探讨新医改模式下的医院药学服务

目的：介绍中国新医改的主要内容及其对医院药学服务的影响,探讨医院药学适应新医改要求的具体做法。方法：综合国内外的文献,结合作者单位的工作实际,从多方面论述医院药学服务的发展方向。结果：新医改对医院药学服务提出了更高的要求,医院药学服务人员要从加强自身学习、优化管理模式、发挥临床药师作用、引入药物经济学方法等多个方面加强医院药学服务,为患者提供安全、有效、经济的药疗服务。结论：医院药学服务人员要根据本地区、本单位的实际,探索适应新医改要求的医院药学服务发展之路。     

开展医院临床药学服务的作用与意义

目的探讨临床药学服务的作用,明确临床药学服务的内涵,促进医院临床药学服务工作的进步与发展。方法对与临床药学服务密切相关的各学科加以分析。结果在临床医院不同的特定的条件下,医院临床药学服务工作能否有效开展有赖于临床药师与医院管理层对医院临床药学服务的认知程度与重视程度。结论医院多学科参与互助支持是医院临床药学服务的基础,同时医院临床药学服务有效开展需要多学科技术人才的有效协作。     

浅谈在我院开展药物咨询工作

随着我国医疗卫生事业改革的不断深入,人们的自我保健与安全意识的提高,医院药学管理模式已由单纯的保障供应型向药学服务型转变.早在2001年卫生部就明确指出,医院药学部门＂要建立以病人为中心的药学管理模式,开展以合理用药为核心的临床药学工作,参与临床疾病诊断、治疗,提供药学技术服务,提高医疗质量.＂而药物咨询工作是临床药学工作的主要内容之一,是药师服务临床、服务患者的重要途径.     

加强医院药学管理 创新医院药学服务

随着科学技术的进步,医院药学发展的总趋势是进行医院药事管理,药学技术工作和药学服务要向临床靠拢。这就要求医院药学部门应掌握国内外药学发展动态,根据实际情况不断引进、吸收和应用现代药学新知识、新技术和新方法,创新医院药学管理。文章对此进行了分析,并就创新医院药学管理提出了建议。     

医院临床药学服务模式定位与改进

目的：探索医院临床药学服务模式中的分层分类方法,为医院临床药学模式的改进和发展提供参考。方法：考察分析医院临床药学服务模式中的工作分层和分类方法,对其模式的制度和问题进行梳理。结果：通过对医院临床药学服务模式的内容进行分类和分层,定位了当前医院临床药学服务模式,井对以后的发展改进提出了可行性建议。结论：定义了当前医院临床药学服务模式的内容,提出的可行性建议对于医院临床药学服务模式的发展和改进有一定的促进作用。     

医院药学在构建和谐医院中的地位及作用

构建和谐医院,是以科学发展观为指导,坚持以人为本,构建社会主义和谐社会的重要工作之一,意义有以下三点。医院药学工作是构建和谐医院的重要工作之一,主要有以下三项工作内容,从而以优质、高效、周到、经济、方便快捷的服务,提高医院药学的地位,发挥医院药学的作用,实现药学和医学相互促进,相得益彰的理想成就——“药到病除”,提高医院的知名度和美誉度,为医药卫生改革发展作贡献。     

刍议新的医疗体系下医院药剂科药学服务工作的重要性

医院的药剂科药学工作随着医药学的飞速发展也发生了很大的变化.医院药房既要为患者提供合格的、高质量的药品,还应该保障患者的用药安全,使药学服务的范围更加广泛.所以药学服务人员应该改变传统的工作模式,使其自身综合素质得到提升,使药学服务的价值得到真正的体现.本文针对医院药剂科药学服务工作提升的必要性,提出了新医疗体系下提高医院药剂科药学服务工作的措施,以供参考.     

浅谈医院药房药学服务的几点体会

通过对医院药学服务的现状进行系统分析,现代药房工作要适应新的形式与发展,必须由传统型“调剂”服务转向为药学型全程服务,建立以患者为中心的服务模式,加强药师队伍建设,提高医院医疗服务质量。     

浅谈教学医院临床药学人才队伍建设

1开展优质药学服务,培养服务型人才药品调剂工作是医疗活动中的一个重要环节,是药剂工作的一项重要内容。参与该工作的各药房,是医院病人较为集中的部门,也是反映一个医院是否具有良好的医疗秩序和医疗水平的重要窗口。由于医疗体制的改革和医药市场竞争的日趋激烈,药品调剂工作也要与时俱进,患者到医院就医,除了需求高质量的诊疗服务外,还应得到优质的药学服务。     

临床药师开展药学服务的实践与体会

目的探讨医院临床药学的工作途径和方法。方法分析临床药师开展药学服务的意义和工作内容。结果发展临床药学是国内外医院药学的普遍趋势。结论临床药师在临床治疗团队中有重要协同作用。应充分发挥临床药师在合理用药中的作用。     

An Overview of Community Pharmacist Interventions

This article evaluates the cost effectiveness of and patients’ willingness to pay for interventions by community pharmacists in the overall context of pharmaceutical care. The rationale for interventions by pharmacists in patient care is examined from the viewpoint of clinical and economic needs of the healthcare system. The philosophy of the practice of pharmaceutical care is compared with that of disease management. The analysis shows that both clinical and economic deficiencies exist in the current healthcare system that the practice of pharmaceutical care could help to rectify. More importantly, there is congruence in the practice philosophies between pharmaceutical care and disease management, with both being patient centered and outcome focused. Therefore, the practice of pharmaceutical care can be facilitated within the context of disease management.There are many examples showing that interventions by community pharmacists can result in cost savings. However, there are few studies on consumers’ willingness to pay for such services provided; those to date suggest that consumers are willing to pay a modest amount for pharmaceutical care provided by community pharmacists.Barriers for implementing pharmaceutical care by community pharmacists are discussed, and some suggestions of strategies to be adopted for the successful implementation of pharmaceutical care are made. The author is of the view that before full reimbursement for pharmaceutical care is achieved, the successful implementation of pharmaceutical care by community pharmacists will hinge on better utilization of available resources and improvement in communications between pharmacists, patients and other healthcare professionals. Coordinated and systematic efforts would be required to collect information regarding consumers’ willingness to pay in order to assist in negotiating an acceptable level of reimbursement.Finally, in this age of accountability in healthcare, it is necessary for community pharmacists to demonstrate the benefits of their interventions in terms of better outcomes whether they be clinical, economic and humanistic, and that the improvement is achieved at a cost acceptable to the healthcare system. Without the evidence of acceptable cost effectiveness and perceived benefits, any attempt to promote the implementation of pharmaceutical care by community pharmacists, especially in countries where the concept is relatively new, would only be perceived as lobbying for the interest of a particular professional group, and could not be justifiable.     

Between intention and behavior: an application of community pharmacists' assessment of pharmaceutical care.

A new practice philosophy for pharmacists, pharmaceutical care, encourages pharmacists to ensure that medication-related health outcomes are optimized. However, its adoption by community pharmacists has been slow due to numerous barriers including the economic structure of retail pharmacy, interprofessional conflicts, information limitations, gaps in pharmacy training and uneven patient demand. The specific study objectives were to (1) describe self-efficacy, beliefs, evaluations and perceived behavioral control in the provision of pharmaceutical care, (2) quantify intention and behavior to provide pharmaceutical care in a period of two weeks and (3) examine the relationships between intention and behavior. A 20% sample of Alberta community pharmacists received an attitude survey followed in two weeks by a behavior survey. Both surveys were developed for this study. Of the 320 pharmacists receiving the attitude survey, 230 completed surveys were obtained (71.9%). The behavior survey was received from 182 of those completing the attitude survey (79.1%). A causal model was constructed predicting pharmaceutical care behavior/s from pharmacists' self-efficacy, beliefs, evaluations and behavioral control. Behavioral control exerted its effect upon behavior via three pathways and its direct effect on belief was strongest. The only direct predictor of behavior was self-efficacy. The chi2 measure indicated that the model was not a perfect fit (chi2 = 99.24, df = 67, p<0.006), but the goodness of fit index (0.931), adjusted goodness of fit index (0.876), and root mean squared error (0.067) fall within acceptable ranges. Thus, it appears that pharmaceutical care implementation programs which address individual factors singly in providing pharmaceutical care will not be successful. The control pharmacists' perceive over their patient care behaviors in their practice environment is critical. Programs which help pharmacists assess their work environment and determine strategies to impact or reconstruct their environments are required.     

Prescription drugs and managed care: can 'free-market détente' hold?

The rapid rise in pharmaceutical benefits costs, often cited as a major contributor to the resurgence in health care cost growth, is beginning to strain the relationship between the pharmaceutical and the managed care industries in the United States. In interviews conducted in 1999, executives from both industries maintained a continued preference for a market-based resolution of these tensions. There is evidence, however, that this private-sector détente may give way in the face of the rising business and political pressures that both industries face. Active leadership will be required to prevent deterioration of the prevailing political climate toward economic controls.     

湖北省医院门诊药事服务项目界定与服务成本测算研究

界定门诊药事服务的项目,测算门诊药事服务成本,推进医院门诊药事服务的开展.通过文献法获得与药事服务的概念及门诊药事服务项目有关的内容,通过专家咨询法和现场调查法,获取开展门诊药事服务的成本资料,运用标准成本测算方法测算湖北省医院门诊基本药事服务成本.界定了药事服务的概念及门诊药事服务项目,测得湖北省三甲医院门诊药事服务成本为30.02元,二甲医院的门诊药事服务成本为10.44元.建议对各级医院按此类标准进行探索性补偿.     

Assessment of pharmaceutical care for pregnant women treated in the public health system in Praia Grande, São Paulo State, Brazil

The use of medication in primary health care has increased steadily in recent decades, thus highlighting the relevance of assessing the pharmaceutical care provided to patients in the primary care setting. This article aimed to evaluate the pharmaceutical care provided by the public system in Greater Metropolitan Santos, S?o Paulo State, Brazil, focusing specifically on women during gestation. Methods included secondary data analysis, document analysis, interviews with key players, and visits to health services and to the pharmaceutical supply center. Deficiencies were identified in most stages of pharmaceutical care: selection, planning, purchase, storage, distribution, and dispensing. The results suggest that in order to improve primary health care, with better access, equality, and comprehensiveness, the evaluation of pharmaceutical care should be incorporated as a routine procedure.     

肝功能不全患者的药学监护研究

目的 开展对肝功能不全患者的药学监护研究.方法 将新入院患者生化指标划分肝功能不全的严重程度分级,将筛选的肝功能不全患者随机分成两组,对干预组进行实施药学监护,观察实施药学监护后两组药物的不良反应发生率、住院天数、住院费用、患者满意度等.结果 干预组实施药学监护干预后,患者平均住院天数,平均住院费用,药费比例,使用抗生素比例、抗生素占总药费的比例、使用注射液比例、注射液占总药费的比例,药物不良反应发生率较对照组均显著降低（p＜0.01）;基本药物使用比例,患者满意度比对照组明显增高（p＜0.01）.结论 对肝功能不全患者实施药学监护和干预,用药的安全性、有效性和经济性.     

建立高危新生儿肠外营养液药学监护新模式

针对高危新生儿肠外营养液药学监护开展品管圈活动。国内目前尚无高危新生儿肠外营养液完善的质量监控体系,结合工作实际发掘了5大攻坚点,包括成立成品输液质量抽检小组,研发PIVAS伴侣软件并建立成品钾离子浓度检测方法,增加资金投入,合理用药建议与科普知识传递信息化并建立营养风险筛查与评估量表,创建团队协作药学监护模式等。针对5大攻坚点进行最适方策追究,从调配前干预、调配中监管、调配后追踪3方面,构建了高危新生儿肠外营养液药学监护模式,并取得了良好的临床应用效果。     

An Innovative Pharmaceutical Care Practical Course

The innovative practical course was developed to improve the students’ ability to acquire pharmaceutical care skills. The primary components of the course were in-school training using small group discussions and hospital experience including identification, analysis, prevention and resolution of drug-therapy problems, patient counseling on their medications and diseases, and interaction with medical team. Specific objectives of the research were to (1) compare students’ performance before and after the course, (2) measure students’ perceptions of their pharmaceutical care skills before and after the course, (3) determine students’ perception of the value of the course. Statistical comparison of pre-test and post-test grades indicated both a retention and acquiring pharmaceutical care skills. A pre-course and post-course survey instrument was designed to measure students’ perception of their pharmaceutical care skills. Perception of most of the items of the survey was significantly improved at the end of the course. Overall, the majority of students were highly satisfied with the course. In conclusion, the present study demonstrates that the innovative pharmaceutical care practical course was successfully introduced.