摘要
背景老年人多患有两种以上的慢性病,存在多重用药的问题。社区卫生服务机构是保障患者合理用药的关键,在目前社区药学服务存在诸多问题情况下,如何更好地利用现有资源提升社区药学服务水平有待探索。目的了解上海市社区药学服务的现况,为改善社区药学服务提供参考。方法课题组前期通过文献积累和现场走访,研制了“社区药学人员调查问卷”和“老年人合理用药”项目访谈提纲。于2020年9—12月,采用分阶段抽样法从上海市抽取235例药学人员参与问卷调查;2020年11月,邀请每所机构社区药学人员、全科医生和社区管理人员各1例,以及各区卫生健康委员会分管人员2~3例,共计82例,参加焦点小组访谈。本研究从中提取出涉及社区药学服务资源配置、社区药学服务开展及管理等方面访谈内容,作为定量研究的补充。结果235例被调查社区药学人员中,分别有221例(94.0%)、194例(82.6%)、151例(64.3%)和122例(51.9%)开展处方调剂、处方审核、药学窗口或门诊咨询指导、处方点评服务;各个服务项目的平均综合得分排序前两位者为处方调剂和处方审核(提示此两项占据了社区药学人员较多的工作时长);开展方式上,分别有226例(96.2%)、119例(50.6%)和109例(46.4%)药学人员开展服务的方式为咨询窗口、药学门诊和宣传讲座。235例被调查社区药学人员中,53例(22.6%)参加家庭医生团队,其中22例(41.5%)拥有临床药师资格;53例参加家庭医生团队的社区药学人员中,分别有47例(88.7%)和45例(84.9%)提供合理用药宣教服务和患者的用药指导与咨询服务。235例被调查社区药学人员中,55例(23.4%)过去1年内未参加过培训,180例(76.6%)参加过培训;参加培训药学人员中,105例(58.3%)培训次数为1~2次,155例(86.1%)培训方式为继续教育。问卷调查和座谈结果均显示,配发药与处方审核等工作量大、临床知识缺乏�
Background Most of the elderly are prone to more than two chronic diseases and polypharmacy.Community health institutions are the key to ensuring rational drug use for in this population.Given many problems existing in the delivery of community pharmaceutical services,how to make better use of existing resources to improve the level of community pharmaceutical services remains to be further explored.Objective To understand the status of community pharmaceutical services implemented in Shanghai,providing a reference for improving community pharmaceutical services.Methods We conducted a survey in Shanghai with 235 pharmaceutical professionals selected by use of phased sampling from September to December 2020 with a questionnaire named as"Community Pharmacists Questionnaire"developed by us based on the results of previous literature review and on-site visits.In November 2020,we conducted a focus group interview with 82 stakeholders(including one pharmaceutical professional,one general practitioner and one community administrator selected from each community,two or three administrators selected from the health commission of each district)in Shanghai guided by an outline named as"Rational Drug Use for the Elderly"developed by us based on the results of previous literature review and on-site visits.The allocation of community pharmaceutical care resources,implementation and management of community pharmaceutical care involved in the interview were extracted as supplements to the survey results.Results Among the 235 community pharmacists surveyed,the prevalence of providing prescription dispensing,prescription review,pharmaceutical drive-thru window services or outpatient consultation and guidance,and prescription comment services was 94.0%(221/235),82.6%(194/235),64.3%(151/235),and 51.9%(122/235),respectively.Among these services,prescription dispensing and prescription review were ranked as the top two in terms of average comprehensive score,indicating that implementing these two services required longer working hours
作者
乔曼华
吴文辉
刘真伟
陈睦涵
王草
唐琪
吕军
陈刚
QIAO Manhua;WU Wenhui;LIU Zhenwei;CHEN Muhan;WANG Cao;TANG Qi;LYU Jun;CHEN Gang(School of Public Health,Fudan University,Shanghai 200032,China;China Research Center on Disability Issues,Fudan University,Shanghai 200032,China;Pharmaceutical Administration Office of Shanghai Municipal Health Commission,Shanghai 200125,China;National Health Commission Key Laboratory of Health Technology Assessment(Fudan University),Shanghai 200032,China)
出处
《中国全科医学》
CAS
北大核心
2022年第28期3562-3568,共7页
Chinese General Practice
基金
国家社会科学基金重大项目(17ZDA078)
国家自然科学基金青年项目(72004030)
上海市卫生健康委员会政策研究课题(2020HP21)
上海市合理用药管理策略研究(SHWJWYZC002)。
关键词
社区卫生服务
药学服务
家庭医生团队
上海
Community health services
Pharmaceutical services
Family doctor team
Shanghai
