Working Mode and Case Analysis of the First Pharmaceutical Ward Rounds in Our Hospital / 中国药房

OBJECTIVE：To est ablish the working mode of the first pharmaceutical ward rounds of clinical pharmacists in our hospital，in order to provide a useful reference for establishing a national standardized pharmaceutical ward rounds model. METHODS：By sharing the clinical cases of the first pharmaceutical ward rounds ，the work content and process of the first pharmaceutical ward rounds in our hospital were introduced. RESULTS & CONCLUSIONS ：The clinical pharmacist ’s first pharmaceutical ward round in our hospital mainly includes self introduction of clinical pharmacists ，diagnosis of patients ’condition under the guidance of doctors ，collection and evaluation of patients ’previous medication information （including previous medication varieties ，usage methods ，efficacy and safety evaluation ），assistance for doctors in formulating initial treatment plan ， carrying out initial medication and diet education ，and intensive communication and cooperation with nurses. The development of first pharmaceutical ward rounds promotes the rational use of drugs in clinic ，elevates the hospitalization satisfaction of patients and improves the professional quality of clinical pharmacists.

Literature Analysis for Clinical Application and Existing Problems of 2 Medical Order Auditing Modes / 中国药房

OBJECTIVE：To summari ze clinical application and existing problems of artificial auditing and information-based medical order auditing modes so as to provide reference for improving rational medication. METHODS ：Collecting data by literature search ，using “Prescription auditing ”“Medical order auditing ”“Prescription pre-auditing ”“Medication error ” “Medication-related problems ”“Medication safety ”“Alert fatigue ”“Medication review ”“Decision support medication review ” “Real-time medication review ”“Real-time prescription surveillance ”“Clinical alarms decision support systems ”“Clinical pharmacy information systems ”“Medication errors ”“Medication related problem ”as keywords ，the related literatures from Jan. 2000 to Nov. 2019 were retrieved from CNKI ，Wanfang database ，PubMed，Embase，Web of Science and other databases. The clinical application and existing problems of 2 medical order auditing modes were analyzed and summarized. RESULTS & CONCLUSIONS：The artificial auditing mode can reduce medication-related problems （such as poor drug treatment effect ， untreated symptoms or indications ，potential adverse drug events ，unnecessary drug treatment ，etc.），improve life quality of patients，but can not decrease the mortality and the length of hospitalization stay ；there are some problems ，such as many pharmacists needed for medical order auditing ，insufficient auditing time ，different auditing standards ，auditing time lagging. The information-based medical order auditing mode can reduce medication-related problems ，save auditing time ，reduce the incidence of medication errors ，reduce unreasonable medical orders ，and improve audit efficiency. Compared with the artificial auditing mode ，it has certain advantages ，but there are problems such as alarm fatigue. At present ，the domestic medical order auditing mode is dominated by artificial audit mode ；the information-based medical order auditing mode is still in the initial stage ，and the most attention is paid to its influence on the qualified rate of prescription ，while the research on the incidence of adverse events and other clinical effects is less. Later ，the 2 midical order can be D181100000218002）； improve to provide a reference for medical order auditing of 2019 hospital pharmacy personnel.

Construction of teaching faculty of clinical pharmacology based on multi-style collective lesson preparation model / 中华医学教育探索杂志

A multi-style collective lesson preparation model was designed and implemented after analyzing the current status of teaching faculty in the teaching and research section of clinical pharmacology,which includes hierarchical collective lesson preparation and exploration of WeChat collective lesson preparation; enrichment of the lesson-preparation content, bringing teaching skills, teaching strategies, courseware design and motivation of students' interest into collective lesson preparation. After carrying out this model, the construction of teaching faculty has been strengthened and the improvement of young teachers has been accelerated. At the same time, the procedures of collective lesson preparation should be made clearer and teachers' performance evaluation should include the assessment result of implementing this model so as to standardize the multi-style collective lesson preparation model.

Construction of teaching faculty of clinical pharmacology based on multi-style collective lesson preparation model / 中华医学教育探索杂志

A multi-style collective lesson preparation model was designed and implemented after analyzing the current status of teaching faculty in the teaching and research section of clinical pharmacology,which includes hierarchical collective lesson preparation and exploration of WeChat collective lesson preparation; enrichment of the lesson-preparation content,bringing teaching skills,teaching strategies,courseware design and motivation of students' interest into collective lesson preparation.After carrying out this model,the construction of teaching faculty has been strengthened and the improvement of young teachers has been accelerated.At the same time,the procedures of collective lesson preparation should be made clearer and teachers' performance evaluation should include the assessment result of implementing this model so as to standardize the multi-style collective lesson preparation model.

Determination of Donepezil and Rivastigmine in Human Serum by High-performance Liquid Chromatogra-phy Combined with Mass Spectrum / 中国药师

Objective: To develop an LC-MS/MS method for the determination of donepezil and rivastigmine in human serum. Methods: After protein precipitation with 600μl acetonitrile, the serum samples were analyzed by LC-MS/MS. Using loratadine as the internal standard, a Waters Xselect CSH C18(150 mm×3 mm, 2. 5 μm) column was used with the mobile phase consisting of water (containing 10 mmol·L-1ammonium acetate)-acetonitrile(20 ∶ 80)at a flow rate of 0. 4 ml·min-1with the column temperature at 40 ℃. The ion transitions were performed in a positive electrospray ionization multiple reaction-monitoring mode regarding [M+H] +as the molecular ion peak of donepezil and rivastigmine monitored with m/z 380. 1→m/z 91. 1 and m/z 251→m/z 206. 5, respectively. The internal standard was monitored with m/z 383. 1→m/z 337. 1. Results: The linear range of donepezil and rivastigmine was 0. 5-400 ng·ml-1(r>0. 99) and the lowest quantification limit was 0. 5 ng·ml-1. For donepezil, the intra-day and inter-day RSD was 2. 06% to 12. 51% , the relative error was -6. 60% to 4. 20% , and the relative recovery was ranged from 80. 76% to 96. 17% (RSD<15% ). For rivastigmine, the intra-day and inter-day RSD was 1. 69% to 9. 31% , the relative error was -5. 58% to 5. 20% , and the mean relative recovery was ranged from 96. 69% to 100. 15% (RSD<15% ). For the two compounds, the serum samples were stable at -40℃ for 75 d and kept stable after three repeated freeze-thaw cycles. The prepared samples were stable in the automatic sample injector (4℃) for 5 h (RSD<15% ). Conclusion: The developed assay method can be applied in the therapeutic monitoring and pharmacokinetic study of donepezil and rivastigmine in human serum.

Current Situation on Medication Therapy Management at Home and Abroad / 中国药房

OBJECTIVE: To investigate the current situation of domestic and overseas medication therapy management (MTM) and the value of pharmacists in this service, to provide new ideas for the development of pharmaceutical care in China.METHODS: By viewing related literatures about MTM at home and abroad, the development background, related concepts, core elements, work pattern, implementation and research status at abroad and development situation at home were reviewed. RESULTS & CONCLUSIONS: MTM is a service strategy that evolves from the practice of pharmaceutical care. It includes five core elements and is mainly provided by pharmacists either face-to-face or using telephone for patients who have chronic disease, use multiple medications and with excessive drug costs. Foreign MTM service is well developed and extensive studies have demonstrated its clinical, economy and cultural effects. Chinese government attaches great importance to the chronic disease management in old patients, which used to be administered mainly by doctors and nurses. And pharmacists' pharmaceutical care has gradually increased in the past five years. Currently there are a lot of reviews on MTM at home but the practical contents have just started and the empirical studies on the effectiveness evaluation are lacking. Pharmaceutical care model of chronic disease management in China can be explored and carried out learning from foreign MTM model.

Construction of the teaching case library on clinical pharmacy for pharmacy residents / 中华医学教育探索杂志

A teaching case library of clinical pharmacy was constructed to improve case teaching for pharmacy residents. Through establishment of draft requirement and organizing a group of authors consti-tuted by preceptors of pharmacy residents, the teaching cases were written, the contents and forms of which were assessed by teaching demonstration, interactively examined and revised by fellow teachers, audited and screened by senior pharmacists , and thus a case library was collaborated , processed and established . Finally, a case library was formed, which included 11 systems, such as endocrine, cardiovascular and neu-rological systems, and 32 cases of drug treatment for common diseases in each system. The construction ofcase library has enhanced the teaching consciousness and skills of resident pharmacists' teaching team. This case library will become an important resource for teaching and scientific research in the future.

Establishment, Implementation and Evaluation of a Case-based Education Program for Resident Pharmacists / 中国药师

Objective: To establish an education program for resident pharmacists to improve clinical problem solving skills with pharmaceutical knowledge.Methods: A case-based education program for resident pharmacists with drug knowledge was established after a questionnaire survey in resident pharmacists and the discussion with clinical teachers.A teaching team was built and the resident pharmacists were divided into several study groups.After a pilot run, the program was operated in pharmacy department.The program was divided into 10 sections by drug indications, and each section was composed of basic drug knowledge lecture and case discussions, which mobilized the study initiative of resident pharmacists.At the half time, resident pharmacists and clinical teachers participated in a midterm survey by a questionnaire.Results: More than 95% resident pharmacists and teachers believed that basic drug knowledge lecture before case discussion was necessary, and compared with previous trainings, the program could further increase study interests of resident pharmacists and improve the clinical problem solving skills.However, 33.3% resident pharmacists and 60% teachers thought the cases were difficult, and 18.5% resident pharmacists and 10% teachers disagreed the cases were close to the actual work.Conclusion: The program is effective in drug knowledge training for resident pharmacists, which can improve pharmaceutical care for patients, while further modifications are still needed to satisfy the demands of resident pharamcists with different working years.

Methodological Studies of the Determination of Lacidipine in Human Plasma by HPLC-MS/MS / 中国药师

Objective: To develop a method for the determination of lacidipine (LAC) in human plasma.Methods: After liquid-liquid extraction with tert-butyl methyl ether, the plasma samples were analyzed by LC-MS/MS.Using lacidipine-13C8 as the internal standard, a Agilent ZORBAX Eclipse XDB C18 column (150 mm×2.1 mm, 5 μm) was used with the mobile phase consisting of water(containing 5 mmol·L-1 ammonium formate)-acetonitrile(15∶85,v/v)at a flow rate of 0.3 ml·min-1 and with the column temperature at 40 ℃.The ion transitions were performed in a positive electrospray ionization multiple reaction-monitoring mode regarding + as the molecular ion peak of lacidipine and monitoring with m/z 473.5→m/z 410.3, m/z 473.5→m/z 400.1 and m/z 473.5→m/z 354.3.The internal standard was monitored with m/z 481.4→m/z 362.3.Results: The linear range of lacidipine was 0.1-10 ng·ml-1 (r＞0.99) and the lower quantification limit was 0.1 ng·ml-1.The intra-and inter-day RSDs were 3.15%-7.04% and the relative error was from-8.58% to 12.71%.The mean relative recovery of lacidipine was from 107% to 118% (RSD＜15%).The plasma samples were stable at-20℃ for 40 d and kept stable after three repeated freeze-thaw cycles.The prepared samples were stable at room temperature for 24 h and in the automatic sample injector (4℃) for 24 h(RSD＜15%).Conclusion: The developed assay method can be applied in the bioequivalence evaluation and pharmacokinetic studies of lacidipine in human.

Systematic Review of Acid-suppressive Drugs Used for the Prophylaxis of Stress Ulcer Bleeding in Postoperative Patients / 中国药师

Objective:To systematically review the efficacy and safety of acid-suppressive therapy including proton pump inhibitors (PPI) and histamine 2 receptor antagonists (H2RA) and compare with those of placebo or blank control in the postoperative patients with stress ulcer bleeding (SUB) to provide evidence-based reference for clinical practice.Methods:The Cochrane library,Medline,Embase,CBM,CNKI,VIP,Wan Fang Data,clinicaltrials.gov,ISRCTN Register and WHO ICTRP were searched.Only randomized controlled trials (RCTs) of acid-suppressive therapy compared with placebo or blank control for postoperative stress ulcer bleeding were selected with bleeding rate,mortality,adverse drug reactions,gastric juice pH and length of stay as the indices.After the quality evaluation and data extraction,Meta-analysis was performed by using Stata12.0 statistics software.The results were expressed as relative risk(RR) and its corresponding 95% confidence interval(CI).Funnel plot and Eggers test were used to determine the publication bias;and then Grade approach was applied to assess the confidence in the evidence for each outcome.Results:Totally 15 trials enrolling 971 patients were selected,and acid-suppressive therapy was more effective than placebo or blank control in reducing the risk of stress ulcer bleeding,overt upper gastrointestinal bleeding and clinical important bleeding(RR 0.29,95% CI:0.19-0.45;RR 0.25,95%CI:0.10-0.64;RR 0.36,95%CI:0.17-0.77)(moderate),however,there was no statistical significance in the incidence of occult bleeding,mortality and adverse drug reactions (RR 0.79,95%CI:0.41-1.50;RR 0.49,95%CI:0.17-1.38;RR 0.78,95%CI:0.33-1.85,very low confidence).The subgroup analysis of drug classification,operation types and administration juncture showed that the incidence of SUB using PPI (RR=0.27) was lower than that using H2RA (RR=0.33);that of heart surgery (RR=0.20) was lower than that of general surgery (RR=0.31) and neurosurgery(RR=0.37);that of postoperative administration (RR=0.26) was lower than that of preoperative administration (RR=0.23).Conclusion:Acid-suppressive drugs seem to be more effective than placebo or blank control in reducing the risk of bleeding without significant increase of the risk of mortality or adverse drug reactions.The robustness of the conclusion is limited because of the low quality of the trial methodology,incomplete outcome indicators and lack of safety indices for pneumonia and clostridium diffcile-associated infection.Trials with high-quality and larger sample size are still needed to verify its clinical effects.

Application of the Global Trigger Tool in detecting adverse drug events / 中华医院管理杂志

Adverse Drug Event(ADE)is a major factor threatening patient safety.For now,the ADE detecting in China mostly relies on spontaneous reporting,a method detecting only a small proportion of ADEs,instead of reflecting the real-world clinical medication safety.Global Trigger Tool (GTT)is a relatively new method for detecting ADEs.This paper described the GTT as an effective and practical method for detecting ADEs,by introducing the history of GTT development,GTT basic principles,operating procedures,current relevant researches and application at home and aboard and comparing with other ADE detection methods.The GTT can evaluate the clinical medication safety in various medical institutions.In particular,it can target specific clinical departments or certain people to detect ADEs for obtaining more evidences of clinical medication safety.That is the reason that we recommend medical institutions at all levels learn and use GTT.

Thinking and suggestion on the teaching of hospital pharmacists standardized training / 中华医学教育探索杂志

To cultivate more excellent pharmacists, ensuring patients rational drug use, standardiza-tion training of hospital pharmacists in Beijing has been carried out since 2000, and the wonderful effect has been achieved. The teaching methods mainly include centralized training model, small lectures, practice teaching and self-study. The training teaching content mainly includes prescription audit, drug dispensing and management as well as the pharmaceutical care. In this paper, based on the analysis of the status quo, it is recommended that detailed training formulate, teaching methods and content of the second stage of the training about the training management policy, and the clinicians teaching should be added to the contents of teaching. The thought moral qualities, laws and regula tions, as well as academic and research training should also be added to the teaching content.

Consideration and Practice of Training and Examination Mode for Hospital Pharmacy Teachers / 中国药房

OBJECTIVE:To provide reference for the training and evaluation for hospital pharmacy teachers. METHODS:19 pharmacists-in-charge in the pharmacy department of our hospital received training of teaching ability,and theory test and multi-sta-tion practical technique test were conducted after training. The items examined in theory test included training rules,the profession-al knowledge of pharmacy and teaching method;the content of practical technique test included checking prescriptions/medication orders,drug dispensing,medication management,patient education and ADR report. Each teacher’s test included 3 of 5 items above based on different responsibilities. All scores were analyzed and summarized. RESULTS:The score of practical technique test was higher than the score of theory test;teachers’grasp of training rules was the worst in theory test;in practical technique test,the score of medication management was the highest for teachers worked at the post of dispensing;while the score of patient education was higher than the score of ADR report for teachers who were clinical pharmacists,the differences were statistically sig-nificant(P<0.05). CONCLUSIONS:In order to improve teaching ability, teachers should receive intensive training on the train-ing rules and the professional knowledge of pharmacy;the multi-station examination mode will be improved in many modes such as increasing stations,standardized test paper and standardized trainees;meanwhile,the young pharmacists should be encouraged for positive commitment to the teaching work and continuously enriched with experience.

Study on the Current Use Situation of National Essential Medicine and Its Related Factors of Priority Use Based on Our Hospital and Parts of the Country / 中国药房

OBJECTIVE:To understand the status of the use of national essential medicines,and provides reference for further implementing the national essential medicine system and promoting the priority use of national essential medicines. METHODS:Ac-cording to the statistics analysis of the use of national essential medicines(for example the antihypertensives and oral hypoglycemic agents)in Beijing,Shanghai and Guangzhou areas,the related influential factors about priority use of national essential medicines were explored. RESULTS:The proportions of use amount of national essential medicines in our hospital in 2012-2013 to the total amount of medicines were 21.20% and 18.75%,respectively,with a downtrend;the proportion of antihypertension drugs to total amount was only 14.05%and 13.70%,respectively;compared with the same generic drugs with individual pricing,the GMP prod-ucts of Valsartan capsule,Bisoprilol tablet and Amlodipine tablet had no advantages in DDDs,or even lower. DDDs of individual pricing drugs of Acarbose tablet in medical institutions in Beijing area and tertiary hospitals in Shanghai and Guangzhou area in 2011-2012 were much higher than the generic GMP products with the same generic drugs. CONCLUSIONS:The clinical use of na-tional essential medicines in our hospital and parts of the country still remains to be further improved,the influential factors includ-ed reimbursement mechanism,awareness rate of related knowledge,physicians’habit to drug use and pursuing economic benefits. The propaganda and training should be strengthened,awareness rate of medical staff and publics to national essential medicines, the availability of national essential medicines and national essential medicine system and medicare reimbursement payment policy should be improved,and the priority use of national essential medicines should be promoted by more measures combination use.

Efficacy and Safety of Sodium Valproate versus Diazepam in the Treatment of Status Epilepticus in Adults:a Meta-analysis / 中国药房

OBJECTIVE:To systematically evaluate the efficacy and safety of sodium valproate versus diazepam in the treat-ment of status epilepticus in adults,and to provide evidence-based reference for clinic treatment. METHODS:Retrieved from Med-line,EMBase,PubMed,Cochrane Library,CJFD,VIP datebase,CBM and Wanfang database,the randomized controlled trials (RCT) about sodium valproate (test group) versus diazepam (control group) in the treatment of status epilepticus in adults were collected. Meta-analysis was performed by using Rev Man 5.0 statistical software after extracting data and evaluating quality. RE-SULTS:A total of 5 RCTs were included,involving 276 patients. Results of Meta-analysis showed that recurrence rate of epilepsy in 48 h in test group was significantly lower than that of control group [OR=0.39,95%CI(0.16,0.96),P=0.04]. Compared with the control group,the effective rate controlling epilepsy within 2 h[OR=1.76,95%CI(0.88,3.52),P=0.11] and incidence of liver injury[RR=1.19,95%CI(0.38,3.70),P=0.77] were no significant differences. CONCLUSIONS:The efficacy and safety of sodi-um valproate was equivalent to diazepam in the treatment of status epilepticus in adults,however,sodium valproate was superior to diazepam in terms of controlling recurrent effect. Due to methodology limit of included studies,large-scale and high quality RCT are required for further validation of the conclusions.

Research on the Standardized Package of Metformin Tablets / 中国药房

OBJECTIVE:To explore the standardized package of Metformin tablets to meet clinical needs. METHODS:Statis-tics was conducted for the utilization data of Metformin tablets in medical and health institutions from 6 cities of China;question-naires were designed to investigate and analyze the evaluation for the suitability of physicians,pharmacists and patients in the pre-scription,deployment and use links to Metformin tablets with different packaging loaded amount in Beijing and Haikou. RE-SULTS:For 0.5 g/tablet,the daily dose of 1.5 g accounted for the largest proportion (32.23%-69.91%) in 5 cities except for Chengdu. Totally 490 questionnaires about package suitability of Metformin tablets in outpatient department were sent out,includ-ing 478 valid questionnaires with effective rate of 97.5%. Results showed that packaging quantity with 4 weeks was considered as appropriate by physicians,pharmacists and patients in Beijing;however,packaging quantity with 1-2 week(s) was considered as appropriate by physicians,pharmacists and patients in Haikou;300-500 tablets of packaging quantity were preferred to be appropri-ate with the matching degree of automatic dispensing machines in both places. CONCLUSIONS:Considering the results in 2 plac-es,for 0.5 g/tablet,2 weeks is appropriate for the packaging loaded amount in outpatient department,that is 0.5 g×45 tablets/box;and 300-500 tablets/box is appropriate for inpatient pharmacies.

Efficacy of Mecobalamin versus α-Lipoic Acid in the Treatment of Diabetic Peripheral Neuropathy:a Me-ta-analysis / 中国药房

OBJECTIVE:To systematically review the efficacy of mecobalamin versus α-lipoic acid in the treatment of DPN, and to provide evidence-based reference for clinical treatment. METHODS:Retrieved from Medline,EMBase,PubMed,Cochrane Library,CJFD,VIP and Wanfang database,randomized controlled trials (RCT) about mecobalamin (test group) vs. α-lipoic acid (control group)in the treatment of DPN were collected. After quality evaluation and data extraction,Meta-analysis was performed by using Rev Man 5.2 statistics software. RESULTS:A total of 11 RCT were included,involving 940 patients. Results of Me-ta-analysis showed the total effective rate in test group was significantly lower than control group,there were significant difference in 2 group [OR=0.17,95%CI(0.12,0.24),P<0.001]. CONCLUSIONS:The efficacy of α-lipoic acid is better than mecobalamin in the treatment of DPN. Due to the limit of methodological quality and sample size,it remains to be further verified with more rig-orously designed and long-term follow-up of large-scale RCT.

Values of continuous renal replacement therapy in the treatment of multiple organ dysfunction syndrome induced by sepsis / 中华急诊医学杂志

Objective To study the values of continuous renal replacement therapy (CRRT) for the treatment of multiple organ dysfunction syndrome ( MODS) induced by sepsis. Methods A total of 62 patients with MODS were divided into three groups, namely non-CRRT group, short period CRRT group (24 ~ 48 h) and long period CRRT group( >48 h). Relevant factors including organ function, plasma endothelin-1 (ET-1),sepsis-related organ failure assessment(SOFA)score, average length of survival time and accumulative survival rate were analyzed . Results Compared with non-CRRT group, a statistically significant difference in SOFA score was evident on the 4th day after long period CRRT group and on the 6th day after short period CRRT group. The survival rates of three groups on the third day after treatment were 56. 3% 、 83.3% and 88.9%, respectively (P0.05). The average lengths of survival time in three groups were(4.4 ±2.6)days, (9.5 ±6. l)days and (10.3 ±5.4)days, respectively. Compared with non-CRRT group, the average lengths of survival time were longer in the other two groups. The levels of serum ET-1 significantly decreased after CRRT treatment (P<0.05). Conclusions The organ function and survival rate could be improved by CRRT. Average lengths of survival time were significantly prolonged in two CRRT groups(P <0.05). More effective therapeutic results including lower SOFA score and longer average length of survival time were observed when the course of CRRT was extended longer properly.

Analysis of 557 Cases with Adverse Drug Reaction in Our Hospital / 中国药房

OBJECTIVE:To understand features of ADR in our hospital and to promote rational clinical drug use.METHODS:A retrospective method was adopted in which 557 ADR cases collected in our hospital in 2004 were analyzed from aspects of reporters,drug categories,routes of administration,the top 10 ADR-induced drugs and etc.RESULTS:Antibacterial and the traditional Chinese medicine injectable preparation dominated the first place and the second place respectively on the list of ADR report cases;55.83%of the ADR cases was induced by IV drop drugs;Clindamycin injection has the highest incidence rate of ADR;63.91%ADR cases were come from pharmacists.CONCLUSION:Carrying out ADR monitoring work is an important task for medical institutions,the strengthening of ADR monitoring can ensure safe drug use of patients.

Pondering on Over-the-counter Service Model in the Outpatient Dispensary / 中国药房

OBJECTIVE:To practice over-the-counter service model in the outpatient pharmacy,to improve the phar-macy service quality of pharmaceutical care and to promote rational drug use.METHODS:The background,preparation,procedure and the whole operation courses in establishing the over-the-counter service model in the outpatient dispensary of our hospital were reviewed,summarized and analyzed.RESULTS:The working objectives and principles of the outpatient pharmacy have been established through the over-the-counter service model;pharmacists'position and responsibility,the operation norm,standardized service language,error-sharing system and the solution schemes for disputes have been further improved and consummated;pharmacists'service consciousness and techniques have been improved and their responsibilities have been reinforced.CONCLUSION:The implementation of the over-the-counter service model can facilitate the estab-lishment of excellent service system in the outpatient dispensary,manifest pharmacist'professional value,promote the at-tractive force of pharmaceutical care in hospital.