Development and validation of a Spanish language patient satisfaction questionnaire with drug dispensing

Objective: To develop and validate a specific questionnaire about patient satisfaction with drug dispensing at Spanish community pharmacies. Method: A self-administered semi-structured questionnaire was designed centered on the perception of the patients with the dispensing service. To validate this questionnaire, it was administered at Spanish community pharmacies, which voluntarily agreed to participate in the study for a period of 2 months (March and April 2006). Patients or caregivers who were able to read and write were included in the study. Main outcome measure: Scores of the items related to satisfaction with the dispensing service. Results: The questionnaire consisted of: an introduction, 10 closed questions in an interval scale of five points, an open section to express comments, and finally demographic data of the patients. Twenty-seven community pharmacies participated in the validation, and 561 questionnaires were obtained with a response percentage of 56.5%. A Cronbach’s α coefficient of 0.91 was obtained. The Kaiser–Meyer–Olkin coefficient was 0.92, and the extraction of the principal components revealed a unique component explaining 55.2% of the total variance. About 15.5% of patients made additional comments that praised the quality of attention received and other aspects of the service such as the amiability and friendliness shown by pharmacy staff. Conclusion: The questionnaire developed shows evidence of validity and reliability for evaluating patient satisfaction with the dispensing service in community Pharmacies in Spain.     

临床药师对1例肾移植术后排斥患者的药学服务

目的 以1例出现术后排斥的肾移植患者为例,探讨临床药师在肾移植受者术后排斥治疗中的药学监护要点。方法 临床药师参与1例肾移植术后发生排斥反应患者的治疗,从调整优化用药方案、关注药物的疗效及不良反应、注意药物的相互作用、以及提供患者用药教育等方面,实施全方位的药学监护。结果 患者肾功能有所好转,治疗期间临床药师提供全方位临床药学服务,完善及提高了临床药物治疗实施。结论 临床药师参与肾移植受者术后治疗团队,为患者制订个体化的药学监护,进行临床药学服务,可保证患者用药安全、有效。     

英格兰社区药房服务及其对中国社会药房发展的启示

目的:探讨英格兰社区药房服务对中国社会药房发展的启示。方法:回顾和探讨2000-2008年英国社区药房各种制度和政策对社区药房服务内容的影响,提出对中国社会药房未来发展的建议。结果与结论:英格兰社区药房的基本服务内容包括配药、重复配药、回收药物、公共健康、提供转诊指导、自我保健以及临床管理。此外,英国皇家药学会也不断推出各项社区药房的额外服务以提高其效能,如抗凝血剂监测服务、特定疾病专用药物管理服务等。这些举措对中国社会药房的发展具有较大启示,也有实际可行性。     

安徽医科大学第二附属医院药学部，合肥 230001

1例37岁青年男性患者,因肠梗阻入院,术后第三天患者伴发十二指肠穿孔,积极为患者行内镜下鼻肠管置入术,并通过鼻肠管鼻饲糖水逐步开展肠内营养支持,于置管第5日顺利过渡至全肠内营养支持。患者病情稳定于术后第13日顺利出院。     

医院药房提升服务质量管理对策分析

目的 :探讨我院医院药房为提升服务质量所实施的管理对策的有效性。方法 :针对首接处方负责制、百日无差错无投诉活动、互换工作质量记录本制度等管理对策 ,采用SPSS10 0统计软件包对有关数据进行分析。结果 :管理对策的有效实施能增加患者就诊的满意度 ,提高患者的信任度。结论 :管理对策有利于药学服务质量的提高 ,也有利于加强药剂科与有关科室的信息沟通。     

社会药房在医改中生存和发展的探讨

真正意义上“医药分开”的医疗卫生体制改革,是让百姓得到医药服务的实惠,促进社会药房健康发展。本文分析了社会药房的生存现状,并提出了社会药房在医疗改革中的生存和发展的看法,以引起有关方面的高度重视和进一步研讨。     

精细化管理在提升我院药房药学服务水平中的应用

目的:提升药房药学技术服务水平,提高患者满意度。方法:从提升药学人员综合素质、加强药品调剂差错管理、药品质量管理及多项措施保障患者用药安全合理等方面介绍我院药房的精细化管理。结果与结论:通过人员操作规范化、加强人员专业知识培训、开展五常法和品管圈活动、加强药师人文素质培训,提升了药师综合素质;通过加强高危药品、易混淆药品管理,对内部差错进行登记与分享,对已发生差错进行深层次分析,减少了发药差错(内部差错件数由134件下降到64件);通过加强特殊管理药品的管理等,强化了药品管理质量;通过落实处方审核、充分运用药品定位系统、设置用药咨询专窗、制作用药交代标签等方式,提高了用药合理性、工作效率(患者候药平均时间从5 min降为3 min)和患者满意度(从80%上升至94.9%),保障了用药的安全、合理。我院实施的精细化管理显著提升了药房药学服务水平。     

药师借助静脉配置中心平台开展肿瘤专科药学服务

对本院静脉配置中心(PIVAS)2011年1～12月抗肿瘤药物医嘱的审核,共发现不合理现象177次,主要表现在溶媒选择、给药剂量、给药顺序和途径方面。药师通过多种手段和方法,提供肿瘤专科药学服务,指导护士药品存放、正确使用共45人次;参与化疗全过程,防范不良反应的发生,提供出院教育123人次。     

探索临床药学之路,开拓我院药学服务特色

目的:确立我院临床药师服务的切入点和服务特色。方法:以药品不良反应监测工作为起点,以《一院药讯》、"南通药事网"和咨询窗口为平台,不断加强业务学习,提高药师自身的综合素质,积极参加临床查房和病例讨论。结果:我院药品不良反应监测工作取得长足的进步;药学服务的理念得到进一步宣传;药师所提供的药学技术服务逐渐得到医师、护士和广大患者的认可和欢迎;药师的药学服务水平在临床用药实践中不断地提升。结论:临床药学工作是一个循序渐进的过程,必须求真务实,因地、因时地推进各项工作的发展。     

试论我国药品零售企业开展药学服务的必要性

目的 :探讨我国药品零售企业开展药学服务的必要性。方法 :分析我国药品零售企业的现状及开展药学服务的必要性。结果与结论 :药品零售企业只有积极开展药学专业化服务 ,才能在激烈的市场竞争中增强核心竞争力。     

Response to the first wave of the COVID-19 pandemic in the community pharmacy of a University Center for Primary Care and Public Health

BackgroundPharmacists played a key role during the coronavirus disease 2019 (COVID-19) pandemic: they contributed to preventing transmission and to maintaining continuity of primary care.ObjectivesTo present the contributions of a Swiss pharmacy of an academic outpatient care department (Unisanté) to the prevention of COVID-19 transmission and the precautionary measures plan implemented as well as to evaluate the impact of Swiss semicontainment on its pharmacy services.MethodsContributions to COVID-19 transmission prevention and the precautionary measures plan are described. The impact on pharmacy services was measured by quantitative comparison before, during and after semicontainment.ResultsThe pharmacy supplied protective equipment to the population and to liberal healthcare professionals and provided COVID-19 recommendations to patients and community pharmacies. The precautionary measures plan implemented required a reorganization of the premises, facilities, staff operation and pharmacy services. Semicontainment had a strong impact on pharmacy services; however, clinical bonds with patients and other healthcare professionals were maintained. Unseen negative impacts may exist and need to be investigated.ConclusionsAlthough innovative solutions remain to be developed to guarantee continuous and secure remote communication with patients, this pandemic was an opportunity to demonstrate the versatility, benefit and importance of community pharmacy services.     

急诊科临床药师工作模式实践与探讨

目的:为我国急诊科临床药师的发展提供参考。方法:借鉴国外经验,结合我国实际情况,以血药浓度监测为切入点,对急诊科临床药师工作模式进行研究。结果与结论:临床药师在急诊科开展工作有很大空间,在中毒解救、促进合理用药、保证患者用药安全等方面起到积极作用,但目前临床药师自身素质和专业知识还需进一步积累和提高。     

心脏术后患者的药学监护

目的:临床药师参与临床药物治疗,对患者进行药学监护。方法:以一位心脏术后患者为例,临床药师参与药物治疗方案的制订,分析患者所用相关药物,跟踪其治疗效果及不良反应,对药物治疗过程进行综合评估。结果:患者的各项指标趋于正常。结论:临床药师的参与使药物治疗更趋合理,在达到治疗目标的同时,可减少药物的不良反应,有利于提高临床的药物治疗水平。     

1例肺癌合并上腔静脉综合征患者的药学服务

摘 要临床药师参与1例肺癌合并上腔静脉综合征患者的治疗过程,通过限制补液量,以及选择无需水化的化疗方案进行干预,建议护士采取下肢静脉留置导管输入补液,并对化疗药物配置及化疗期间可能出现的不良反应进行监护,患者在上腔静脉支架置入术及相关治疗之后面部、颈部、右上肢肿胀较前缓解,胸闷气促、咳嗽咳痰逐渐好转,肝肾功能及电解质指标均在正常范围,明确诊断后,排除化疗禁忌,开始治疗。     

我院药房停电应急药学服务管理的实践

目的:探讨医院药房针对停电事件的应急预案及工作流程。方法:介绍我院的《药房停电应急预案》,并评价其实施4年来的应用效果。结果与结论:预案从药品管理与安全及对患者服务方面明确了药学人员的岗位职责及相应的应急工作流程。通过演练及培训,在2010-2013年间发生的7次停电事件中,药学部从未发生药品管理差错,并保证患者及时得到药品治疗。该预案经实践后取得了良好效果,降低了医疗风险,提高了药学应急服务水平,有效地促进了应急药品保障工作。     

1例进展性卒中患者个体化抗栓药物治疗实践

目的:探讨进展性卒中患者的抗栓治疗策略.方法:分析1例进展性卒中患者诊治情况,并对患者不同病情下的抗栓治疗方案进行调整和药学监护.结果:临床药师参与进展性卒中患者的诊疗,通过临床指南、专家共识及文献报道,为患者在多个治疗关键节点提供个体化药学建议,提供规范的药学宣教、随访,患者病情得到有效控制并好转,药学监护全过程未发...     

临床药师借助静脉配置中心平台对医院外科病房开展药学服务的效果分析

目的：研究临床药师借助静脉配置中心平台对医院外科病房开展药学服务的效果。方法统计外科病房2O1O-2O12年PIVAS输液处方1147752份,对不合理用药医嘱进行点评及统计分析。结果2O1O-2O12年 PIVAS输液处方分别为324212份、387271份、436269份,其中不合理用药医嘱分别为6O26份（占1.86%）、5343份（占1.38%）、4433份（占 O.97%）,不合理用药医嘱逐年下降,其中干预效果最为明显的是Ⅰ类切口手术围术期预防使用率也逐年下降,分别为97.1%,63.9%,31. O%。结论临床药师借助 PIVAS 平台对静脉医嘱进行审核,进一步提高了医院合理用药水平。     

临床药师对肾内科患者抗菌药物选用的药学服务

目的研究临床药师对肾内科患者抗菌药物选用的药学服务。方法选取我院肾内科2例患者对抗菌药物的选用进行药学服务,从药师对药物的选择、药物用量、出现不良反应的症状等方面进行观察。病例1患者由药师选择头孢哌酮舒巴坦、美洛培南等药物进对患者进行治疗;病例2患者药师给予氨曲南、法莫替丁、碳酸氢钠片、胃舒平片等药物进行治疗。并根据患者病情变化临床药师的经验选择用药时间。结果 2例患者经临床医师的用药指导后,未出现明显的不良反应症状,药效有效的得到发挥,提高了患者药物的依从性。病例1患者用药后临床症状基本消失,血压也得到有效控制。病例2患者临床症状基本好转,中性粒细胞、白细胞、血清生物化验指标均比治疗前明显改善(P<0.05)。结论对我院2例肾内科患者给予有效的药学服务,通过临床药师对肾内科患者进行抗菌药物的选择,用药方法指导、药物剂量及发生的不良反应症状给予分析,促使药物药效充分发挥,保证患者用药的安全、有效,减少病发症的产生。     

运用药学服务单对高血压患者进行患者教育的案例讨论

目的:探讨药学服务单的设计与患者教育的方式。方法:通过对2例存在不同问题的老年高血压患者应用药学服务单进行患者教育,探讨设计药学服务单及其在患者教育的实际应用中遇到的问题和解决方法。结果:药学服务单在提高患者用药依从性、建立药患关系、在治疗团队中找到临床药师的位置起到非常好的作用。结论:利用药学服务单进行患者教育是临床药师开展药学服务的一个很好的工作模式,值得推广。     

Pharmacy care perspectives on problems with HIV antiretroviral therapy in Sweden

Objective This study has three main objectives (1) to identify the major problems or difficulties pharmacy staff in Sweden experience regarding pharmacy care of patients receiving antiretroviral therapy, (2) to identify the perceptions of pharmacy staff regarding what are patient-related concerns with antiretroviral therapy and (3) to compare the extent to which pharmacy staff awareness matches patient perceptions regarding what are the major problems or difficulties associated with antiretroviral therapy. Methods A problem detection study (PDS) containing two questionnaires was conducted: one to be completed by pharmacy staff and another to be completed by both pharmacy staff and patients. In the latter survey, staff were asked about what they thought that patients would have responded. Staff and patient responses were then matched and compared with one another. Results The pharmacy staff expressed their need for continuous education so as to assist the patients with their complex regimens. The staff were aware that patients were worried about therapy failure and viral resistance, medication-related problems and negative attitudes from the public. The staff however were less aware of the extent to which patients worried about not having their HIV infection under control. The staff also valued written patient information to a much higher extent than the patients. Conclusions The pharmacy staff’ awareness of the major problems HIV patients are experiencing seems incomplete and may lead to lack of concordance between the patients and pharmacy staff. This in turn may lead to non-adherence and poor therapy outcomes. Pharmacy staff should be encouraged to improve and systematically assess patient issues regarding antiretroviral therapy. Through assessing patient needs and concerns, the pharmacists can better identify patient needs and thus better tailor their educational and behavioural interventions to improve therapy outcomes.