The theory of Rational Addiction

The Theory of Rational Addictions, by Gary Becker & Kevin Murphy (1988), was a rational choice model that became a standard tool for economists modeling addictive behavior. The approach differs from other theories of addiction by modeling addictive behavior as the gradual implementation of a rational, forward‐looking plan, where consumption at any point in time is partly motivated by the immediate payoff of consumption and partly by the effects this consumption has on the individual in the future. This makes addictive behavior a subset of rational behavior, requiring no more specific government policies or attention than any other consumption choice. Later work by economists extended the theory in different ways, allowing it to match an increasing number of consumption patterns, and searched for ways to test the forward‐looking assumption in different types of market data. While the work was successful as a contribution to rational choice theory, with possible statistical applications, there are several reasons to dismiss its usefulness as an explanation of real‐world addictive behavior and its ability to assess the welfare effects of addictions.     

1040例在院病人抗生素一日使用调查报告

目的了解住院病人抗生素使用情况。方法采用横断面调查的方法时我院2005年7月27日所有住院病人抗生素使用情况进行调查。结果抗生素日使用率为34．81％（304／1040），治疗用抗生素占39．67％（144／363），预防用占16．25％（59／363），治疗＋预防占44．08％（160／363），抗生素单用和二联占95．04％（344／363），三联及以上者4．96％（18／363），抗生素日使用种类47种，病原体送检率7．57％（23／304）。结论我院抗生素日使用率不高，抗生素联合使用总体较好，但仍有病原送检率低、抗生素使用品种多、起点高、部分囤术期抗生素预防用药的时机不合理等现象，建议加强宣传教育力度，提高监测速度和指导医师合理用药。     

重视药物利用评价研究,开展药物利用评价活动

药物利用评价是当前医院合理用药的深入发展的重要体现,也是临床药学的重要工作之一。本文论述了药物利用评价的目的、意义、方法和进展,以及药物利用评价在医院药房中的应用,以期引起有关人员的重视。     

门诊抗菌药物使用调查

目的了解医院门诊抗菌药物应用情况，为临床合理应用抗菌药物提供依据。方法抽查2006年1月至11月份门诊处方18163张，统计抗菌药物使用情况，并评价其合理性。结果含抗菌药物处方5809张，占总处方数31．98％。头孢菌素类药物使用率最高，其次为喹诺酮类。给药途径主要为口服给药。结论抗菌药物应用基本合理，但使用中存在一些问题，应引起重视。     

重视合理用药 提高药物疗效

目的:提高合理用药的意识,促进临床用药向安全、合理、高效、经济的目标发展。方法:结合临床实际,对用药的过程和结果进行分析讨论。结果:通过用药现状分析,证明不合理用药现象广泛存在。结论:合理用药应引起高度重视,以减少药物不良反应的发生,发挥药物的最佳疗效。     

Relational continuity of care in community pharmacy: A systematic review

Relational continuity of care (COC) is becoming an important concept related to improving healthcare quality, reducing medical costs and increasing patient satisfaction with primary care. While community pharmacy (CP) has a considerable role in primary care, there are few reports dedicated to the role of relational COC in CP. This study reviewed the existing evidence of relational COC in CP and its effect on patients. PubMed, Embase, CINAHL, Cochrane Library CENTRAL and Google Scholar were used to search for relevant studies from the date of database inception through to January 2021, which were appraised according to eligibility criteria. There were no limitations on the primary outcome or language. Case reports and studies without control groups were excluded. The Newcastle–Ottawa quality assessment scale was used to assess the quality of the studies. Database searches identified 13 records. Relational COC measures in the included studies were grouped in three kinds; pharmacy-visiting pattern, Continuity of Care Index and loyalty. The assessed outcomes were medication adherence behaviour (e.g., the proportion of days covered, medication possession ratio), adverse drug reactions, potentially inappropriate drug prescribing and clinical outcomes. The odds of patients adhering to their medication regimen were about 1.1~2.5 times higher among those who consistently visited a single pharmacy compared to patients visiting multiple pharmacies. Additionally, the care provision with a high level of relational continuity could lower inappropriate drug use by 21~32 per cent and the use of other costly services by 12~29 per cent. This study suggests that a high degree of relational COC in CP could improve safe use of medications among patients. Future research is needed to employ more rigorous methods to reduce heterogeneity and to measure effects on clinical outcomes.     

中药肾毒性成分及其毒性机制研究进展

近年来,随着我国医药产业的稳步发展,中药作为补充和替代医学制剂在世界各地赢得了认可和信赖。然而,随着对中药的广泛应用和深入研究,中药的肾脏毒性引发了国内外学者的广泛关注。为保障中药临床应用的安全性,有必要深入研究并整理中药肾毒性成分及其毒性机制。在查阅近30年国内外常见中药肾毒性相关文献的基础上,对中药肾毒性成分及其毒性机制进行了总结与分析,以期为中药肾毒性深入研究提供思路,为中药安全合理应用提供参考。     

600例儿童青少年药品不良反应报告分析

目的 研究某区域儿童药品不良反应(adverse drug reaction,ADR)的发生规律和特点,为预防儿童药品不良反应和保障儿童安全用药提供参考。方法 收集2017年1月—2018年4月南京市鼓楼区市场监督管理局上报国家药品不良反应监测系统所有儿童不良反应报告,共计600例,按照患者性别、年龄、给药途径、药品种类,涉及的器官或系统及其临床表现等进行统计分析。结果 600例不良反应报告中,男女比例为1.48:1;ADR发生年龄段主要在学龄期(160例)和学龄前期(152例);共涉及药品 150 种,其中抗感染药是引发ADR最主要药品种类,共221例,占36.83%;引发ADR主要途径为静脉给药,共486例,占81.00%;ADR的主要临床表现为皮肤及其附件损害,占41.60%。其次是消化系统损害,占19.97%。结论 应加强3～12岁儿童临床用药安全,在静脉用药和抗感染药物的头孢菌素的使用中警惕ADR的发生。     

住院病人抗生素的合理使用回顾与前瞻

本文报告我院抗生素的用药情况,发现抗生素使用面广,应用中存在问题较多,因此,我们采用“药历表”调查病历中抗生素的使用情况,并在提倡“围术期”预防用抗生素等方面做了一些工作。随机抽查1988年7月～1990年4月已出院病历710份,对使用过抗生素的病历进行了回顾性调查,发现抗生素使用率达到85％左右。前瞻性检查方式:参加对严重感染或混合感染病人的会诊用药,并追踪观察抗生素的使用效果;实地检查抗生素所用溶媒、给药间隔、给药方法、配伍变化及联合用药,并对其安全性、合理性进行了讲评,逐步改变目前带普遍性不合理使用的现象和预防性使用抗生素是否合理的问题。     

围手术期抗菌药物应用的调查分析

目的：了解苏州第四人民医院外科手术病人抗菌药物应用的现状及合理性。方法：根据事先设计好的调查表，按统一方法、统一标准和统一内容对10个科室的575例手术病人的出院病历作回顾性调查。结果：外科出院手术病人抗菌药物总使用率92．52％，预防性应用率56．77％。头孢菌素类药物使用频率最高，其次为氟喹诺酮类、硝咪唑类，三共占71．69％。结论：加强抗菌药物应用的管理，执行规范的围手术期抗菌药物的使用原则非常重要。