门诊药房以患者为中心的药物服务浅析

随着我国医疗体制改革进程的不断深入,门诊药房服务理念也逐渐转变,成为了以患者为中心。药物服务指的是药师利用药学知识为患者和医护人员提供与药物直接相关的各项服务,以提高药物治疗的经济性、有效性和安全性,为临床合理用药提供保证。在门诊药房实施以患者为中心的药物服务的主要目标在于提高临床用药的合理性。本文就对门诊药房以患者为中心药物服务的具体实施措施进行了分析。     

我院开展以患者为中心的药物咨询服务的实践与思考

目的:分析我院开展药物咨询的工作情况,提高医院药学服务质量,促进合理用药。方法:收集我院2006年1月-2010年9月我院门诊咨询窗口的553例药物咨询实例,分析总结咨询者构成、药物咨询问题构成和咨询药物类别构成等。结果:咨询者女性多于男性(女性300例,男性253例),50岁以上老年患者占30.6%;主要药物咨询内容为用法用量(65.5%);主要咨询药物类别为抗感染药(32.2%)。结论:开展药物咨询,对指导患者安全、有效、合理、经济地用药具有重要的作用。     

美国患者报告结局测量工具在药物研发与注册中的应用

对患者报告结局测量工具在美国药物研发与注册中的应用进行研究,通过阐述患者报告结局测量工具定义、分类、资格认定、法规及指南要求,分析美国FDA根据患者报告结局工具为临床终点批准药物,为我国提供参考和借鉴.     

以患者为中心理念下双向转诊管理对策研究

本文通过分析双向转诊制度建立的背景,其实施的基本条件,"以患者为中心"的双向转诊管理理念,并对其存在问题进行分析。     

患者参与药物研发

患者参与药物研发,这里的患者是广义的,包括患者个体、患者组织及其家属等.患者参与药物研发涉及从立题到上市后研究的全生命周期各阶段,而不仅局限在临床研究期间.在这方面,欧美的药物研发已经积累了相当的经验,日本的药品主管当局和工业界在近年已经开始实践.我国尚无相关规范或者指导原则等出台.本文将针对国外和我国患者参与药物研发...     

高原地区病房应用以患者为中心的护理模式的效果

目的:将以人为本以患者为中心的护理模式应用在高原病房,提高患者对护理工作的满意度,提升我科高原优质护理病房的护理质量。方法:总结2010年9月～2012年12月入住我科的250名患者的临床资料,观察以患者为中心的护理模式应用在护理过程的效果。结果:患者及其家属对护理服务的满意率提高,护理人员成就感提升,病房护理质量提升。结论:以患者为中心的护理模式,针对每位患者的个性化如:意愿、文化差异、性格特点等实施人文关怀,以提高护理质量,提高患者满意度和护理人员工作成就感。     

以患者为中心是护理工作改革的宗旨

目的探讨“以患者为中心”的护理模式是改革的宗旨。方法认识新的医学模式，运用心理学、伦理学，加强心身兼护。结果护士转变了从属型的执行医属和单纯地护理操作，提高了护理质量，满足了患者的健康需求。结论以患者为中心是护理改革的必然，是护理工作适应社会发展，满足大众需求的举措。     

医院药房以患者为中心的药学服务的探讨

医院药房以患者为中心的药学服务,是以药师自身药学的理论知识为基础,充分发挥药师的自身优势,开展药学咨询,对患者的用药行为进行监督,转变门诊药房的服务观念,提升医院药房的服务水平。医院药房开展以患者为中心的药学服务,能够拉近了医患的关系,提升门诊药房的服务水平,促进了用药行为的合理性,提高患者用药行为的安全性、有效性、依从性。     

以患者和家庭为中心的护理对白血病患儿生命质量的影响

目的 探讨以患者和家庭为中心的护理(patient-and family-centered Care,PFCC)干预对白血病患儿生命质量的影响.方法 河北医科大学第四医院儿科2013年1月至2015年6月收治的急性淋巴细胞白血病-标危型接受诱导治疗的患儿及其家长随机分为试验组和对照组.对照组给予儿科血液病常规护理,试验组在此基础上,根据不同年龄患儿特点、患儿家长的心理特点以及化疗方案中的药物反应对患儿及其家长应用PFCC理念进行护理干预.干预前后采用儿童生命质量癌症模块量表(pediatric quality of life inventory TM cancer module,PedsQLTM)3.0中文版对其生命质量进行测评.结果 应用PFCC理念进行护理干预后2组2~4岁患儿家长得分、5~7岁和8~9岁患儿自评得分和家长得分,差异均有统计学意义(P<0.05).结论 应用PFCC理念对急性淋巴细胞白血病患儿及其家长进行护理干预可以提高患儿的生命质量.     

以家庭为中心的干预对高血压患者治疗依从性的影响

目的:探讨以家庭为中心的干预对高血压患者血压控制及治疗依从性的影响.方法:以性别、年龄、高血压等为配对条件,筛选80例满足配对条件的高血压患者,随机分为实验组与对照组各40例.实验组给予以家庭为中心的干预,对照组给予常规性社区护理,共干预4个月.结果:两组患者干预4个月后降压效果及依从性差异均有显著性意义(P＜0.05).结论:以家庭为中心的干预可提高高血压患者的治疗依从性,促进血压降低,有利于减少并发症的发生,从而提高患者生活质量.     

电子化患者报告结局在新药临床试验疗效评价中的应用

患者报告结局（PRO）作为临床结局疗效评价最重要的指标之一,被广泛用于新药临床试验。在新药临床试验电子化的趋势下,电子化患者报告结局（ePRO）数据采集系统基于其种种可以推进新药临床评价的优势,迎来了快速发展。然而,ePRO在中国仍然处在初期发展阶段,因此将对ePRO的基本概念、功能、国内外临床应用情况及其在新药临床试验疗效评价中的价值等进行介绍;同时总结概括了目前ePRO在我国临床试验应用中存在的问题,最后对ePRO在中国的发展前景进行了探讨。     

规范的临床研究在新药创制中的作用

临床评价是药物研发的一个重要环节。本文从建设研究团队、组织研究方式和试验过程管理三方面阐述了国际化临床试验成功进行的TOP三原则,并介绍了国际上药物上市后进行比较效果研究(CER)的新趋势。     

The clinical pharmacologist in drug discovery and development

1 Clinical pharmacology is a key activity in drug discovery and drug development with much to contribute to drug innovation.
2 However, very few clinical pharmacologists choose the pharmaceutical industry as their ultimate career.
3 Medical alumni of the RPMS clinical pharmacology department illustrate this; only four industrial careers vs thirty professors of clinical pharmacology or medicine.     

新药开发中的基因导向型个体化发展战略

药物基因组学在新药开发的多个阶段可发挥重要作用。研究者可借助基因组信息更好地发现新药的作用靶点及其作用机制,药物基因组及其相关技术的发展帮助研究者在新药开发的临床前研究阶段淘汰化学性质不良的化合物,还可指导新药开发的临床试验设计以增加药物有效性和安全性,同时降低开发所需的时间和成本。     

Emerging strategies for drug development in motor neuron disease

Until recently, attempts to identify disease-modifying treatments in motor neuron disease have largely failed. This was due to a lack of understanding of the disease pathogenesis and poor clinical trial design. Recent advances in the genetics of motor neuron disease and the maturation of tissue culture techniques have increased our understanding of the mechanisms of cell death in motor neuron disease. This has in turn led to better in vitro and transgenic animal models, allowing for a more systematic study of the disease process and analysis of potential therapeutic agents. With the advent of these models, motor neuron disease drug research has entered a new era. It is now possible to pursue mass screening of compounds in the in vitro models. Successful compounds in vitro can be advanced to the transgenic animal models. Once toxicity and potential therapeutic effects in animals are known, agents which remain promising can be taken to Phase I, II and III clinical trials. This will increase the likelihood of success and is more desirable than methods previously utilised. A hierarchical approach such as this will be even more important as multi-drug regimens are to be studied. The number of combinations for these multi-drug regimens becomes prohibitive without a screening method.     

Model-based drug development applied to oncology

Model-based drug development (MBDD) is an approach that is used to organize the vast and complex data streams that feed the drug development pipelines of small molecule and biotechnology sponsors. Such data streams are ultimately reviewed by the global regulatory community as evidence of a drug’s potential to treat and/or harm patients. Some of this information is captured in the scientific literature and prescribing compendiums forming the basis of how new and existing agents will ultimately be administered and further evaluated in the broader patient community. As this data stream evolves, the details of data qualification, the assumptions and/or critical decisions based on these data are lost under conventional drug development paradigms. MBDD relies on the construction of quantitative relationships to connect data from discrete experiments conducted along the drug development pathway. These relationships are then used to ask questions relevant at critical development stages, hopefully, with the understanding that the various scenarios explored represent a path to optimal decision making. Oncology, as a therapeutic area, presents a unique set of challenges and perhaps a different development paradigm as opposed to other disease targets. The poor attrition of development compounds in the recent past attests to these difficulties and provides an incentive for a different approach. In addition, given the reliance on multimodal therapy, oncological disease targets are often treated with both new and older agents spanning several drug classes. As MBDD becomes more integrated into the pharmaceutical research community, a more rational explanation for decisions regarding the development of new oncology agents as well as the proposed treatment regimens that incorporate both new and existing agents can be expected. Hopefully, the end result is a more focussed clinical development programme, which ultimately provides a means to optimize individual patient care.     

药物基因组学在药物研发中的转化与应用

药物安全性和有效性是新药开发和临床用药的核心问题,也是药物基因组学研究的主要内容。目前,已阐明影响药物安全性有效性及个体化差异的首要因素是药物相关生物标记。近年来,药物基因组学各机构正式成立,各发达国家也纷纷出台各种规章,对药物研发中药物基因组学的应用进行规定。药物基因组学在上市药物的评价中已获得巨大的成功,并成功指导了数例肿瘤靶向药物从研发到上市的全过程,缩短了药物开发周期、降低了研究成本及毒副反应。