药学职业的责，权，利所在，明确药学职业法律规范与道德规范的关系，明确药学职业道德规范的制定和监督部门。加强药学职业道德教育和继续教育。     

面向消费者开展优良药学咨询服务

目的 :为药店开展优良用药咨询服务提出建议。方法 :对消费者进行问卷调查 ,对调查结果进行统计学处理。结果 :大多数消费者需要和认可用药咨询服务 ,并希望通过用药咨询获得医药知识。结论 :药店应积极推行《优良药房工作规范》 ,重视医药健康知识的宣传     

微细药物表面包覆技术在制剂中的应用

新型药物开发制备过程中，需要对药物颗粒进行粒子设计，通过多层微胶囊化而得到复合包覆药物颗粒。药物包覆、微胶囊制备方法很多，可分为化学法、物理化学法、物理法。本文着重介绍了制备复合多层包覆药物颗粒的几种物理机械方法：复合杂化系统，高速椭圆转子混合法、喷流床包覆法。简要分析了该技术用于中药现代化加工的可能性。