Views of pharmacist prescribers,doctors and patients on pharmacist prescribing implementation

Aim The aim of this study was to explore the perspectives of pharmacist supplementary prescribers, their linked independent prescribers and patients, across a range of settings, in Scotland, towards pharmacist prescribing. Method Telephone interviews were conducted with nine pharmacist prescribers, eight linked independent prescribers (doctors) and 18 patients. The setting was primary and secondary care settings in six NHS Health Board areas in Scotland. Key findings In general, all stakeholders were supportive of pharmacists as supplementary prescribers, identifying benefits for patients and the wider health care team. Although patients raised no concerns, they had little idea of what to expect on their first visit, leading initially to feelings of apprehension. Pharmacists and doctors voiced concerns around a potential lack of continued funding, inadequate support networks and continuing professional development. Pharmacists were keen to undertake independent prescribing, although doctors were less supportive, citing issues around inadequate clinical examination skills. Conclusions Pharmacists, doctors and patients were all supportive of developments in pharmacist supplementary prescribing, although doctors raised concerns around independent prescribing by pharmacists. The ability of pharmacists to demonstrate competence, to be aware of levels of competence and to identify learning needs requires further exploration.     

Exploring pharmacists' perceptions of the feasibility and value of pharmacist prescribing of antimicrobials in secondary care in Scotland

Objectives The introduction of non‐medical prescribing in the UK has provided opportunities and challenges for pharmacists to help ensure prudent use of antimicrobials. The objective of this research was to explore pharmacists' perceptions of the feasibility and value of pharmacist prescribing of antimicrobials in secondary care in Scotland. Methods Pharmacists' perceptions were explored using focus groups in five Scottish regions representing (a) urban and rural areas and (b) district general hospitals and large teaching centres. Senior hospital pharmacists, both prescribers and non‐prescribers, working in specialities where antimicrobials are crucial to patient management, were invited to participate. A topic guide was developed to lead the discussions, which were audio‐recorded and transcribed. The framework approach to data analysis was used. Key findings Six focus groups took place and some emerging themes and issues are presented. Pharmacists believed that the feasibility of antimicrobial prescribing is dependent upon the patient's clinical condition and the area of clinical care. They identified potential roles and opportunities for pharmacist prescribing of antimicrobials. Perceived benefits included giving patients quicker access to medicines, reducing risk of resistance and better application of evidence‐based medicine. Conclusions Pharmacists feel they have a good knowledge base to prescribe and manage antimicrobial treatment, identifying possible opportunities for intervention. Roles within a multidisciplinary antimicrobial team need to be clearly defined.     

Educating nonmedical prescribers

The last decade has seen developments in nonmedical prescribing, with the introduction of prescribing rights for healthcare professionals. In this article, we focus on the education, training and practice of nonmedical prescribers in the UK. There are around 20 000 nurse independent prescribers, 2400 pharmacist supplementary/independent prescribers, several hundred allied health professional supplementary prescribers and almost 100 optometrist supplementary/independent prescribers. Many are active prescribers, managing chronic conditions or acute episodes of infections and minor ailments. Key aims of nonmedical prescribing are as follows: to improve patient care; to increase patient choice in accessing medicines; and to make better use of the skills of health professionals. Education and training are provided by higher education institutions accredited by UK professional bodies/regulators,namely, the Nursing and Midwifery Council, General Pharmaceutical Council, Health Professions Council and General Optical Council. The programme comprises two main components: a university component equivalent to 26 days full-time education and a period of learning in practice of 12 days minimum under the supervision of a designated medical practitioner. Course content focuses on the following factors: consultation, decision making, assessment and review; psychology of prescribing; prescribing in team context; applied therapeutics; evidence-based practice and clinical governance; legal, policy, professional and ethical aspects; and prescribing in the public health context. Nonmedical prescribers must practise within their competence, demonstrating continuing professional development to maintain the quality engendered during training. Despite the substantial progress, there are several issues of strategy, capacity, sustainability and a research evidence base which require attention to fully integrate nonmedical prescribing within healthcare.     

新西兰处方药师培训体系对我国的启示

目的:通过介绍新西兰药师处方权发展及处方药师培训体系构建情况,为探索我国处方药师培训体系提供建议.方法:检索相关文献,通过比较研究法,将新西兰同我国的处方模式和相关培训设置进行对比.结果:目前我国药师的药物治疗水平普遍不足,且缺乏对处方药师核心能力的培养.结论:我国可借鉴新西兰的经验,通过改善本科教育结构,提高处方药师...     

加强临床药师培训基地建设与提升临床药师培训质量

目的在临床药师培训基地试点工作的基础上,通过岗位培训模式培养具有参与临床药物治疗能力的临床药师。方法调动医院药学界的积极性,开展临床药师培训基地建设,制定临床药师培训基地认定管理规定,明确遴选临床药师培训基地的基本条件。结果通过多次各医院申报、专家评审,建立了150余家临床药师培训基地和13家带教临床药师师资培训基地,培养了一批临床药师和带教师资。结论实践证明在有条件的三级医院建立临床药师培训基地,通过岗位培训模式培养应用型药学专业人才的办法是可行的。     

湖北省494家医疗机构临床药学发展及临床药师培训现状调研

目的:调查湖北省各级医疗机构中临床药学发展及临床药师培养现状.方法:基于湖北省临床药师培训管理中心平台,由湖北省卫生健康委员会向全省各市、州及部省属医疗机构下发调查问卷,内容包括医院基本信息及情况、药学部门情况、专职临床药师情况、师资带教药师情况及临床药学工作情况.结果:共收到全省494家医疗机构有效调查问卷,其中三级...     

‘It's showed me the skills that he has’: pharmacists' and mentors' views on pharmacist supplementary prescribing

Objectives Supplementary prescribing has seen pharmacists assume greater responsibility for prescribing in collaboration with doctors. This study explored the context and experiences, in relation to the practice of supplementary prescribing, of pharmacists and physicians (who acted as their training mentors) at least 12 months after pharmacists had qualified as supplementary prescribers. Methods The setting was primary and secondary healthcare sectors in Northern Ireland. Pharmacists and mentors who had participated in a pre‐training study were invited to take part. All pharmacists (n= 47) were invited to participate in focus groups, while mentors (n= 35) were asked to participate in face‐to‐face semi‐structured interviews. The research took place between May 2005 and September 2007. All discussions and interviews were audiotaped, transcribed and analysed using constant comparison. Key findings Nine pharmacist focus groups were convened (number per group ranging from three to six; total n= 40) and 31 semi‐structured interviews with mentors were conducted. The six main themes that emerged were optimal practice setting, professional progression for prescribing pharmacists, outcomes for prescribing pharmacists, mentors and patients, relationships, barriers to implementation and the future of pharmacist prescribing. Where practised, pharmacist prescribing had been accepted, worked best for chronic disease management, was perceived to have reduced doctors' workload and improved continuity of care for patients. However, three‐quarters of pharmacists qualified to practise as supplementary prescribers were not actively prescribing, largely due to logistical and organisational barriers rather than inter‐professional tensions. Independent prescribing was seen as contentious by mentors, particularly because of the diagnostic element. Conclusions Supplementary prescribing has been successful where it has been implemented but a number of barriers remain which are preventing the wider acceptance of this practice innovation.     

PBL和CBL教学法在糖尿病专科药师培养模式中的应用

目的:使用以问题/以病例为导向的教学方法(PBL/CBL)教学法培养糖尿病专科药师(DSP);并探讨该教学法在培训中的效果。方法:以DSP组学员为试验组(DSP组),设计糖尿病临床药学PBL/CBL教学课程,并进行3个月的培训。根据卫计委临床药师培训基地培训标准,以内分泌专业和通科专业的临床药师学员为对照组(临床药师组);使用内分泌专业糖尿病理论考试,结合使用标准化病人模拟案例考核和知识技能雷达图评价两组学习效果的差异。结果:DSP组总共完成了25次培训课程,包含203个PBL和110例次CBL教学;临床药师组经过52学时基础/专业课和521个学时临床实践,完成了125例次的临床实践。前后考试考核对照,DSP组理论考试达标率40%,平均成绩从32.4分提升至56.85分,成绩增幅75.46%。临床药师组理论考试达标率为20%,平均成绩仅从41.8分提升至59.9分,增幅为43.30%。结论:DSP组学员在相对更少的时间内的培训效果高于对照组,在培训主动性、成绩提高率、时间成本效益比和经济成本效益比等方面具有明显的优势。PBL/CBL培训相比于传统培训模式具有快速、高效、针对性强的特点,适用于住院药师规范化培训和专科临床药师培养,对药师临床药学知识技能培养和训练具有明确的实用价值。     

我国临床药师培训试点情况调查与分析(英文)

通过对626份问卷的统计分析,对临床药师培训试点工作开展3年以来的培训工作状况进行调研,发现基地医院、学员和派出单位对培训成果评价均很高,其中,评价最高的是基地医院,可以说是培训的最大获益者。在对基地医院和学员进行的培训形式的重要性排序中,基地医院认为最重要的培训方式和学员认为最有收获的培训方式有所不同,学员更倾向于主动性、实践性、参与性更强的培训方式,更希望能从查房过程中学习,基地医院更倾向讨论和教授知识形式的培训形式。因此建议增加符合条件的培训基地量,效仿美国实行一对一的住院药师培训导师制,增加培训内容中的主动学习内容。本研究结果对我国更有影响、效率更高的临床药师培训体系的建立有一定的帮助。     

临床药师"三段式"在职培养模式

本文介绍了专科化临床药师在职培训中“三段式”模式的组成、内容、实施方法及实际应用效果。“三段式”模式即按照临床实践为主、理论教学为辅的基本原则．由医药老师联合带教，通过药学准备、临床实践和拓展提高三个递进阶段不同内容和形式的培训．使具有一定学历和专业工作基础的医院药师初步具备胜任专科临床药师基本工作的素质，能够在特定临床专科开展药师参与临床药物治疗工作。     

Community pharmacy and the extended community pharmacist practice roles: The UAE experiences

Background: The pharmaceutical care and ‘extended’ roles are still not practiced optimally by community pharmacists. Several studies have discussed the practice of community pharmacy in the UAE and have shown that most community pharmacists only counsel patients. However, UAE, has taken initiatives to allow and prepare community pharmacists to practice ‘extended’ roles. Aim of the review: The aim was to review the current roles of community pharmacists in Abu Dhabi Emirate, United Arab Emirates (UAE). Objective: The objective was to encourage community pharmacists toward extending their practice roles. Methods: In 2010, Health Authority Abu Dhabi (HAAD) surveyed community pharmacists, using an online questionnaire, on their preferences toward extending their counseling roles and their opinion of the greatest challenge facing the extension of their counseling roles. Results: Following this survey, several programs have been developed to prepare community pharmacists to undertake these extended counseling roles. In addition to that, HAAD redefined the scope of pharmacist roles to include some extended/enhanced roles. Abu Dhabi Health Services (SEHA) mission is to ensure reliable excellence in healthcare. It has put clear plans to achieve this; these include increasing focus on public health matters, developing and monitoring evidence-based clinical policies, training health professionals to comply with international standards to deliver world-class quality care, among others. Prior to making further plans to extend community pharmacists’ roles, and to ensure the success of these plans, it is imperative to establish the views of community pharmacists in Abu Dhabi on practicing extended roles and to gain understanding and information on what pharmacists see as preferred change strategies or facilitators to change. Conclusions: In an attempt to adapt to the changes occurring and to the growing needs of patients and to maximize the utilization of community pharmacists’ unique structured strategies are needed to be introduced to the community pharmacy profession.     

基于柯氏评估模型的药师培训效果评价指标体系构建

目的 构建我国药师培训效果评价指标体系。方法 通过文献研究法和专家访谈法构建基于Kirkpatrick评估模型的指标体系初始框架,运用Delphi法确定指标体系。结果 研究构建的我国药师培训效果评价指标体系,包括反应评估、学习评估、行为评估和过程评估4个一级指标,培训方案、师资队伍、培训条件、理论知识、实践技能、工作能力变化、职业态度变化、个人收益和组织收益9个二级指标,以及药学专业知识等32个三级指标。结论 药师培训效果评价指标体系对培训活动进行全过程及跟踪评价,具有较高的科学性和系统性,能为药师培训效果评价方案设计、药师培训方案持续改进提供参考。     

应用态势分析法创建全医嘱审核药师培训体系的实践

目的:建立规范化全医嘱审核培训体系,提升药师全医嘱审核服务质量,促进临床合理用药.方法:运用态势分析法(SWOT),制定全医嘱审核药师培训工作策略,建立三阶梯分层次由简入难的全医嘱审核药师培训考核模式.结果:全医嘱审核药师培训形成制式流程,各层次全医嘱审核药师人数增长明显,医嘱审核服务能力提升明显,其中不合理医嘱较去年...