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我国DTP药房肿瘤药学服务能力现状调研
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| 篇名： | 我国DTP药房肿瘤药学服务能力现状调研 |
| TITLE： | Status Investigation on Antitumor Pharmaceutical Care Ability of DTP Pharmacy in China |
| 摘要： | 目的：调研我国直销患者（DTP）药房的肿瘤药学服务能力与工作现状，为构建以药学服务为核心的DTP药房质量评价体系提供参考。方法：于2019年9－12月期间，以电子问卷的形式调查我国全部126家挂牌DTP药房从事肿瘤相关工作的药师的背景、专业知识来源、药学服务能力（包括审方与调配、用药咨询与指导、药物治疗管理、随访等方面）、抗肿瘤药物药学专业知识等情况；对126家挂牌的DTP药房进行现场检查，对其药学服务管理现状进行评价，并结合问卷调查结果描述现场检查印象，评价我国DTP药房肿瘤药学服务能力现状并提出相应建议。结果：共发放问卷400份，回收有效问卷392份，有效回收率为98.0％。DTP药房药师主要集中在华东地区，以江西（73人，18.62％）、安徽（68人，17.35％）为主；学历主要为大专及以下（229人，58.42％），其次是本科（158人，40.31％）；工作年限主要为＞5年（241人，61.48％）；专业方向以药剂学为最多（123人，31.38％），药学（含药理学）次之（81人，20.66％）。DTP药房药师常规知识来源包括培训课程的学习资料（302人次，77.04％）、教科书（250人次，63.78％）和微信推送（206人次，52.55％），前沿知识来源包括培训课程（347人次，88.52％）、微信推送（211人次，56.38％）和参加学术会议（162人次，41.33％）；其期望的培训方式包括网络视频课程（344人次，87.76％）和线下课程（248人次，63.27％）。在审方与调配方面，主要存在医疗文书及资料尚未完全到位等问题，分别有82.91％、64.54％的药师审方时需要常规病历本、出院小结，91.58％的药师以医师手写处方作为调配新型抗肿瘤药物的依据。药师在进行用药咨询与指导方面对过敏史、遗传史、不良反应关注较少，认为药物治疗管理过程中的难点包括监测患者不良反应（239人次，60.97％）、评估用药的合理性（222人次，56.63％）、形成完整的用药记录（219人次，55.87％）；药师期望的随访形式主要以电话（334人次，85.20％）、配药现场（313人次，79.85％）为主，且333位（84.95％）药师认为需要实行配药预约制。药师的抗肿瘤药学专业知识考核得分率为40.56％～84.69％。在药学服务管理方面，扣分以用药评估、药物治疗管理的内容及流程、用药随访及记录为主，扣分比例分别为93％、86％、64％。现场检查发现，药师工作知识来源单一、对药物不良反应分级标准等评估表的内容掌握不完全、审方不符合要求等问题较突出。结论：我国DTP药房在相关政策的引导下发展迅速，但其药学服务尚停留在基础阶段，与为患者提供全程化的药学服务的要求有较大差距。有必要提高DTP药房药师的专业服务能力，并建立相应的药房质量评价体系，从药师个人和监督管理层面不断提升DTP药房的药学服务质量。 |
| ABSTRACT： | OBJECTIVE：To investigate antitumor pharmaceutical care ability a nd the current status of direct to patient （DTP） pharmacy in China ，and to provide reference for building a quality evaluation system of DTP pharmacy which focuses on the pharmaceutical care. METHODS ：From Sept. to Dec. 2019， an electronic questionnaire survey was conducted amongpharmacists of all of 126 listed DTP pharmacies and involved wang_star@163.com education background ，professional knowledge sources andpharmaceutical care ability （such as prescription checking and E-mail：dujoan-88@163.com dispensing，medication consultation and guidance ，medication management，follow-up），pharmaceutical knowledge of antitumor medicine ，etc. DTP pharmacies in C hina were inspected on site ， and their pharmaceutical care management were evaluated ，and impression of on-site inspection were discribed with questionnaire survey. The current situation of oncology pharmaceutical care ability of DTP pharmacy in China was evaluated and corresponding suggestions were put forward. RESULTS ：A total of 400 questionnaires were sent out ，and 392 valid questionnaires were collected with recovery rate of 98.0％. The cancer pharmacists in DTP pharmacy were mainly from East China ，mainly in Jiangxi （73 persons，18.62％），Anhui（68 persons，17.35％）. The pharmacists were mainly junior college or below （229 persons，58.42％）， followed by undergraduate （158 persons，40.31％）. The working years were more than 5 years（241 persons，61.48％）. The majors were mostly pharmaceutics （123 persons，31.38％），followed by pharmacy （including pharmacology ）（81 persons， 20.66％）. The regular knowledge sources of pharmacists in DTP pharmacy included learning materials （302 person times ， 77.04％），textbooks（250 person times ，63.78％）and Wechat push （206 person times ，52.55％）；the latest knowledge sources included training courses （347 person times ，88.52％），Wechat push （211 person times ，56.38％）and academic conferences （162 person times ，41.33％）. The expected training methods included online video courses （344 person times ，87.76％）and offline courses（248 person times ，63.27％）. In terms of prescription checking and dispensing ，there were mainly problems such as incomplete medical documents and materials ；82.91％ and 64.54％ of pharmacists needed routine medical records and discharge summary，and 91.58％ of pharmacists took the doctor ’s handwritten prescription as the basis for dispensing new anti-tumor drugs ； pharmacists paid less attention to allergy history ，genetic history and ADR in the field of drug consultation and guidance. According to DTP pharmacists ，the difficulties in the process of drug treatment management included patient ’s ADR monitoring （239 person times，60.97％），evaluating the rationality of drug use （222 person times ，56.63％），making a complete drug use record （219 person times ，55.87％）. The main follow-up visits of pharmacists were telephone （334 person times ，85.20％）and dispensing site （313 person times ，79.85％）. And 333 pharmacists（84.95％）thought it was necessary to make an appointment for dispensing ；the score rates of professional knowledge examination of antitumor pharmacy for the respondents were 40.56％-84.69％. In the aspect of pharmaceutical care management ，the main points of deduction were drug evaluation ，content and process of drug treatment management，drug follow-up and record ，and the proportion of deduction was 93％，86％ and 64％ respectively. In the on-site inspection，it was found that the pharmacist had a single source of working knowledge ，did not fully grasp the contents of the evaluation forms such as ADR classification standard ，and prescription checking did not meet the requirements. CONCLUSIONS ： DTP pharmacy in China develops rapidly under the guidance of relevant policies ，but its pharmaceutical care is still in the basic stage，which is far behind the requirements of providing whole-course pharmaceutical care for patients. It is necessary to improve the professional service ability of DTP pharma |
| 期刊： | 2020年第31卷第09期 |
| 作者： | 王喆元，罗鑫，叶真，叶璇，余波，翟青，杜琼 |
| AUTHORS： | WANG Zheyuan ，LUO Xin，YE Zhen，YE Xuan，YU Bo，ZHAI Qing，DU Qiong |
| 关键字： | 直销患者药房；调查问卷；现场验收；药学服务能力 |
| KEYWORDS： | DTP pharmacy ；Questionnaire；On-site inspection ；Pharmaceutical care ability |
| 阅读数： | 826 次 |
| 本月下载数： | 49 次 |
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