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Objective To investigate the implementation of pharmacist-managed clinic(PMC) in Guangdong, and to provide reference for quality management of pharmacist-managed clinics. Methods Collection of a list of all medical institutions that have established pharmaceutical clinics in Guangdong province before July 2018. The development of PMCs at these institutions found in the list was investigated by conducting a questionnaire survey via WeChat and telephone interviews. Results 41 questionnaires were completed, of which 40 were valid, accounting for 97.6% . A total of 40 institutions established PMCs, in which 39 were tertiary hospitals(22.5% of the total number of tertiary hospitals in the province), and 1 was level-1 hospital ( 0.26% of the total number of first-class hospitals in the province). The main PMC categories are chronic disease management clinics, followed by anticoagulant/thrombolytic clinics, pregnant and lactating PMC, COPD management clinics, and drug counseling comprehensive clinics. 81.7% of the visiting pharmacists were of head pharmacist qualifications. The average daily outpatient volume of the 25 hospitals were 3-5 patients. The service time was about 10 -60 minutes per patient in most cases. Their common causes for consultation were adverse drug reactions, drug interactions or incompatibility, drug usage and dosage, drug adjustment and drug selection. Only 9 institutions established a management system, working process and standardized medical records for medication therapy management. Conclusions PMC is an important part of medical services. To ensure its service quality, we should learn from the concept of three-level management of medical quality, and perfect the construction of quality management system of pharmaceutical outpatient clinics.
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OBJECTIVE: To introduce the formation background, development course and common service items of foreign pharmacist-managed clinic, deepen our understanding of its development satus, and provide us a reference of hospital pharmacy development and pharmacist-managed clinic build. METHODS: We search key words"pharmacist-managed clinic"and "medication therapy management" in database PubMed, CNKI and WANFANG DATA, then find out and read relevant research literatures published in recent 20 years. Browse the medical forum and website for related reports of pharmacist-managed clinic. Sum up the relevant clinical research cases, analyze and evaluate the effect of pharmacist-managed clinic. RESULTS AND CONCLUSION: We can conclude that the development of pharmacist-managed clinic can improve the compliance of patients with medication, reduce the incidence of drug-related diseases and hospitalization rates due to drug interactions and adverse reactions under the premise of ensuring the efficacy of drugs, while reducing medical expenses and promoting the rational allocation of medical resources, which is of great significance to the development of hospital medicine and the improvement of national health.
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Adherence to antiretroviral therapy is key contributor to decreasesing morbidity and mortality from HIV/ AIDS infection. However, it is affected by treatment-related factors including the multiple adverse reactions and interactions arising from chronic polypharmacy. In order to determine drug-related problems, 66 outpatients from Hospital Carlos Van Buren on antiretroviral therapy were monitored. 100 % had medication-related problems and 46.1% of those problems were related to the safety of the therapy. Hypertriglyceridemia associated to the combined use of both nucleoside reverse transcriptase inhibitor and a non-nucleoside reverse transcriptase inhibitor was the most frequent adverse reaction. Results show that pharmacological monitoring of patients on antiretroviral treatment is necessary for the early identification of drug-related problems and for the proposal of alternatives that promote therapeutic safety and efficacy.
La adherencia al tratamiento anti-retroviral es un pilar fundamental en la reducción de la morbi-mortalidad de la infección por VIH/SIDA. Sin embargo, se ve dificultada por ser un tratamiento que involucra numerosos medicamentos administrados de forma crónica, con posibilidad de presentar reacciones adversas y/o interacciones. Se realizó un seguimiento farmacoterapéutico a 66 pacientes ambulatorios con tratamiento anti-retroviral del Hospital Carlos Van Buren. El 100% de los pacientes presentó problemas relacionados con medicamentos, afectando en 46,1% a la seguridad de la terapia. La reacción adversa más frecuente fue hipertrigliceridemia, principalmente asociada al uso de dos inhibidores nucleosídico de la transcriptasa reversa con un inhibidor no nucleosídico de la transcriptasa reversa. Los resultados permiten concluir que la monitorización farmacológica de pacientes con tratamiento anti-retroviral identifica en forma precoz los problemas relacionados con medicamentos, favoreciendo la seguridad y eficacia de la terapia propuesta.