Community pharmacists'' perspectives on pharmaceutical care implementation in New Zealand

Objective: There were three objectives to this study: to establish New Zealand community pharmacists' level of understanding of the pharmaceutical care process; to determine their attitudes to the concept of pharmaceutical care; and to determine the barriers to commencing pharmaceutical care practice. Comparisons were made between proprietors (pharmacy owners) and employees, males and females, and younger and older pharmacists. Method: The research tool was a questionnaire instrument, encompassing a total of 67 questions designed to determine community pharmacists' understanding, attitudes and appreciation of the opportunities and barriers inherent in the pharmaceutical care process. A total of 490 pharmacists representing 286 proprietors and 204 employees randomly selected from the Pharmaceutical Society register were sent a questionnaire. Results: The total responses numbered 377, which was a 76.9% overall response rate. Over 60% of the pharmacists surveyed had a correct understanding of pharmaceutical care. Approximately the same percentage felt the future of pharmacy would depend on the provision of services other than dispensing. Insufficient time, as a barrier to implementation, was identified by 87% of respondents, and an absence of a reimbursement system by a further 82%. Lack of: therapeutic knowledge; clinical problem solving skills; finance; appropriate space; patient demand; access to patient medical records; and data on the value of PC were identified as major barriers by over 50% of all respondents. There were significant differences in response to a number of issues recorded by males and females, proprietors and employees, and pharmacists above and below the mean sample age of 45 years.Conclusion: This study found that the community pharmacy environment in New Zealand had a high level of understanding of the pharmaceutical care process, but identified some significant barriers to implementation.     

Community pharmacists' perspectives on pharmaceutical care implementation in New Zealand

Objective: There were three objectives to this study: to establish New Zealand community pharmacists' level of understanding of the pharmaceutical care process; to determine their attitudes to the concept of pharmaceutical care; and to determine the barriers to commencing pharmaceutical care practice. Comparisons were made between proprietors (pharmacy owners) and employees, males and females, and younger and older pharmacists. Method: The research tool was a questionnaire instrument, encompassing a total of 67 questions designed to determine community pharmacists' understanding, attitudes and appreciation of the opportunities and barriers inherent in the pharmaceutical care process. A total of 490 pharmacists representing 286 proprietors and 204 employees randomly selected from the Pharmaceutical Society register were sent a questionnaire. Results: The total responses numbered 377, which was a 76.9% overall response rate. Over 60% of the pharmacists surveyed had a correct understanding of pharmaceutical care. Approximately the same percentage felt the future of pharmacy would depend on the provision of services other than dispensing. Insufficient time, as a barrier to implementation, was identified by 87% of respondents, and an absence of a reimbursement system by a further 82%. Lack of: therapeutic knowledge; clinical problem solving skills; finance; appropriate space; patient demand; access to patient medical records; and data on the value of PC were identified as major barriers by over 50% of all respondents. There were significant differences in response to a number of issues recorded by males and females, proprietors and employees, and pharmacists above and below the mean sample age of 45 years.Conclusion: This study found that the community pharmacy environment in New Zealand had a high level of understanding of the pharmaceutical care process, but identified some significant barriers to implementation.     

广州市基层医疗机构医师和药师对社区药学服务的认知现状调查分析

目的:优化家庭药师在家庭医生服务团队中的工作模式,为开展社区药学服务提供依据.方法:对广州市21家社区卫生服务中心的临床医师和药师开展问卷调查,并对调查数据进行分析.结果:共发出198份问卷,回收198份有效问卷,有效回收率为100％.两种问卷的Cronbach'α系数分别为0.753和0.710,具有较高的信度.28...     

开展社区药学服务的实践探讨

目的:探讨开展社区药学服务的途径和意义。方法:药师走出医院,深入社区,针对常见病、慢性病患者进行健康宣教和用药知识讲座,追踪重点患者并定期随访,提供社区药学服务。结果:药师通过多学科知识积累和沟通交流技巧学习,在药学服务实践中,根据患者的具体情况,进行针对性的用药咨询和宣教,指导社区患者了解饮食调整方法、药物作用机理和病程特点,帮助患者了解药物、战胜疾病。结论:开展社区药学服务,能够发挥药师职能,促进用药知识传播,有助于提升合理用药、提高公众健康和生活质量。     

Recurrent education for pharmacists to support regional medicine

New-generation pharmacists who graduate from the 6-year pharmacy education program will come into being in Japan in 2 years' time. The new program regards technical skills and caring attitudes suitable for healthcare professionals as important, as well as expert knowledge. Pharmacists are expected to become more involved in pharmacotherapy and patient care to overcome rural physician shortage and achieve better outcomes in pharmacotherapy. Pharmacists themselves also want to contribute to improve pharmacotherapy and patient care. Pharmacists educated with the former 4-year education program, however, hardly had a chance to learn clinical pharmacy or pharmaceutical care when they were pharmacy students. They have so far studied clinical knowledge, skills, and attitudes by themselves mostly after graduation. Therefore most pharmacists have not received systematic education or training about clinical pharmacy. Pharmacy schools employ pharmacists and physicians as professors, and built practical rooms for pre-clinical training to study pharmacy practice in recent years. We should use those human resources and laboratory equipment in pharmacy schools to facilitate recurrent education for pharmacists. Internet-based real time remote lecture is also useful for pharmacists working far from pharmacy schools to attend a recurrent class. I propose an education system in which pharmacists who completed the recurrent education program teach students pharmacy practice in their worksites, and both pharmacists and students are developing their practical skills to a high degree together.     

适应药学模式的发展,探索本科生实习改革

社会的发展促使医院药学工作模式、药师的工作内容发生变革，影响着药学专业毕业生的就业，反过来促进药学教学内容和模式的改革。毕业前实习阶段的教学关系到药学教育改革的成效。调查显示，药学专业本科毕业生在医院药房工作的比例较大，医院药学工作需要的不仅是科研型人才，更应该是综合型人才，才有利于药学事业的持续发展。为此，我们作了一些探索，改革了实习模式，实习分两个阶段，第一阶段让学生参加科研实践，学习科研工作的方法；第二阶段参加医院药学日常工作的同时进行调研，锻炼学生能力。新实习模式是科研实践和医院药学实践并重，强调科研工作的基本方法，培养学生独立工作解决实际问题的能力，培养学生爱岗敬业精神。通过五届毕业生的教学实践，初见成效。毕业学生能较快地适应工作，很快成为业务骨干。实习期的教育对学生思想和能力的影响是很大的。完善实习教育模式，当然还有许多路要走。     

对社区医院药师履行社会责任的思考

目的:探索社区药学服务的开展。方法:通过分析现状,阐述社区药学服务的重要意义,就提高社区药学服务水平进行一些理论上的探讨。结果与结论:以患者为中心的社区药学服务是社区药师的首要责任,社区药师必须加强学习,不断调整知识结构,在社区医疗服务中发挥其重要作用。     

Development, validation and implementation of continuous professional development programmes for community pharmacists

In India, structured continuous professional development modules are not available to update the knowledge and skills of the practicing community pharmacists. A prospective study was designed to develop, validate and implement continuous professional development modules and to assess the impact of training programme on knowledge and skills of community pharmacists. Modules were developed by referring to standard texts and data bases and were validated for the content. The impact of training programme on pharmacists' knowledge and skills was assessed using suitably designed pre and post training knowledge attitude and practice questionnaires, pre and post training questionnaires for individual continuous professional development training sessions, pre and post training patient counseling skill assessment, blood pressure measurement skill assessment and capillary blood glucose check-up skill assessment check-lists. Data was analyzed by applying suitable statistical methods using InStat version 3.01 statistical software. Fourty eight community pharmacists were enrolled in to the study. A statistically significant (P<0.05) improvement was observed in post training knowledge attitude and practice scores and in post training scores of individual training sessions. A statistically significant (P<0.05) improvement was also observed in post training scores of professional skills such as Patient counseling, capillary blood glucose recording and blood pressure measurement skills. The study findings conclude that continuous training updates the knowledge and skills in practicing the pharmaceutical care in their pharmacies.     

ERCP术后急性胰腺炎患者的药学监护

目的：通过临床药师对ERCP术后急性胰腺炎患者的药学服务,探讨临床药师如何在临床治疗中发挥作用。方法：临床药师在1例ERCP术后急性胰腺炎患者的治疗过程中,与临床医师共同制订治疗方案,监护患者用药全过程,针对患者病情变化提出合理用药建议。结果与结论：在临床药师参与下,优化了急性胰腺炎临床治疗方案,真正做到治疗个体化,取得了良好效果。     

Pharmaceutical care in a community‐based practice setting in Jordan: where are we now with our attitudes and perceived barriers?

Objectives The objective of this study was to answer the following questions. How do community pharmacists in Jordan understand pharmaceutical care? What is the extent of pharmaceutical care practice in community pharmacies in Jordan? What are the main barriers to practising pharmaceutical care in Jordan? What is the attitude of community pharmacies in Jordan when considering provision of pharmaceutical care? Method A questionnaire was hand delivered to a random sample of 310 community pharmacists. The questionnaire was composed of six different sections including patient demographics, pharmacists' understanding of pharmaceutical care, frequencies of practice of pharmaceutical care, pharmacists' general attitudes about pharmaceutical care, pharmacists' intentions to provide specific pharmaceutical care activities and barriers to providing pharmaceutical care. Frequencies, percentages, means and standard deviations were used to describe pharmacists' responses. Chi‐square and regression analysis were also conducted to identify important associations. Key findings More than 62% of respondents had a correct understanding of the basic concept of pharmaceutical care. The data show that the level of reported pharmaceutical care activities was limited. In general pharmacists have very good attitudes toward pharmaceutical care. Interestingly, more than 90% of respondents fully support the concept of pharmaceutical care. The need for pharmaceutical care training was found to be the top barrier to the provision of pharmaceutical care as indicated by more than 80% of pharmacists. Conclusions While pharmaceutical care provision is limited at this stage in Jordan, the responding pharmacists had a good understanding of pharmaceutical care. They expressed a willingness to implement pharmaceutical care practice but have identified a number of barriers to successful implementation. With the introduction of PharmD and Master of Clinical Pharmacy programmes, publication of the results of local studies on the benefit of pharmaceutical care, improved communications with physicians and modification of the current undergraduate pharmacy curriculum to include more focus on therapeutics and pharmaceutical care, many of these perceived barriers may be eliminated in the future.     

我国基层医疗机构药学服务现状及问题研究(三):药学服务开展现状分析

目的：通过调查分析了解我国基层医疗机构药学服务开展的基本情况，发现其中存在的问题并寻求改进措施。方法：以面对面访谈的形式发放调查表，对全国各地基层医疗机构开展药学服务的内容、医师药师对药学服务的态度、药学服务的需求以及患者的认可与满意度情况等进行统计、分析。结果：发药（91.1%）、患者用药咨询（90.0%）、处方审核（79.6%）和药品管理（78.7%）是基层医疗机构药师开展频率最高的药学服务工作；几乎所有的药师（98.7%）和医师（96.5%）都认为基层医疗机构需要药师提供药学服务，绝大多数医师（85.3%）会对药师的用药建议予以不同程度的采纳；大部分患者服药前会仔细阅读药品说明书（78.6%）和留意药品保质期（82.1%），约一半的患者会主动了解相关药物知识（55.6%）；患者在出现药物不良反应时咨询药师（13.7%）以及从药师处获取药物信息（11.0%）的比例偏低，接受药学服务相对不足；患者在医保报销比率（17.6%）、合理用药宣传（9.9%）和购药配药便利性（7.0%）方面的满意度相对欠缺。结论：我国基层医疗机构药学服务已有初步开展，具有一定的社会效益，但仍存在转变药师工作模式、提高药师与药学服务认可度以及满足患者更多服务需求等提升空间。     

Teaching patient-centered care to pharmacy students

The concepts of pharmaceutical care are distinctively different from the responsibilities of dispensing pharmacists and in accordance with the standards of practice of other professionals in the health care system. By taking direct responsibility for individual patient's medication-related needs, pharmacists can make unique contribution to the outcome of medication therapy and to their patients' quality of life. If the pharmacists are to contribute effectively to the new patient-centered pharmaceutical practice they must have the opportunity to acquire the new knowledge and skills required for their new role. To do this they must become life-long learners, one of the roles of the new pharmacist. Therefore, an important outcome for pharmacy education is to perform graduates capable to provide patient-centered pharmaceutical services. The purpose of this paper is to stimulate reflection on the relevance of teaching patient-centered care to pharmacy students, consistent with the practice of pharmaceutical care as a current trend in the pharmacy practice.