ABSTRACT
OBJECTIVE To explore the value of providing pharmaceutical service related to risdiplam in direct-to-patient （DTP） pharmacies. METHODS The follow-up data of spinal muscular atrophy （SMA） patients who purchased and used risdiplam from Shangyao Yunjiankang Yiyao Pharmacy （Shanghai） Co.， Ltd. from May 2021 to January 2023 were collected. The medication information， therapeutic efficacy and the occurrence of adverse events were retrospectively analyzed. RESULTS A total of 42 prescriptions were checked by pharmacists in the DTP pharmacies， and 7 prescriptions were found to be unreasonable （16.7%， 7/42）， which were corrected after the timely intervention. During the follow-up management， pharmacists replied to 4 patients （9.5%， 4/42） regarding medication consultation about medication requirements and adverse events. Two patients with type Ⅰ SMA experienced adverse events： one of them presented with fever and the other presented with skin dryness with darkening. Both of them were grade Ⅰ toxic reactions and generally did not require clinical treatment. Considering that the patient sustained low-grade fever for a long time， the pharmacist suggested symptomatic treatment under the guidance of the doctor. CONCLUSIONS Pharmacists in DTP pharmacies conducting follow-up management of risdiplam use for rare disease SMA patients can help promote rational， standardized medication for patients.
ABSTRACT
OBJECTIVE To in vestigate the existing problems about store construction and market operation and management of DTP （direct-to-patient）pharmacies in Guizhou province ，and to provide countermeasures and suggestions for the improvement and development of professional operation of DTP pharmacies in Guizhou province. METHODS According to the literature review ， the questionnaire was designed. Then the field survey of 11 DTP pharmacies and questionnaire survey for the person in charge （or store managers ） in Guizhou province were conducted from April to May 2021. The questionnaire mainly included the basic information，online sales channel construction ，pharmaceutical logistics distribution ，pharmaceutical care ，vocational training ， construction of pharmacy management system and application of drug management information system etc. ，in order to analyze the inadequacies of market operation and management of DTP pharmacies in Guizhou province and put forward suggestions. RESULTS Totally 11 questionnaires were delivered and 9 valid questionnaires were retrieved ，the effective response rate of questionnaires was 81.82％ . The sample pharmacies were all from Guiyang ，most of them （77.78％）were established by local pharmaceutical enterprises in Guizhou province ，and only 22.22％ of the sample pharmacies had opened online drug purchase channels. In terms of pharmaceutical care ，55.56％ of the sample pharmacies provided basic testing and life style interventions respectively ，44.44％ of the sample pharmacies provided adverse drug reaction monitoring ，and 33.33％ of the sample pharmacies implemented health education presentations and chronic disease rehabilitation program respectively. In term of personnel training ，only 11.11％ of the sample pharmacies implemented weekly business training ，and 66.67％ of the sample pharmacies received innovative and academic pharmacy information training. The construction of DTP pharmacy management systems in Guizhou province was completed basically ， but in terms of application of drug management information system ， 22.22％ of the sample pharmacies conducted drug application analysis and monitoring. CONCLUSIONS The development of DTP pharmacies in Guizhou province is still in initial stage currently. The convenience and accessibility of medicines for patients and the construction of online sales channel need to be improved ；the internet channel construction is slow ；an effective selection and evaluation mechanisms for pharmaceutical logistics enterprises need to be created ；pharmaceutical care ability and pharmacy service personnel training system need to be strengthened ；informatization management and industrial recognition of DTP pharmacies in Guizhou province need to be promoted. Therefore ，the enterprises ， government， universities and associations should work together and strengthen the professionalization ， informatization， institutionalization and standardization of DTP pharmacies in Guizhou province ，in order to provide patients with a convenient drug sales channels and high-quality personalized pharmaceutical care platforms eventually.
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