全球社区药房报告简介及对我国的启示

目的 促进我国零售药店的发展，服务公众健康。方法 基于国际药学联合会（FIP）调研，介绍全球社区药房概况，包括人员分布、所有权、设立与分布标准、社区药师执业范围、薪酬模式、监管模式等，与我国零售药店的现状进行对比与分析。结果 截至2020年，全球每万人口所有执业领域执业药师数均值为8.54人，每万人口社区药房执业药师数均值为5.14人，每家社区药房配备执业药师人数均值为1.88人，而我国分别为4.21人、3.83人、0.98人，差值分别为4.33人、1.31人、0.90人。我国每万人口社区药房的平均密度为3.92家，较全球均值2.75家高1.17家；每家零售药店服务人口数为2 549人，较全球均值8 940人少6 391人。全球29.11%的国家和地区社区药房管理和决策权由执业药师主导，46.84%的国家和地区使用地理或人口标准来设定药房。全球药房执业药师执业范围涉及治疗开始、继续或修改临床决策的服务，在药房外提供药品和药学服务，疾病筛查及提供急救/即时护理。15.28%的国家和地区表示，社区药房薪酬模式主要基于专业服务获得的费用，91.89%的国家和地区允许执业药师选用和调配仿制药。...     

完善法律确保药品安全

根据当前和今后一段时期我国药品安全的形势，党的十七大提出要确保药品安全，提高全民健康水平。作为面向药店、医疗机构药房等药品零售、使用终端广大执业药师和药学技术人员的杂志，我们最为关心的就是法律怎样才能真正保证患者在社会零售药店和医疗机构药房购买药品时能得到执业药师为其提供的优质药学服务，     

目前我国药房药学服务的现状与发展研究

目的研究和分析目前我国药房开展药学服务的现状和主要影响因素,为促进药房药学的服务提升提供有益的参考。方法联系国内外的实际情况,开展相关资料的分析研究。结果目前我国社会药房的药学人才不足、执业药师的作用难以发挥,社会公众对于药学服务的认知度还偏低,这些因素都是影响药房药学服务发展的关键要素。结论伴随着我国医疗体制改革的不断深刻,患者对于药学的期望值不断的提升,在临床上提供优质的药学服务可以提升药房的核心竞争力,同时促进患者的合理用药也是社会药房应当承担的重要社会责任。     

药师随访,DTP药房的软实力

DTP(Direct to Patient)药房是直接面向患者提供更有价值的专业服务的药房.对于DTP药房的药师来说,除了药品的准时配送,后续的随访跟踪、用药咨询与指导等也是很大的挑战.药学服务工作的重要性也真正凸显出来.目前我工作的合肥苏祥大药房供应药品主要以小分子肿瘤靶向药、免疫检查点抑制剂及抗病毒药物为主,所服务...     

我国社会药房执业药师药学服务能力研究

目的:探索我国社会药房执业药师药学服务能力提升的可靠途径及有效措施.方法:运用问卷调查法,对执业药师药学服务能力现状、能力提升的态度、面临的主要困难、以及未来预期获得的帮助四个层面进行调查;采用知情人访谈法,了解提升我国社会药房药学服务能力的对策建议.结果:本研究涉及全国8个省市的9家社会药房连锁公司共l 260名执业...     

天津市零售药店药学服务开展现状调查

目的：为提升零售药店执业药师药学服务水平提供参考。方法：设计调查问卷,对天津市零售药店的执业药师的药学服务开展现状进行调查,并就数据进行统计和分析。结果：共发放问卷3021份,回收有效问卷3001份,有效回收率为99.34%。被调查对象中大专及以上学历者占86.23%,（中）药学类专业人员占76.27%（47.95%+28.32%）,副高级及以上职称人员仅占1.17%。参与调研的天津市各种类型药店均开展了较为详实的药学服务事项。但是非处方药店中药品安全及安全用药相关科普教育不足,在经营处方药及非处方药的零售药店,执业药师仅开展口头用药指导,在建立药历、开展用药情况追踪方面存在欠缺。慢性病管理药店,制定药学监护计划、分级分层管理疾病,用药疗效定期随访评估难以持续。医保药店中疗效追踪和安全性随访还有不足。直接面向患者提供专业服务的药房（DTP）中欠缺完整记录,长期随访不足。接入药品网络交易第三方平台药店的执业药师忙于订单核对、调配药品,用药交代没有落到实处。执业药师工作满意度达87.67%,执业药师对中成药推荐正确率27.16%,药品不良反应、患者教育相关知识掌握不精准。结论：执业药师队伍长足发展,但专业学历结构尚待优化;零售药店已逐步开展起基础的药学服务,但服务的水平和标准化程度尚待提高;执业药师工作满意度较高,但执业能力尚有差距。故提出鼓励零售药店开展多种类型及层次的药学服务满足公众多样化的社会需要;执业药师严守服务规范底线,不断提升执业能力素质;管理机构调动社会各界力量,提升执业药师职业荣誉感,增强职业吸引力,从而优化执业药师队伍结构,并采取一定措施,有效提升零售药店执业药师药学服务水平的建议。     

临床药学专业社会药房实习现状调查分析

目的 调查临床药学专业社会药房实习(CPP)课程的开展情况,分析该课程存在的问题,以期改进CPP课程。方法 根据已发表的CPP课程调查问卷,开展横断面研究。以中国药科大学临床药学专业本科生为调查对象,开展关于CPP课程的内容、障碍以及学生对该课程的态度、能力提升和改进建议等方面的问卷调查。结果 学生表示CPP课程帮助他们了解社会药房销售的药物,但大多数学生对CPP课程内容表示不满意,与药学监护相关的教学内容比重低（占比39.21%）,希望课程内容突出临床药学专业特色;绝大多数学生就业不考虑社会药房;大于50%的学生认为由于我国国情,社会药房不能承担药学服务相关实习任务,社会药房的执业药师不能胜任实习带教工作,需要加强执业药师的专业水平和带教能力。结论 CPP课程目前尚存在许多问题,该课程需要结合我国国情和相关政策并借鉴国外的教学经验进一步改进;加强执业药师的师资培训并建立CPP带教标准有助于推动我国高校CPP课程的发展。     

三级医院团队与社会药房执业药师合作 管理糖尿病模式的探索

目的：社会药房的执业药师经过由三级医院构建的糖尿病管理团队的培训,对在本店配药的糖尿病患者进行管理,探讨社会药房执业药师的糖尿病管理模式。方法：经三级医院团队培训后的社会药房执业药师,对本店的糖尿病患者进行健康宣教及药学服务,患者随机分为对照组和试验组,试验组接受执业药师的药学服务,对照组未接受执业药师服务。结果：接受执业药师管理的患者前后体重指数（BMI）、收缩压（SBP）、空腹血糖（FPG）、餐后2小时血糖（2 h PPG）、糖化血红蛋白（HbA1c）、用药依从性都有明显改变,且腰臀比（WHR）、SBP、2hPPG、HbA1c、用药依从性等指标改善显著优于对照组,仅WHR、舒张压（DBP）无显著改善;未接受管理的患者,随访前后指标无显著差异。结论：经培训的社会药房执业药师在糖尿病管理工作中发挥着重要的作用,可明显改善糖尿病患者BMI、WHR、血压、血糖、用药依从性等指标;此模式为社会药房执业药师工作模式的探索提供了一种方案。     

三级医院团队与社会药房执业药师合作 管理糖尿病模式的探索

目的：社会药房的执业药师经过由三级医院构建的糖尿病管理团队的培训,对在本店配药的糖尿病患者进行管理,探讨社会药房执业药师的糖尿病管理模式。方法：经三级医院团队培训后的社会药房执业药师,对本店的糖尿病患者进行健康宣教及药学服务,患者随机分为对照组和试验组,试验组接受执业药师的药学服务,对照组未接受执业药师服务。结果：接受执业药师管理的患者前后体重指数（BMI）、收缩压（SBP）、空腹血糖（FPG）、餐后2小时血糖（2 h PPG）、糖化血红蛋白（HbA1c）、用药依从性都有明显改变,且腰臀比（WHR）、SBP、2hPPG、HbA1c、用药依从性等指标改善显著优于对照组,仅WHR、舒张压（DBP）无显著改善;未接受管理的患者,随访前后指标无显著差异。结论：经培训的社会药房执业药师在糖尿病管理工作中发挥着重要的作用,可明显改善糖尿病患者BMI、WHR、血压、血糖、用药依从性等指标;此模式为社会药房执业药师工作模式的探索提供了一种方案。     

我国药学服务人才告急与对策

医疗机构药师和药品零售企业执业药师都是我国药学服务人才,但数量和能力已双双告急。应加强药师和执业药师岗位能力培养,并加快面向药学服务的学生培养。在国家相关政策引导下,加快药师和执业药师、医疗机构药房和药品零售企业的整合。     

医药分开背景下社会药房药事服务费探索

目的：分析社会药房药事服务费收费机制,为深化医药卫生体制改革提供参考和建议。方法：通过定性分析和研究推理,探索社会药房药事服务收费管理机制并提出改革建议。结果：设立社会药房药事服务费,对全面取消以药养医、落实医药分开、提升药品流通企业转型升级具有重要的价值和意义。结论：应尽快创设社会药房药事服务费管理机制,建立合理的执业药师专业服务的补偿机制和激励机制。     

Factors associated with the intensity of government remunerated and unremunerated service provision in community pharmacies

BackgroundMany community pharmacies provide medication and disease state management services with and without specific remuneration. Availability of these services is often reported, however little is known about factors influencing the intensity of their provision.ObjectiveTo investigate factors associated with the intensity of provision of selected government remunerated and unremunerated community pharmacy services in Western Australia (WA).MethodsA questionnaire was mailed to a random sample of 421/628 (67%) community pharmacies in WA. The first dependent variable was intensity of government remunerated MedsCheck and Diabetes MedsCheck service frequencies per month. The second was the intensity of the sum of government unremunerated asthma screening, blood glucose testing, cholesterol testing and smoking cessation disease state management service frequencies per week. Principal Component Analysis defined attitudinal components influencing service provision. Linear regression with bootstrap confidence intervals determined variables associated with intensity of provision of the selected services. The variables were: pharmacist; pharmacy setting characteristics; and, attitudinal factors.ResultsThe questionnaire yielded a response rate of 49.2%. Attitudinal components that facilitated service provision were: general practitioners (GPs) willingness to collaborate; pharmacists are capable and ready; and pharmacists require further training. Staff capability and low return on investment were barriers to increased service provision. The intensity of government remunerated services was independently associated with pharmacies having pharmacy interns, fewer dispensary technicians, and being capable and ready to provide the services. Higher intensity of the provision of the unremunerated disease state management services was independently associated with the intensity of provision of MedsCheck and Diabetes MedsCheck services.ConclusionsImproved pharmacy workflow, achieved by the availability of pharmacy interns, and pharmacists being capable and ready, were important factors in the intensity of MedsCheck and Diabetes MedsCheck services. Intensity of the provision of government remunerated services facilitated a higher prevalence of disease state management services provision.     

基层医疗机构药学服务对口帮扶的实践与探索

目的:促进医联体内药学服务同质化发展,提升基层医疗机构药学服务能力.方法:与3家社区医院共同构建药学帮扶体系.根据社区医院药事管理方面存在的问题、基层药师的专业能力以及药师、医师对药学信息的需求和培训意愿等,对社区医院开展持续性药事管理改进和药学专业技能培训,提高社区药学人员的业务能力.结果:经过18个月的药学帮扶行动,加强了社区医院药事管理建设,提高药师专业水平.基于工作实践,对目前社区医院药学服务现状进行分析,对药事管理、药品供应、药学服务等方面提出改进建议.结论:在"医联体"模式的药学对口帮扶下,社区医院的药学服务能力得到提升,有利于社区医院药学服务的创新发展.     

A qualitative case study exploring the implementation of pharmacist care planning services in community pharmacies

ObjectivesTo describe the comprehensive annual care plan (CACP) process and to conceptualize how remunerated CACP services were implemented by community pharmacists.DesignA comparative, multiple case study approach with data comprising document review, observation, and semistructured interviews.Setting and participantsPharmacists, pharmacy technicians and staff, and student pharmacists from 4 different community pharmacy sites in Alberta, Canada, including independent, franchise, and corporate chain pharmacies. In addition, patients and other health care providers were included in the interviews.Outcome measuresConstructivist grounded theory was used to understand how care planning services were implemented in the real-world context of community pharmacies and how pharmacists provided CACPs within their practice.ResultsBetween May 2016 and January 2018, a total of 77 interviews and 94 hours of observations were completed at the 4 pharmacy sites, and 61 documents were collected. The CACP service required adaptation of the workflow at each of the sites. However, pharmacists and other pharmacy staff recognized benefits of the service with respect to pharmacists’ role expansion. The overarching grounded theory concept was changing the status quo. The following 4 themes emerged representing how the service was implemented: engaging patients, professional development and learning from experience, creating a supportive environment, and building community connections.ConclusionThis study found that practice change or changing the status quo was needed to implement remunerated care planning services in community pharmacies. The results of this study may be of interest to community pharmacists, pharmacy managers, and policy makers who are implementing remunerated care planning services in other jurisdictions.     

凸显药学服务能力的执业药师职业资格考试改革尝试

目的：通过分析普通高等学校药学专业类项下,包括临床药学专业在内的各专业毕业生参加执业药师职业资格考试成绩,观察执业药师职业资格考试内容改革与执业药师具备药学服务知识和能力的契合程度。方法：提取2020-2022年度参加药学类执业药师职业资格考试的全日制本科学历药学专业类参考人员的考试成绩,进行统计分析。结果：在药学专业科目考试中,临床药学专业参考人员的成绩显著高于药学、药物制剂、药事管理等专业参考人员的成绩。结论：执业药师职业资格考试改革后,考试内容基本实现了面向患者安全用药的转移,凸显了临床药学的知识与技能,初步满足了药品监督管理对药学服务的要求。     

国外现行执业药师(药师)资格考试制度的研究与借鉴

目的：为完善我国执业药师职业资格考试制度提供借鉴。方法：收集并分析美国、英国、日本、 新加坡现行执业药师（药师）资格考试制度政策、管理机构、报名条件、考试内容、考试形式及合格标准等信息,结合我国执业药师资格考试制度的发展现状,提出建议。结果与结论：我国应加快执业药师立法进程,不断完善执业药师资格考试制度,建立高等院校药学教育与药学实践的有效衔接,培养具有临床实践能力、能够提供准确药学服务的合格执业药师。     

Recommendations and guidance for providing pharmaceutical care services during COVID-19 pandemic: A China perspective

BackgroundThe novel coronavirus pneumonia (COVID-19), which was first detected in Wuhan City, has now became a pandemic that affecting patients around the world. Particularly, the community patient population are at high risk of infection and are facing potential failure of proper medication use during the pandemic.ObjectiveTo discuss community pharmacists’ role and the content of pharmaceutical care (PC) during the novel coronavirus pandemic to promote effective prevention and control and safe drug use of the community patient population.MethodCollect and summarize the experience Chinese community pharmacies gained from providing pharmacy services during the COVID-19 outbreak, and taking patients' PC needs into consideration, analyze and discuss the methods and strategies that community pharmacies and pharmacists shall use to provide PC during the pandemic.ResultsCommunity pharmacy management teams shall support PC services by providing adequate supply of COVID-19 related medications and preventative products, following environment regulations, and providing sufficient staff trainings. Pharmacists shall use various approaches to provide PC services in drug dispensing, consulting and referrals, chronic disease management, safe use of infusions, patient education, home care guidance and psychological support to promote the COVID-19 pandemic control and ensure safe medication use of community patients during the pandemic.ConclusionPC services in communities during the COVID-19 shall possess different properties due to disease characteristics and related change in patients' need. Community pharmacies shall work as a strong supporter of patient's medication and protective equipment supply. Community pharmacists shall be prepared to provide skilled and effective PC services for community patient population to ensure medication safety and promote the overall COVID-19 pandemic control.