Detección de las necesidades de capacitación de los asistentes de farmacia / Detection of training needs in pharmacy assistants

Introducción: La capacitación es, sin duda, uno de los temas actuales más importantes cuando se habla de competitividad, innovación y mejora continua de una empresa. Este proceso implica: detección de necesidades, planeación, implementación, evaluación, retroalimentación y seguimiento de resultados. El eje fundamental de este proceso es el Diagnóstico de Necesidades de Capacitación, pues señala de manera precisa los aspectos sobre los cuales ha de trabajar el capacitador. Objetivo: Realizar un diagnóstico de las necesidades de capacitación de los asistentes de farmacia del Municipio Santa Clara. Métodos: Para elaborar el Diagnóstico de Necesidades de Capacitación se utilizó el método comparativo. Este método se basa en la identificación de las discrepancias entre lo que es y lo debe ser, lo que posibilita constatar los requisitos que son necesarios cubrir. Se utilizaron como técnicas la entrevista y la encuesta. Resultados: Finalmente, después del análisis de todos los datos obtenidos de las matrices y preguntas abiertas, se elaboró el Diagnóstico de Necesidades de Capacitación final que se entregó a la Empresa Farmacias y Ópticas. Conclusiones: Estos resultados mostraron que esta empresa necesita de manera inmediata implementar actividades de capacitación a sus asistentes de farmacia en lo referente a conocimientos.

Introduction: training is, undoubtedly one of the most important current issues when talking about competitiveness, innovation and continuous improvement of a company. This process involves: detection of needs, planning, implementation, evaluation, feedback and monitoring of results. The fundamental axis of this process is the Diagnosis of Training Needs, since it indicates precisely the aspects on which the trainer must work. Objective: to carry out a diagnosis of the training needs in pharmacy assistants from Santa Clara municipality. Methods: the comparative method was use to prepare the Training Needs Diagnosis. This method is based on the identification of discrepancies between what is and what should be; it made possible to verify the necessary requirements to be met. Interviews and surveys were used as techniques. Results: Finally, after analyzing all the data obtained from the matrices and the open questions, a final Diagnosis of Training Needs was prepared and delivered to the Pharmacy and Optics Company. Conclusions: these results showed that this company needs to immediately implement training activities for their pharmacy assistants in terms of knowledge.

Application of FMEA model and 6S management method in reducing dispensing errors in PIVAS of children’s hospitals / 中国药房

OBJECTIVE To reduce dispensing errors in pharmacy intravenous admixture service （PIVAS） of children’s hospitals. METHODS The risk of dispensing procedures in our PIVAS was identified by applying failure mode and effect analysis （FMEA） model. Potential failure modes that might lead to dispensing errors in each link were determined， and failure causes were analyzed. The severity， incidence and detection degree of potential failure modes were quantitatively scored， and their risk priority number （RPN） was calculated to screen failure modes that needed to be improved in priority； the corresponding improvement measures were developed by 6S management method from six aspects， namely， finishing （seiri）， rectifying （seiton）， sweeping （seiso）， sanitation （seiketsu）， literacy （shitsuke） and safety. The effect of intervention before and after rectification was evaluated. RESULTS Based on the RPN， 32 potential failure modes were selected， of which a total of 18 critical failure modes that needed to be improved in priority. After implementing corresponding measures according to 6S management method， the RPN of 18 critical failure modes decreased. The total RPN decreased from 497 to 142 with a decrease rate of 71.43%. The error rates of 15 critical failure modes were significantly lower than before implementation （P＜0.05）. CONCLUSIONS Applying FMEA model and 6S management method to the risk control of all aspects of PIVAS workflow can effectively reduce the risk of PIVAS dispensing errors and ensure the safety of children’s intravenous medication.

Construction of performance management system for pharmacy department of tertiary public hospitals under new situation / 中国药房

OBJECTIVE To provide reference for improving the work efficiency of staff and promoting the discipline construction of pharmacy department. METHODS By analyzing the current situation of performance management in the pharmacy department of our hospital， the key successful factors were sorted out， strategic decoding was carried out and key performance indicators were extracted. The quarterly and annual performance appraisal forms were formulated for the departments of pharmacy warehouse， outpatient pharmacy， ward pharmacy， clinical pharmacy department， prescription examination center， laboratory and other departments； the performance management information platform was built. The work efficiency and output of each department were compared half a year before and after the implementation of the performance management plan. RESULTS After the implementation of the program， the average queuing time for drug collection in the outpatient department was shortened from 5 minutes to 3 minutes， the average number of dispensing infusion bags per hour in the pharmacy intravenous admixture services increased from 50 bags to 60 bags， and antibacterial use density of the hospital decreased from 42.7 DDD（defined daily doses） to 40.2 DDD. The number of academic papers published had increased from 8 to 10， and the satisfaction of clinical departments with ward pharmacies increased from 85% to 95%. CONCLUSIONS The performance management system has been successfully established in pharmacy department of our hospital， which can improve the enthusiasm of pharmacists， reflect the value of pharmaceutical care， and promote the discipline construction of pharmacy.

Perfil das pessoas com diabetes que utilizaram a telefarmácia na pandemia de covid-19: resultados da DIABETES / Profile of people with diabetes who used telepharmacy during the covid-19 pandemic: results from DIABETES / Perfil de personas con diabetes que usaron telefarmacia durante la pandemia de covid-19: resultados de DIABETES

O objetivo foi analisar o perfil das pessoas com diabetes que utilizaram a telefarmácia na pandemia de covid-19. Trata-se de um estudo transversal com dados oriundos da websurvey DIABETESvid que ocorreu nos meses de setembro e outubro de 2020. Verificou-se que 45 participantes recorreram à telefarmácia, sendo que 55,6% eram do sexo masculino, 42,2% tinham idade compreendida entre 18 e 34 anos e 46,7% estudaram 12 ou mais anos. Além disso, 48,9% autorreferiram diabetes mellitus tipo 1. A maioria usava insulina (55,6%) e obteve os medicamentos para o diabetes em farmácias do sistema público de saúde (60%). Ademais, as pessoas que tiveram o diagnóstico de covid-19 buscaram mais pela telefarmácia (RP=2,20; IC95% 1,23­3,94). Sabe-se que os medicamentos são essenciais para o tratamento do diabetes. Logo, no período estudado em que se preconizava o distanciamento físico, os participantes apropriaram-se da telefarmácia a fim de obter a integralidade do cuidado

The objective was to analyze the profile of people with diabetes who used telepharmacy during the covid-19 pandemic. This is a cross-sectional study with data from the DIABETESvid websurvey that took place in September and October 2020. It was found that 45 participants used telepharmacy, 55.6% of whom were male, 42.2% were between 18 and 34 years-old and 46.7% studied 12 or more years. In addition, 48.9% self-reported type 1 diabetes mellitus. Most used insulin (55.6%) and obtained their diabetes medication from pharmacies in the public health system (60%). Also, people diagnosed with covid-19 used telephar-macy more often (PR=2.20; 95%CI 1.23­3.94). It is known that drugs are essential for the treatment of diabetes. Therefore, in the period studied in which physical distancing was advocated, the participants used telepharmacy to obtain comprehensive care

El objetivo fue analizar el perfil de las personas con diabetes que utilizaron la telefarmacia durante la pandemia del covid-19. Estudio transversal con datos de la encuesta por internet DIABETESvid realizada en septiembre y octubre de 2020. Se encontró que 45 participantes recurrieron a la telefarmacia, de los cuales el 55,6% eran hombres, el 42,2% tenían entre 18 y 34 años y el 46,7% estudiaban 12 o más años. Además, el 48,9% se autorrefirió diabetes mellitus tipo 1. La mayoría utilizaba insulina (55,6%) y recibía su medicación antidiabética en farmacias del sistema público (60%). Además, las personas diagnosticadas con covid-19 buscaron telefarmacia con más frecuencia (RP = 2,20; IC 95% 1,23­3,94). Los medicamentos son esenciales para el tratamiento de la diabetes. Por lo tanto, en el período estudiado en el que se propugnaba el distanciamiento físico, los participantes se apropiaron de la telefarmacia para la atención integral

Empirical antimicrobial therapy based on active surveillance cultures in ICU patients

Objetivo: Avaliar o valor preditivo da colonização prévia por Acinetobacter baumannii (CRAB) e Pseudomonas aeruginosa (CRPA) resistente a carbapenêmicos estabelecida em culturas de vigilância para infecção subsequente por esses patógenos em pacientes internados em UTI. Métodos: Foi realizado um estudo de coorte com pacientes internados na unidade de terapia intensiva por pelo menos 48 h. Foram medidos os valores preditivos negativos e positivos, sensibilidade e especificidade das culturas de vigilância em CRAB e CRPA. Resultados: Foram incluídos 693 pacientes infectados. Pacientes previamente colonizados por CRAB e CRPA tiveram maior probabilidade de serem infectados por esses patógenos: OR ajustado: 10,34 (6,58 - 16,45; p < 0,001) e 2,30 (3,88 - 10,26; p < 0,001), respectivamente. Encontramos altos valores preditivos negativos de culturas de vigilância para CRAB (87,18%) e CRPA (88,30%) e alta especificidade 91,96% e 90,13%, respectivamente. Conclusões: Pacientes não colonizados por CRAB e CRPA mostraram-se menos propensos à infecção por esses patógenos. Esses achados podem contribuir para a escolha da terapia antimicrobiana empírica e desencorajar a prescrição de antibióticos contra esses patógenos em pacientes sem colonização prévia.

Objective: To assess the predictive value of prior carbapenem-resistant Acinetobacter baumannii (CRAB) and Pseudomonas aeruginosa (CRPA) colonization established in surveillance cultures for subsequent infection by these pathogens in ICU patients. Methods: A cohort study was performed with patients admitted to the intensive care unit for at least 48 h. Negative and positive predictive values, sensitivity, and specificity of surveillance cultures in CRAB and CRPA were measured. Results: 693 infected patients were included. Patients previously colonized by CRAB and CRPA were more likely to be infected by these pathogens: adjusted OR: 10.34 (6.58 - 16.45; p < 0.001) and 2.30 (3.88 - 10.26; p < 0.001), respectively. We found high negative predictive values of surveillance cultures for CRAB (87.18%) and CRPA (88.30%) and high specificity 91.96% and 90.13%, respectively. Conclusions: Patients not colonized by CRAB and CRPA were less prone to infection by these pathogens. These findings may contribute to the choice of empirical antimicrobial therapy and discourage the prescription of antibiotics against these pathogens in patients without previous colonization.

A cross-sectional evaluation of behavior and attitude of pharmacists toward dispensing non-OTC drugs without prescription in a city of Southern Rajasthan

Background: Over the counter (OTC), drugs are found to be safe and appropriate for use without supervision of a healthcare professional such as physician and they can be purchased by consumers without prescription. The study gains its importance because of the spreading of misuse of antibiotics and various drugs adverse drug reactions in the society. Aims and Objectives: The main aim of the study is to observe as to how many pharmacists/chemists/drug store sellers follow or violate the drug cosmetic act. Materials and Methods: It is an observational and cross-sectional study conducted among pharmacies of Udaipur city, urban areas of Southern Rajasthan. The study includes a sample size of 200 pharmacies selected through convenient random sampling. A detailed semi-structured questionnaire is administered to the pharmacists. The set of questions include types of drugs, reason for dispensing, knowledge, and attitude of pharmacist toward dispensing non-OTC drugs. All the private pharmacies willing to participate were included in the study. Data are entered in Microsoft Excel and statistically analyzed. Results: The results throw light on the behavior and pattern of dispensing habits of the drug store sellers of the city of Udaipur, Southern Rajasthan. It was observed that many pharmacists are in fact in the habit of dispensing non-OTC drugs in almost all the areas. Conclusions: Results give insights about the groups of drugs, logic, behavior, and knowledge level of pharmacists involved in dispensing practices in the city of Udaipur. There should be structured educational campaigns (or use of media, internet, newspaper, radio, television, advertisements, mobiles, etc.) for both pharmacists and public.

Calculating the risk of fire in community pharmacies. Gustav-Purt method

Introduction: Fire is a chemical reaction of combustion, based on the strongly exothermic "oxidation-reduction" phenomena that produce a big detachment of light and heat.Its effects are, generally, harmful, producing personal injuries due to smoke, toxic gasses, and extremely hot temperatures; and damaged materials and buildings. Fire is produced when the three following factors simultaneously coexist in time and space: Fuel; a comburent agent, usually the oxygen in the air; and heat, which contributes the necessary energy to actuate the reaction. Besides, it is necessary, for the production of the flame, the existence of a chain reaction. Method: The Gustav-Purt Method, which aim is to calculate the potential risk in a determinate building and of the means to fight fires should be implemented. Results: After the calculation of the distinct factors, the conclusion that the risk of fire in a pharmacy is high is reached. Discussion: Therefore, strict inspection by sanitary authorities to avert the danger of the fire is necessary.

Introducción: El fuego es una reacción química de combustión, basado en los fenómenos de oxidación-reducción fuertemente exotérmica que se manifiesta por desprender gran cantidad de luz y calor. Sus efectos son generalmente perjudiciales, produciendo daños personales por el humo, gases tóxicos y temperaturas extremas, causando grandes daños a instalaciones y bienes. El fuego se produce cuándo existen simultáneamente en el tiempo y en un mismo lugar los tres factores siguientes: Combustible, Agente Comburente, normalmente el oxígeno del aire y Calor, que contribuye con la energía necesaria para activar la reacción. Además, es necesario, para la producción de la llama, la existencia de reacciones de cadena. Método: El método de Gustav Purt, tiene por objetivo calcular el riesgo potencial existente en un edificio determinado y qué medios de lucha contra incendios son necesarios implementar. Resultados: Tras el cálculo de los distintos factores, se llega a la conclusión que el riesgo de incendio en una farmacia es elevado. Discusión: Por consiguiente, es necesario la estricta inspección de las autoridades sanitarias de la Administración para evitar el peligro del fuego.

Tratamiento farmacológico para tromboembolismo pulmonar dirigido a pacientes con fibrilación auricular / Pharmacologic treatment for pulmonary thromboembolism in patients with atrial fibrillation / Tratamento farmacológico para tromboembolismo pulmonar em pacientes com fibrilação atrial

La fibrilación auricular es una de las arritmias cardiacas más frecuentes. Afecta a 1 de cada 200 personas de entre 40 y 50 años de edad, pero puede llegar a afectar a más de 1 de cada 10 personas de 80 años. Objetivo. Proponer una guía de tratamiento farmacológico para evitar el tromboembolismo pulmonar en pacientes con fibrilación auricular con respuesta ventricular. Materiales y métodos. Los métodos utilizados fueron de nivel teórico como histórico lógico, modelación, hipotético- deductivo, dialectico, holístico-holográfico y sistémico estructural- funcional. Como métodos empíricos. se aplicaron la revisión de documentos guías, historias clínicas, encuestas a médicos y farmacéuticas, también se realizó la observación científica, los resultados se reflejaron la revisión de las historias clínicas de los 38 pacientes con diagnóstico de fibrilación auricular crónica. Resultados. Se representa el tipo de tratamiento con un predominio de 24 pacientes que toman anticoagulantes (63,16%), los pacientes en su mayoría no estaban anti coagulados, pacientes anti coagulados (34,62%), además se elaboró la propuesta de una guía de tratamiento farmacológico para evitar el tromboembolismo pulmonar en pacientes con fibrilación auricular con respuesta ventricular rápida, de acuerdo a los estándares internacionales para para prevenir las complicaciones tromboembólicas de la fibrilación auricular. Conclusiones. Debido a su prevalencia creciente, al impacto en la supervivencia, la calidad de vida de los pacientes, los elevados costos sanitarios que conlleva su tratamiento y el incesante avance en nuevos tratamientos de la fibrilación auricular con respuesta ventricular rápida, hace que sea necesario actualizar de manera periódica las recomendaciones basadas en la evidencia.

Atrial fibrillation is one of the most common cardiac arrhythmias. It affects 1 in 200 people between 40 and 50 years of age, but may affect more than 1 in 10 people in their 80s. Objective. To propose a pharmacological treatment guideline to prevent pulmonary thromboembolism in patients with atrial fibrillation with ventricular response. Materials and methods. The methods used were of theoretical level as historical-logical, modeling, hypothetical- deductive, dialectical, holistic-holographic and systemic-structural-functional. As empirical methods, the review of guidelines documents, clinical histories, surveys to physicians and pharmacists were applied, as well as scientific observation, the results were reflected in the review of the clinical histories of the 38 patients with a diagnosis of chronic atrial fibrillation. Results. The type of treatment is represented with a predominance of 24 patients taking anticoagulants (63.16%), most of the patients were not anti coagulated, anti coagulated patients (34.62%), also the proposal of a pharmacological treatment guide to avoid pulmonary thromboembolism in patients with atrial fibrillation with rapid ventricular response was elaborated, according to international standards to prevent thromboembolic complications of atrial fibrillation. Conclusions. Due to its increasing prevalence, the impact on survival, the quality of life of patients, the high health care costs involved in its treatment, and the incessant advance in new treatments for atrial fibrillation with rapid ventricular response, it is necessary to periodically update the evidence-based recommendations.

A fibrilação atrial é uma das arritmias cardíacas mais comuns. Afeta 1 em cada 200 pessoas entre 40 e 50 anos de idade, mas pode afetar mais de 1 em cada 10 pessoas em seus 80 anos. Objetivo. Propor uma diretriz de tratamento farmacológico para prevenir o tromboembolismo pulmonar em pacientes com fibrilação atrial com resposta ventricular. Materiais e métodos. Os métodos utilizados foram de um nível teórico, como histórico-lógico, modelagem, hipotético-dedutivo, dialético, holístico-holográfico e sistêmico-estrutural-funcional. Como métodos empíricos, a revisão de documentos de orientação, históricos clínicos, pesquisas de médicos e farmacêuticos foram aplicados, assim como a observação científica, os resultados foram refletidos na revisão dos históricos clínicos dos 38 pacientes com um diagnóstico de fibrilação atrial crônica. Resultados. O tipo de tratamento é representado com uma predominância de 24 pacientes tomando anticoagulantes (63,16%), a maioria dos pacientes não era anticoagulante, anticoagulante (34,62%), e uma proposta de um guia de tratamento farmacológico para prevenir o tromboembolismo pulmonar em pacientes com fibrilação atrial com resposta ventricular rápida foi elaborada, de acordo com as normas internacionais para prevenir complicações tromboembólicas da fibrilação atrial. Conclusões. Devido a sua crescente prevalência, o impacto na sobrevivência, a qualidade de vida dos pacientes, os altos custos de saúde envolvidos em seu tratamento e o incessante avanço em novos tratamentos para fibrilação atrial com resposta ventricular rápida, é necessário atualizar periodicamente as recomendações baseadas em evidências.

El largo y sinuoso camino de la farmacia clinica en Chile / The long and winding road of the clinical pharmacy in Chile

Clinical pharmacy is a health discipline in which pharmacists provide patient care that optimizes rational medication use and promotes health, wellness and disease prevention. The beginnings of clinical pharmacy in Chile were inspired by the origin in the School of Pharmacy of the University of California, San Francisco (UCSF), in the mid-1960s. However, the historical development in our country, both in teaching and in the professional field, was accompanied by difficulties and success, which became a long and winding road. This article shares the events that gave rise to its beginnings in Chile, first through teaching, then in pharmacovigilance and clinical pharmacokinetics, to later describe its professional expansion and recognition as a specialty of pharmacy. This article briefly recounts the history of the Chilean clinical pharmacy to this day. Some names of people or institutions were not mentioned. Therefore the authors apologize in advance to pharmacists and organizations whose contribution cannot be recognized in this way. However, we know that this specialty has not been forged only by the names that appear, but by all those who love and respect the work of the clinical pharmacy.

Establishment and evaluation of “integration of drug storage and dispensing”intelligent drug validity management system in outpatient pharmacy / 中国药房

OBJECTIVE To build an “integration of drug storage and dispensing” intelligent drug validity management system in outpatient pharmacy， and to evaluate the effect of this system. METHODS The information technology was used to connect the drug information in the primary storage， the intelligent secondary storage and the rapid dispensing machine； an “integration of drug storage and dispensing” intelligent drug validity management system was constructed. At the same time， the implementation effects of drug validity management system in outpatient pharmacy of our hospital were evaluated one year before and after the construction of the system. RESULTS By using information technology， intelligent closed-loop management of batch number and expiration date information throughout the entire process of drug circulation in outpatient pharmacy of our hospital had been achieved， making it easy to track and trace drug information. After the establishment of the intelligent system， the time spent on managing drug validity every month was reduced from 103 people·h to 8 people·h； the number of near-expired drugs per month had decreased from （30.67±1.10）types to （17.67±1.17）types（P＜0.05）. CONCLUSIONS The intelligent drug validity management system in outpatient pharmacy based on the mode of “integration of drug storage and dispensing” makes the drug validity management in the outpatient pharmacy more scientific， reasonable and efficient.

Effect of clinical pharmaceutical care on our outpatient service of Traditional Chinese Medicine pharmacy / 药学实践杂志

Objective To explore the role of clinical pharmaceutical care in outpatient service of traditional Chinese medicine. Methods Two hundred patients who were not taking medicines for the first time (had received routine medication explanations) and had made an appointment for the next outpatient TCM service were randomly selected for questionnaire survey during July to October, 2021. After the intervention of clinical pharmacy care, the questionnaire survey was conducted again, and the results of the questionnaire survey of patients before and after the clinical pharmacy care were compared. Results After clinical pharmacy intervention, the scores of eight questions in the questionnaire were significantly improved (except for the awareness of taking drugs, P values of the other seven items were all <0.05). Conclusion The development of TCM clinical pharmaceutical care could effectively improve patients' safety awareness of medication safety. The patients' awareness of the use of Traditional Chinese Medicine and medication compliance had also been significantly improved. The awareness of pharmacists role in patients was enhanced. The outpatient pharmaceutical care of Traditional Chinese Medicine was effectively improved, which is important to rational drug use.

Analysis on the funding of pharmacy administration from National Natural Science Foundation in China from 2010 to 2021 / 药学实践杂志

Objective To summarize the project and fund of Pharmacy Administration from the NSFC during 2010 to 2021 and to provide references for the funding application. Methods The data and relevant documents which related to the projects status of Pharmacy Administration on the website of NSFC were collected and analyzed by Excel. Results There were more paths which were suitable to the Pharmacy Administration in NSFC. The direction and measure were expanded. There were more interdisciplinary researchers involved in Pharmacy Administration projects, while the funded organizations and regional distribution were concentrated. Conclusion The funding situation, research hotspots and basic information of applicants in recent years were summarized through statistical data of NSFC from 2010 to 2021, which suggest that the advantage, regional characteristics, cross-discipline and the policies should be concerned by the applicants .

Practice and effect of construction of rational drug use mode of PIVAS by the activities of quality control circle / 药学实践杂志

Objective To establish a rational drug use model of PIVAS and promote the rational drug use in clinical practices by enhancing the quality of prescription review by pharmacists. Methods The PIVAS physician orders received from 2014 to 2021 were extracted through the hospital information management (HIS) system. The types of irrational physician orders were statistically analyzed, the improvements were made by the method of quality control circle (QCC). Results The model of PIVAS rational drug use formed a standardized process. The proficiency of physician order review was improved. From 2014 to 2021, the number and proportion of unreasonable physician orders in PIVAS decreased year by year. Every type of unreasonable physician orders was improved year by year. Conclusion The professional and technical levels of pharmacist for physician order review at our hospital were improved by the model of PIVAS rational drug use. The quality of pharmaceutical service was significantly improved which ensured the safety of patients' medication.

Fluctuation analysis and prediction of intravenous medication dispensing workload based on time series analysis method / 药学实践杂志

Objective To explore the fluctuation characteristics of long-term doctor's order workload in pharmacy intravenous admixture services (PIVAS) and build a daily workload fluctuation prediction model and provide reference for the adjustment of PIVAS work mode. Methods Daily workload data of long-term doctor’s orders from PIVAS in the East Campus of Zhongshan Hospital affiliated to Fudan University from July 2020 to June 2021 were selected , and the time series analysis method was used to analyze the workload fluctuation characteristics and a prediction model was established. The accuracy of the model was verified by fitting parameters and prediction results. Results The fluctuation of PIVAS long-term doctor's daily workload data had the characteristics of periodicity, short-term slow rise and irregular variation. The Winters multiplier model was used to fit the series with R2 = 0.777, the significance value of Ljung-Box statistic value (P value) was 0.060, and the mean absolute error percentage between the fitted and actual values was 4.45%, indicating that the model fitting accuracy was high. The average relative deviation between the predicted and actual results was 3.81%, indicating that the model prediction was effective. Conclusion The model constructed in this study could be used for the analysis and prediction of long-term doctor's orders workload of PIVAS. However, because the workload of doctor's orders has fluctuations such as periodicity and irregular changes, it is necessary to adjust the working model according to the fluctuation characteristics of the workload and the prediction results to ensure the efficient operation of PIVAS.

The Actual Status of Handling Prescription Refills in Community Pharmacies and Pharmacists' Awareness of the Refill-Prescription System / 医薬品情報学

Objectives: A refill-prescription system startedin April, 2022 in Japan. Refill-prescriptions can be usedrepeatedly, but pharmacists are required to check patients' medication and determine whether refills are appropriate. This study aimed to clarify the actual status of community pharmacies' treatment of prescription refills and pharmacists’ concerns about them.Design: Questionnaire survey.Methods: A self-administered questionnaire survey was conducted for pharmacists at community pharmacies from June to July, 2022, shortly after the refill-prescription system was launched, focusing on handling of prescription refills in community pharmacies, and concerns and challenges about refill-prescriptions.Results: Responses were obtainedfrom 377 pharmacists in 34 prefectures throughout Japan. Among them, 30.8% had received refill-prescriptions. Many pharmacists checked medical histories, changes in patients' symptoms, and medication and medical examination status when determining the appropriateness of refills, but few reviewed past laboratory values or laboratory values measuredby patients themselves at the time of their pharmacy visit. Moreover, 34.8% of the pharmacies had internal rules for dealing with refills, and 39.8% had equipment to measure laboratory values. Many pharmacists were concerned about how to share patients’ information with other pharmacies. Challenges that were identified included “Determining whether the refill is appropriate for the patient” and “Establishment of a pharmacy system to receive refill-prescriptions”.Conclusion: This study clarified the actual status of community pharmacies handling of prescription refills, and pharmacists' concerns or challenges about them. Potential improvements include increasing the number of devices that can measure laboratory values at pharmacies, improving home-use measuring devices, creating guidelines to determine the appropriateness of prescription refills and improving pharmacists' skills.

Exploration of reform paths of high-level talents training in clinical pharmacy / 中国药房

OBJECTIVE To help to realize high-quality development of clinical pharmacy education in China by exploring new reform paths of high-level talents training in clinical pharmacy. METHODS The concept definition and key links of high-level talents training in clinical pharmacy were consulted by expert consultation， and the literature analysis and empirical methods were used to prepare a questionnaire to conduct online research on clinical pharmacy professionals in universities and hospitals. RESULTS A total of 637 effective electronic questionnaires were received. Totally 95.13% of the respondents believed that the cultivation of high-level talents in clinical pharmacy was very or relatively important； 51.96% expressed different degrees of dissatisfaction with the current situation of training； 88.85% regarded “rational clinical use of drugs” and 88.70% regarded “clinical research of drugs” as one of the main training objectives and service orientation； precision pharmacy， evidence-based pharmacy， medication therapy management， therapeutic drug monitoring and evaluation， clinical discovery and evaluation of new drugs were considered as important core specialty knowledge and competences， which were different from those high-level talents in clinical medicine；62.01% agreed that “academic degree+professional degree” dual degree training was the main degree type for high-level talents training in clinical pharmacy； 79.28% thought it was very necessary or relatively necessary to adopt the “long schooling” education mode； 98.58% thought that the core courses of clinical pharmacy such as clinical pharmacotherapy were very important or relatively important；59.81% believed that college or department of clinical pharmacy was the most important educational management organization that played the most important role； 87.13% agreed with the dual tutor structure of “college teachers+ pharmacists” and “pharmacists+physicians”. CONCLUSIONS Starting with the target orientation， core knowledge and competence， academic degree system， curriculum system and faculties， it is necessary to speed up the exploration of new reform paths of talent training and build a high-level talent training system of clinical pharmacy with Chinese characteristics and world level.

Practice and thinking of AB working system in the management of pharmacy department of hospital / 中国药房

OBJECTIVE To provide reference for improving work efficiency and promoting the rapid development of pharmacy department. METHODS AB working system was established in pharmacy department， and task division and working process were formulated. The response time of role B， management performance， the construction of discipline platform， scientific research achievements and other indexes were analyzed comparatively before （2016-2020） and after （2021） the implementation of AB working system. RESULTS Compared with before the implementation， the response time of role B was shortened to 0.5 h； the score of management performance was increased from 27.67 to 73.00； scientific research projects， SCI papers and discipline construction funds had increased significantly after the implementation. CONCLUSIONS The practice of AB working system should shorten the response time and be beneficial to build a high-quality management personnel， improve the management level and work efficiency， promote rapid development of pharmacy department.

Literature analysis on the status quo of performance appraisal of pharmacy intravenous admixture services in China / 中国药房

OBJECTIVE To analyze the status quo of performance appraisal of pharmacy intravenous admixture services （PIVAS） in China based on literature analysis， and provide reference for the implementation of performance management of PIVAS in China. METHODS Retrieved from domestic and foreign databases such as CNKI， VIP， Wanfang， PubMed， Embase， the Cochrane Library and CBM， the literature on the status quo evaluation of performance appraisal of PIVAS in China was included from the inception to Sept. 2022. The descriptive analysis was carried out on performance appraisal measures， performance appraisal indicators， performance appraisal achievement， etc. RESULTS Twelve pieces of literature were included， involving 8 before-and-after controlled studies and 4 experience sharing. The performance appraisal subjects of 10 pieces of literature were all staff and those of 2 pieces of literature were nurses. The measures of PIVAS performance appraisal were roughly the same， mainly involving contents and indicators of workload， work quality （including errors）， clinical service satisfaction， labor discipline， department contribution， personal comprehensive evaluation， and so on， but the main accounting proportion was different. Performance appraisal indicators mainly included the rate of medical order review， dispensing rate， check rate， delivery rate， finished product review rate， etc. The performance appraisal achievement mainly included the improvement of work efficiency， the improvement of work quality， the reduction of error rate， and the improvement of clinical satisfaction and employee satisfaction. CONCLUSIONS By building performance appraisal system and adopting corresponding performance management measures of PIVAS， it can improve the work efficiency and quality， reduce the error rate， ensure the safety of patients’ medication， and promote the standardized management of PIVAS in China.

Development of shared traditional Chinese medicine pharmacy from the perspective of primary medical care / 中国药房

In order to make the shared traditional Chinese medicine （TCM） pharmacy develop more efficiently and normatively at the grass-roots level， using the “shared TCM pharmacy” as the retrieval word， this paper uses the literature research method to retrieve the reports， documents and policies from CNKI， the websites of people’s governments at all levels， the official websites of the State Administration of Traditional Chinese Medicine， people.com， China News Network， Xinhua News and other platforms before May 20， 2022， sort out the development mode and history of two “Internet plus” TCM pharmacies， namely “shared TCM pharmacies” and “smart TCM pharmacies”， and compare them with each other. Combined with the actual work of community hospitals and community service centers （stations）， the necessity and advantages （such as reducing the costs of the intermediate links of drug circulation and standardizing the grass-roots drug use process） of the development of “shared TCM pharmacy” are obtained from the perspective of primary medical care. Combined with the current situation of the promotion and application of shared TCM pharmacy in county medical communities， it is concluded that the shared TCM pharmacy should be further constructed from four aspects： improving the work process of drug centralized procurement under the background of normalization， improving the compatibility and synchronization of the whole process dispensing information system module， unifying pharmaceutical services and personnel training， defining the authority of data query and clarifying the boundaries of patient privacy to further build a shared TCM pharmacy. Finally， it integrates information technology， summarizes the definition of shared TCM pharmacy and its future construction direction， and provides reference for the next development of shared TCM pharmacy at the grass-roots level.

Construction of pharmacogenomics-guided individualized medication list for elderly patients / 中国药房

OBJECTIVE To develop an individualized medication list for elderly patients by evidence-based pharmacy method， and to support clinical decisions on rational use of METHODS　Firstly， drugs with risk genetic information were screened out by systematically reviewing evidence-based pharmacy information. Secondly， researchers investigated the included drugs in lists from different data E- sources. Drugs included in three or more data sources and drugs proposed by the expert committee were then included in the medication list. Thirdly， for the drugs included in two data sources， researchers designed questionnaires to investigate the necessity of drug-related gene testing. According to the scoring results of the expert questionnaire， drugs with higher scores were included in the list. Data sources included real-world data （list of high frequency medication in hospitals， high frequency medication for elderly outpatients and inpatients in National Health Care Claims Data， drugs related to frequent medication errors and so on） and evidence-based pharmacy evidence （the websites of Clinical Pharmacogenomics Implementation Consortium， Dutch Pharmacogenetics Working Group， Food and Drug Administration and so on）. RESULTS　The study obtain 68 drugs with risk genetic information which were included in three data sources. Combined with 23 drugs proposed by the expert committee， a list containing 74 drugs was preliminarily formed after de-duplication. A total of 37 drugs included in two databases with risk genetic information were scored through the questionnaire survey to form a supplementary list of 26 drugs. This is the final composition of the list of 100 drugs developed in this study. Among them， there are 43 drugs for the central nervous system， 15 drugs for the cardiovascular system， 12 anti-tumor drugs and so on. Twelve drugs were included in six or more data sources， which mainly consisted of drugs for digestive system， all proton pump inhibitors. CONCLUSION　In this study， a list of 100 commonly used drugs which require individualized medication for the elderly was developed by evidence-based pharmacy method. The drug list will be updated in time as available evidence changes， and can provide guidance for rational use of medicines for elderly patients.