Competências gerais, específicas e dificuldades para a atuação dos farmacêuticos como preceptores: revisão integrativa / General and specific competencies and difficulties for pharmacists to act as preceptors: an integrative review / Competencias generales y especificas y dificultades del farmacéutico para el trabajo como preceptor: una revisión integrativa

O presente estudo teve como objetivo descrever e analisar as competências gerais, específicas e as dificuldades para a atuação dos farmacêuticos como preceptores. Para isso, foi realizada uma revisão de literatura nas bases de dados eletrônicas PubMed, Web of Science, Embase e Scopus, utilizando artigos publicados sobre competências gerais e específicas dos preceptores farmacêuticos. A busca inicial identificou 355 artigos, dentre os quais 14 atenderam aos critérios de inclusão. Foram encontradas como principais competências gerais: habilidade de comunicação, conhecimento, resolução de problemas, desenvolvimento de pensamento crítico e profissionalismo; como específicas: feedbacks, relacionamento interpessoal, atividades baseadas nas necessidades dos alunos, planejamento, expectativa compartilhada e liderança; e foram vistas como principais dificuldades: necessidade de maior qualificação dos preceptores e falta de tempo para exercer as atividades da preceptoria. O conhecimento dessas competências e dificuldades pode contribuir para uma melhor força de trabalho na educação acadêmica e experiencial em farmácia

The present study aimed aimed at describing and analyzing the general and specific skills and difficulties for pharmacists to act as preceptors. To this end, a literature review was carried out in the electronic databases PubMed, Web of Science, Embase and Scopus, for articles published on general and specific competencies of pharmaceutical preceptors. The initial search identified 355 articles and 14 using articles published met the inclusion criteria. The main general competencies were found to be: communication skills, knowledge, problem solving, development of critical thinking and professionalism; as specific: feedback, interpersonal relationships, activities based on student needs, planning, shared expectations and leadership; and the main difficulties were seen as: need for greater qualification of preceptors and lack of time to carry out preceptorship activities. Knowledge of these skills and difficulties can contribute to a better workforce in academic and experiential pharmacy education

El presente estudio tuvo como objetivo describir y analizar las competencias generales y específicas y las dificultades para la actuación de los farmacéuticos como preceptores. Para ello, se realizó una revisión de literatura en las bases de datos electrónicas PubMed, Web of Science, Embase y Scopus, usando artículos publicados sobre competencias generales y específicas de los preceptores farmacéuticos. La búsqueda inicial identificó 355 artículos, dentro de los quales 14 cumplieron con los criterios de inclusión. Se encontraron como principales competencias generales: habilidad de comunicación, conocimiento, resolución de problemas, desarrollo de pensamiento crítico y profesionalismo; como específicas: retroalimentación, relaciones interpersonales, actividades basadas en las necesidades de los alumnos, planificación, expectativa compartida y liderazgo; y fueron vistas como principales dificultades: necesidad de más cualificación de los preceptores y falta de tiempo para ejercer las actividades de la preceptoría. El conocimiento de estas competencias y dificultades puede contribuir a una mejor fuerza laboral en la educación académica y experiencial en farmacia

Participation of clinical pharmacists in QTc interval prolongation induced by gilteritinib / 药学实践与服务

Objective To explore the role of clinical pharmacists involved in the case of a patient with acute myeloid leukemia whose QTc interval prolongation was induced by gilteritinib, and to provide reference for drug treatment and monitoring of those patients. Methods The abnormal electrocardiogram （ECG） of a patient with acute myeloid leukemia was found in time by clinical pharmacists, who participated in clinical diagnosis and treatment by analyzing the patient’s underlying diseases, diagnosis and treatment process, therapeutic drugs and their potential interactions. Results Clinical pharmacists suspected that the prolonged QTc interval was likely to be an adverse reaction caused by gilteritinib, and recommended immediate discontinuation of the drug and re-examination of the electrocardiogram.The physician took the suggestion to stop the suspected drug therapy with gilteritinib promptly, and ECG was rechecked 3 d later, and the QTc value returned to the normal range. Conclusion Clinical pharmacists participating in clinical diagnosis and treatment could provide better pharmaceutical care for patients.

Exploring Factors Affecting Patients’ Perceptions of the Interpersonal Work of Pharmacy Pharmacists / 社会薬学

In order for pharmacists to be collaboratively involved with patients in pharmacotherapy, there is a need to improve patients’ understanding of pharmacists’ involvement in extended pharmacotherapy, i.e., their interpersonal work. This study explores the factors that affect patients’ perceptions of pharmacists’ interpersonal work. A survey on patients’ perceptions of pharmacists’ interpersonal work was conducted among 450 patients aged 20 years or older who visited a pharmacy. Logistic regression analysis was performed with low and high patient perceptions of pharmacists’ interpersonal work as the objective variables. Valid responses were obtained from 350 participants. More than half of the respondents did not understand the nature of the interpersonal work of pharmacists. Patients who were unaware of pharmacists checking for side effects were more prevalent than those who were unaware of other interpersonal work. Explanations from the family pharmacist (OR＝2.25, P＝0.033) and trust in the pharmacist (OR＝1.11, P＝0.001) had a positive influence on patients’ perceptions of the pharmacist’s interpersonal tasks. As pharmacy pharmacists are increasingly becoming more involved with patients’ drug treatment and to ensure safe drug treatment practices for patients, it is considered important for pharmacists to actively explain their involvement in drug treatment to patients. This will be conducive to building trusting relationships, and for pharmacists to fulfil their function as family pharmacists.

Investigation of the Current Status of Information Sharing Tools between Community Pharmacies and Hospitals on Hospital Websites as a Way for Community Pharmacists to Obtain These Tools / 医薬品情報学

Objective: Owing to the increase in the rate of outpatient prescriptions each year, community pharmacists are expected to actively participate in the drug treatment of patients. Currently, tracing reports (TRs) are used as a tool to feedback patient information obtained at community pharmacies to medical institutions. However, it is reported that about 30% of community pharmacists have never used TRs. It has been reported that the use of templates can increase the use of TRs. Community pharmacists need to understand cancer chemotherapy regimens as outpatient cancer chemotherapy is increasing. The purpose of this study was to examine the utility of using hospital websites as one method of obtaining TR templates and cancer chemotherapy regimens.Methods: 348 hospital websites in Osaka Prefecture were visited between June 26 and August 28, 2022 to investigate the TR template and cancer chemotherapy regimen.Results: Among hospitals in Osaka Prefecture investigated in this study, 16.2% posted tracing reports and 24.0% posted cancer chemotherapy regimens. By the bed functions, both tracing report postings and cancer chemotherapy regimen postings decreased in the order of decreasing acuity. By secondary medical area, although there were regional differences, both tracing reports and cancer chemotherapy regimens were posted in all medical areas.Conclusions: This study allowed many of the surveyed hospitals to access their websites, and found the current status of patient information sharing tools between community pharmacies and hospitals on hospital websites. The percentage of hospitals where these tools are posted is low. However, there are hospitals in all regions that have these tools posted, and it is utility to use hospital websites as a way for community pharmacists to obtain these tools.

Establishment and Initial Application of YOLO-V5 Deep Learning Prediction Model for Accurate Identification of Drug Packaging in Outpatient and Emergency Pharmacies / 医药导报

Objective To develop an accurate deep learning prediction model of YOLO-V5 capable of accurately iden-tifying medication packaging boxes in outpatient and emergency pharmacies,aiming to assist pharmacists in achieving"zero dis-pensing error".Methods A total of 2 560 images of packaging boxes from 136 different drugs were collected and labeled to form the deep learning dataset.The dataset was split into training and validation sets at a ratio of 4∶1.YOLO-V5 deep-learning algorithm was employed for training the data using images from our dataset(train epochs:500,batch size:4,learning rate:0.01).The values of the precision(Pr)and mean average precision(mAP)were used as measures for model performance evaluation.Results The Pr of the four sub-models of YOLO-V5 in the training set all reached 1.00.The mAP_0.5 of YOLO-V5x was 0.95,which was higher than those of YOLO-V5s(0.94),YOLO-V5l(0.94),and YOLO-V5m(0.94).The mAP_0.5:0.95 of YOLO-V5l and YOLO-V5x were 0.85 which were higher than those of YOLO-V5s(0.84)and YOLO-V5m(0.84).Training time and model size were 82.56 hours and 166.00MB for YOLO-V5x which were the highest among the four models.The speed of detection in one im-age was 11ms for YOLO-V5s which was the fastest among the four models.Conclusion YOLO-V5 can accurately identify the packaging of drugs in outpatient and emergency pharmacies.Implementing an artificial-intelligence-assisted drug dispensation sys-tem is feasible for pharmacists to achieve"zero dispensing error".

Application and evaluation of management mode for the use of antimicrobial drugs in county-level medical communities led by anti-infective clinical pharmacists / 中国药房

OBJECTIVE To provide reference for improving the rational use of antimicrobial drugs in primary township medical institutions. METHODS Based on the county prescription pre-review center， a team led by anti-infective clinical pharmacists constructed the management mode for the use of antimicrobial drugs in county-level medical communities with clinical pharmacists as the main team by finding out the main problems in the use of antimicrobial drugs in primary township medical institutions， providing feedback on the problems， organizing relevant training for the problems， improving the customization rules of the prescription pre-review software， implementing the automatic interception and pharmacist online prescription review and other measures. Data on the use of antimicrobial drugs were collected and compared in the 15 primary township medical institutions between January-June in 2022 （before the implementation of the mode） and January-June in 2023 （after the implementation of the mode）. RESULTS Compared with before the implementation of the mode， the utilization rate of antimicrobial drugs in outpatients of primary township medical institutions decreased from 24.97% before the implementation of the mode to 19.39% after the implementation of the mode； the utilization rate of antimicrobial injection in outpatients decreased from 66.10% to 46.80%； the utilization rate of intravenous drip of antimicrobial drugs in outpatients decreased from 52.33% to 40.35%； the rates of combined use of antimicrobial drugs in outpatients decreased from 12.70% to 8.19%； the reasonable rate of antimicrobial prescribing in outpatients increased from 55.28% to 73.93%. After the implementation of the mode， the proportion of antimicrobial prescriptions for each diagnosis was basically the same as before； the defined daily dose system （DDDs） and proportion of a few antimicrobial drugs changed compared with before according to the anatomical therapeutic chemical classification of drugs， among which DDDs of lincomycin， gentamicin and other drugs declined significantly； DDDs of antimicrobial drugs for each classification was basically the same as before according to AWaRe classification. CONCLUSIONS The management mode of the use of antimicrobial drugs led by anti-infective clinical pharmacists is constructed in the prescription pre-reviewing center of county-level medical communities， which can effectively improve the rational use of antimicrobial drugs in the primary township medical institutions.

Prescrição farmacêutica em farmácias comunitárias públicas e privadas de Vitória-ES: barreiras e facilitadores para a implementação da atividade / Pharmacist prescribing in public and private community drugstores in Vitória, Espírito Santo State: barriers and facilitators for the implementation of the activity

Resumo A prescrição farmacêutica avança no mundo, com diferentes países regulando a prática. No Brasil, essa regulação ocorreu em 2013, porém são escassas as informações sobre sua inserção no cotidiano do exercício farmacêutico. Este estudo objetivou analisar a prescrição farmacêutica no município de Vitória-ES, Brasil, e os fatores que influenciam na adesão da prática. Trata-se de um estudo qualitativo com 20 farmacêuticos e 10 gestores de farmácias comunitárias públicas e privadas, realizado a partir de entrevistas, com posterior análise de conteúdo temática para apreender percepções e opiniões. Os farmacêuticos desta pesquisa não prescreviam. Farmacêuticos e gestores identificaram facilitadores para a implementação da atividade, com destaque para os fatores: infraestrutura; fácil acesso ao farmacêutico; e boa receptividade à prescrição. Como barreiras, os fatores foram: número insuficiente de recursos humanos; falta de estímulo institucional à prescrição; e fatores individuais. Além da observação da não execução da prescrição farmacêutica, este estudo trouxe uma oportunidade para identificar elementos que podem estar contribuindo para que o exercício dessa atividade não seja realizado nas farmácias comunitárias. Adaptar rotinas ou contratar pessoal se mostraram as principais modificações necessárias. Paralelamente, ações destinadas a qualificar a formação por meio da educação permanente também se apresentam como necessárias.

Abstract Pharmacist prescribing advances in the world with different countries regulating this activity. In Brazil, this regulation took place in 2013, but there is little information about its insertion in the routine of pharmacist practice. This study aimed to analyze the pharmacist prescribing in the city of Vitória, Espírito Santo state, Brazil, and the factors that influence adherence to the practice. This is a qualitative study based on interviews with 20 pharmacists and 10 managers of public and private community drugstores with subsequent content analysis to apprehend perceptions and opinions. The pharmacists in this research did not prescribe. Pharmacists and managers identified facilitators for the implementation of the activity, highlighting the following factors: infrastructure; easy access to the pharmacist; and good receptivity to the prescription. As barriers, the factors were insufficient number of human resources; lack of institutional stimulus to prescribing; and individual factors. In addition to the observation of non-execution of pharmacist prescribing, this study provided an opportunity to identify elements that may contribute to the non-existence of this activity in community drugstores. Adapting routines or hiring staff were the main necessary changes. At the same time, actions aimed at qualifying training through permanent education are also necessary.

Omissões de prescrição e inclusão de novos medicamentos na farmacoterapia de pacientes idosos na atenção primária à saúde / Prescribing omissions and inclusion of new medications in the pharmacotherapy of older adults in primary care

A falta de uso de um medicamento necessário envolve riscos consideráveis para o idoso. Por meio da prestação de serviços de gerenciamento da terapia medicamentosa (GTM), os farmacêuticos podem contribuir na identificação de condições de saúde não tratadas que precisam de tratamento farmacológico. O objetivo deste estudo é descrever potenciais omissões de prescrição identificadas por farmacêuticos que cuidam de idosos na atenção primária brasileira e se elas estão incluídas na ferramenta START - Screening Tool to Alert to Right Treatment. Os dados foram coletados dos prontuários de 585 idosos acompanhados em serviços de GTM na atenção básica em Minas Gerais, Brasil, de 2014 a 2017. Os farmacêuticos identificaram a necessidade de adicionar pelo menos um medicamento para 28,4% dos pacientes idosos, totalizando 233 medicamentos relacionados a 31 diferentes problemas de saúde não tratados. Um terço (n = 79) dos medicamentos sugeridos pelos farmacêuticos correspondeu a algum critério proposto pela ferramenta START. Estes resultados enfatizam a importância do atendimento holístico ao paciente nos serviços de GTM.

The lack of use of a necessary medication involves considerable risks to the older person. Through the provision of comprehensive medication management (CMM) services, pharmacists may identify untreated health conditions that need pharmacological treatment. The purpose of this study is to describe potential prescribing omissions identified by pharmacists taking care of older adults in Brazilian primary care and whether they are included in the Screening Tool to Alert to Right Treatment (START). Data were collected directly from the records of 585 older adults followed up in CMM services in primary care in Minas Gerais, Brazil, from 2014-2017. Pharmacists identified the need to add at least one medication for 28.4 % of the older patients, totaling 233 drugs related to 31 different untreated health problems. One third (n=79) of the drugs suggested corresponded to some criterion proposed by START. These results emphasize the importance of holistic patient care in CMM services.

Psychodermatology – a case for sensitization of pharmacists in Mumbai, India

Background: Though studies have looked at the attitudes of dermatologists towards psychodermatology, few have highlighted the attitudes of pharmacists towards these conditions. Objectives: To study the knowledge, attitudes and practices of pharmacists towards the prescription of psychotropic medications to dermatology patients. Methods: This cross-sectional analysis included 80 pharmacists from Mumbai, India. We used an interviewer-administered questionnaire to collect information from pharmacists on their demographics, psychotropic medications in dermatological patients, knowledge about psychocutaneous conditions and comfort about dispensing these medications. Results: In our study, 37 (46%) of pharmacists received prescriptions of psychotropic drugs from dermatologists; however, 24 (30%) were not comfortable dispensing them. Sixty (75%) pharmacists felt that only psychiatrists should prescribe psychotropic drugs and 37 (46%) felt that they had a right to refuse to dispense prescribed medication; of these, 15 (19%) had actually refused to give medications to patients. Pharmacists who disagreed with the statement that 'the state of mind is associated with medical conditions', were more likely to discourage psychotropic prescription from dermatologists (29% vs 11%, P = 0.04). Pharmacists with experience of more than five years were significantly more likely to refuse to dispense medications (odds ratio: 5.14, 95% confidence interval: 1.02, 25.83; P = 0.047). Limitations: We did not have a list of all pharmacists in Mumbai; thus, no sampling frame could be applied. Conclusion: Pharmacists do comment on doctors’ prescriptions, discourage certain medications and even refuse to dispense them based on their personal opinions. Since they are the last stop for patients between the doctor and the medication, their inclusion (in addition to dermatologists, psychiatrists and psychologists) in integrated awareness, training and care programs would improve the quality of care of patients with psychocutaneous disorders

Discussion on the concept of collaboration between clinical pharmacists and physicians in China / 中国药房

OBJECTIVE To make up the research gap of the concept of collaboration between clinical pharmacists and physicians in China， and to provide a theoretical basis for further improving the collaboration. METHODS Literature analysis was used to sort out the existing concepts of collaboration. Combined with the current practice and development trend of the collaboration between clinical pharmacists and physicians in China， the basic elements of the concept were deconstructed and the connotation of each component of the concept was explained in detail. RESULTS & CONCLUSIONS Based on the above theoretical research and practical analysis， the concept of collaboration between clinical pharmacists and physicians in the context of China was defined， that is， clinical pharmacists and physicians adhere to the patient-centered and rational drug use as the core in clinical drug therapy， and make joint decisions on drug management and drug therapy on the basis of communication， respect， trust and sharing， so as to ensure the effectiveness， safety and economy of clinical pharmaceutical care， and improve the coordination and cooperation process of comprehensive disease treatment system.

Practice of pediatric pharmacists providing internet medication consultation services based on the platform of “Our Pharmacists” / 中国药房

OBJECTIVE To analyze the effect of pharmaceutical practice of pediatric pharmacists providing internet medication consultation services. METHODS A total of 8 356 children’s medication cases through the “Our Pharmacists” online medication consultation platform （hereinafter referred to as “Our Pharmacists”） were collected from July 2020 to June 2022. The general information， disease type and irrational drug use were analyzed statistically. RESULTS Among 8 356 cases， 4 234 were male and 4 122 were female； the age of children was mainly from 12 months to 3 years old； the consulting diseases were mainly respiratory diseases （46.56%）， followed by digestive system diseases （18.41%） and skin system diseases （12.71%）. Among respiratory diseases， the proportion of irrational drug use was 92.30%， mainly including the use of antibiotics without indication （83.59%）， inappropriate selection of Chinese patent medicines （61.14%） and compound cold medicines （49.77%）， etc. Among digestive system diseases， the proportion of irrational drug use was 71.15%， mainly including not using oral rehydration salts （48.85%）， inappropriate use of probiotics （31.19%）， the use of antibiotics without indication （26.89%）， etc. A total of 4 273 evaluations of pharmacist services were received from child guardians， with a five-star rating of 99.88%. CONCLUSIONS Pharmacists provide pediatric medication consultation services through “Our Pharmacists”， providing individualized evidence-based medication suggestions， increasing the safety of drug use and satisfaction with pharmaceutical care， and ensuring the safety of children medication.

Clinical pharmaceutical practice of constructing mind map by clinical pharmacists for the consultation of pulmonary nocardiosis / 中国药房

OBJECTIVE To explore the construction of mind map by clinical pharmacists for the consultation of pulmonary nocardiosis and its application in clinical practice， and to provide reference for promoting the correct selection of nocardiosis treatment drugs in clinical practice and ensuring drug safety and efficacy. METHODS A total of 7 patients with Nocardia pulmonary infection from January 2017 to April 2022 in our hospital were collected. Based on evidence-based medicine， a consultation mind map （mainly including understanding the medical history， identifying infectious bacteria， identifying risk factors， developing treatment plans， and conducting evaluations） was constructed to address the difficulties of large differences in drug sensitivity among different strains of Nocardia and numerous adverse reactions of Compound sulfamethoxazole as a first-line drug. The treatment plan was developed for 7 patients with pulmonary nocardiosis， and whole-process pharmaceutical care was provided. RESULTS Combined with the mind map， different antibiotic combination regimens were given according to the drug sensitivity results of Nocardia， the different species of Nocardia， and the patient’s allergy history. Among them， 4 cases were treated with imipenem cilastatin， the patients receiving Compound sulfamethoxazole and linezolid for a long time were given full pharmaceutical care， and the adverse drug reactions were timely treated.CONCLUSIONS Clinical pharmacists apply the consultation mind map of pulmonary nocardiosis to the treatment of inpatients， take advantage of pharmacy， participate in clinical drug therapy， and really play a role in the clinical treatment team so as to promote rational drug use.

Exploration of pharmaceutical service model in multidisciplinary diagnosis and treatment of rare diseases in children / 中国药房

OBJECTIVE To explore the pharmaceutical service model in multidisciplinary diagnosis and treatment （MDT） of rare diseases in children. METHODS Clinical pharmacists of West China Second University Hospital （hereinafter referred to as “our hospital”） participated in the process of MDT of children’s rare diseases. Clinical pharmacists took part in the entire diagnosis and treatment process of children and established the MDT pharmaceutical service model of children’s rare diseases by formulating drug treatment plans based on evidence-based practice， improving the accessibility of drugs， pharmaceutical monitoring and drug treatment management. RESULTS From January 2021 to April 2022， clinical pharmacists of our hospital had participated in a total of 39 cases of rare diseases MDT in children， including 21 hospitalized children with rare diseases and 18 outpatient com children with rare diseases， involving a total of 23 rare diseases. Clinical pharmacists completed 45 pharmaceutical zhanglingli@scu.edu.cn rounds and 26 pharmaceutical consultations for rare diseases inpatients， 25 outpatients’ MDT and 5 pharmaceutical outpatient service for outpatients with rare diseases， 38 medication educations for inpatients and outpatients with rare diseases and 25 follow-up services for out-of-hospital patients. There were 24 cases （61.54%） of off-label drug use， involving 13 rare diseases and 16 therapeutic drugs， among which off-label drug use registration of 11 drugs had been completed or was in progress. The temporary purchase evaluations of 3 drugs had been completed； 268 cases of medical insurance drug and high-value drug prescription had been reviewed. CONCLUSIONS Our hospital have primarily established a loop pharmaceutical service model of MDT for children with rare diseases， which covers inpatients and outpatients. The model improves the availability and standardization of clinical application of therapeutic drugs， and diagnosis and treatment level for children with rare diseases in our hospital.

Effects of intensive pharmaceutical intervention led by clinical pharmacists on the risk of ischemic stroke in hypertensive patients / 中国药房

OBJECTIVE To explore the effects of intensive pharmaceutical intervention led by clinical pharmacists on hypertension patients with medium and high risk of ischemic stroke. METHODS The hypertension outpatients with medium and high risk of ischemic stroke， who were assessed by the modified Framingham stroke scale in Zhengzhou People’s Hospital from Oct. 2019 to Apr. 2020， were randomly divided into control group and intervention group， with 200 cases in each group. Patients in the control group received conventional treatment without pharmaceutical intervention； on the basis of conventional treatment， patients in the intervention group received 12-month intensive pharmaceutical intervention （grading management of compliance+ regular follow-up， involving medication education and guidance， blood glucose， blood pressure， blood lipid management and healthy life guidance） provided by clinical pharmacists. The blood glucose indexes， blood lipid indexes， blood pressure compliance rate， medication compliance， 10-year stroke risk and stroke incidence were compared between two groups at baseline and 12 months after enrollment. RESULTS After 12 months of enrollment， the level of low-density lipoprotein cholesterol （LDL-C） in intervention group was significantly lower than that in the same group at baseline， and the levels of fasting blood glucose， glycosylated hemoglobin， total cholesterol and LDL-C in intervention group were significantly lower than those in control group at the same time points （P＜0.05 or P＜0.01）. The compliance rate of blood pressure and medication compliance in intervention group were significantly higher or better than those in control group （P＜0.01）. There were 12 and 15 patients in control group and intervention group turned into low-risk ones respectively， and the proportion of high-risk patients in intervention group was significantly lower than that in control group（P＜0.01）， while the proportion of medium-risk patients was significantly higher than that in control group（P＜0.05）； the incidence of stroke in intervention group was significantly lower than that in control group （1.0% vs. 4.5%， P＜0.05）. CONCLUSIONS The pharmaceutical intensive intervention led by clinical pharmacists can reduce blood glucose and blood lipid levels of hypertensive outpatients， improve their blood pressure compliance rate and medication compliance， and help reduce the risk of stroke.

Practice and experience of clinical pharmacists participating in pharmaceutical care for patients after heart valve replacement / 药学实践与服务

Objective To explore the starting point of pharmaceutical care by clinical pharmacists for patients after heart valve replacement. Methods Combined with typical cases, the content, focus and effects of pharmaceutical care for patients after heart valve replacement were summarized. Results Clinical pharmacists provided pharmaceutical services such as anticoagulant care and warfarin dosage adjustment, infection monitoring and rational use and care of antibacterial, perioperative airway management, stress ulcer (SU) prevention and pharmaceutical care, and warfarin medication education for patients, which had promoted the rational use of drugs and improved the treatment results of patients. Conclusion Pharmaceutical care by clinical pharmacists could be helpful to improve the safety and efficacy of drug treatment for patients after heart valve replacement.

An Approach for Providing Drug Information to Primary Care Physicians of Patients Undergoing Nephrectomy Using Information Forms Created by Urologists and Pharmacists / 日本プライマリ・ケア連合学会誌

Tohoku Medical and Pharmaceutical University Hospital uses an information form created by doctors and pharmacists to provide postoperative information to patients who undergo nephrectomy at the Department of Urology. The form recommends that patients' physicians change prescriptions and adjust medication doses considering post-nephrectomy deterioration of renal function in patients with a single remaining kidney. Of the 7 patients who used this information form, prescription changes were made in 4 patients. An information form jointly created by a physician and pharmacist may affect prescription changes.

Practice research on problem-based learning combined with case-based learning in the training and teaching of traditional Chinese medicine clinical pharmacists / 中华医学教育探索杂志

Objective:To investigate the application effect of problem-based learning (PBL) combined with case-based learning (CBL) in standardized training of traditional Chinese medicine (TCM) clinical pharmacists.Methods:A total of 40 TCM clinical pharmacists who received the standardized training of TCM clinical pharmacy in Chongqing Traditional Chinese Medicine Hospital from August 2020 to July 2021 were enrolled as subjects and were randomly divided into research group (PBL combined with CBL) and control group (traditional teaching). The two groups were compared in terms of theoretical knowledge, practical skills, and the degree of satisfaction with training. SPSS 23.0 was used to perform the t-test and the chi-square test. Results:Compared with the control group, the research group had significantly higher scores of theoretical knowledge [(49.45±5.52) vs. (40.54±5.65), P<0.05] and practical skills [(48.65±5.23) vs. (41.53±4.41), P<0.05]. As for the degree of satisfaction with training, the questionnaire survey showed that compared with the control group, the research group had significantly better results in strong ability to analyze and solve clinical issues, strong learning initiative and enthusiasm, teachers' willingness to interact with students, teaching and learning benefiting each other, and satisfaction with this assessment method ( P<0.05). Conclusion:The combined teaching model of PBL and CBL can help to improve the teaching quality of standardized training for TCM clinical pharmacists and cultivate the good learning habits, independent thinking ability, and clinical thinking ability of pharmacists, and therefore, it is beneficial to cultivating high-quality TCM clinical pharmacists.

Analysis of the current performance of pharmacy outpatient services at grassroots medical institutions at home and abroad / 中华医院管理杂志

Pharmacy services in grassroots medical institutions provide professional pharmacy services for patients. This service not only expanded the scope of primary care delivery, but also meets the residents′need for appropriate medication. At present, the majority of grassroots medical institutions in China provide outpatient pharmacy services by means of pharmacy service alliance, and foreign grassroots medical institutions mainly provide pharmaceutical outpatient services with drug treatment management as the core for patients by granting pharmacists partial prescription rights.In recent years, pharmaceutical outpatient services in grassroots medical institutions had achieved good results in improving patient clinical outcomes, enhancing medication rationality, and enhancing patient compliance. However, there were many unresolved issues, including low public awareness, shortage of pharmaceutical talents, and imperfect guarantee systems. The author suggestted that efforts should be made to increase the publicity of pharmaceutical outpatient services, improve the training mechanism for pharmacists, strengthen cooperation between pharmacists and clinical physicians, include pharmacists in the contracted service team of family doctors, and improve various guarantee systems, in order to provide reference for promoting the sustainable development of pharmaceutical outpatient services in grassroots medical institutions in China.

Analysis and enlightenment on the current situation of pharmacist team construction in Japanese hospitals / 中华医院管理杂志

With the acceleration of China′s economic and social development and aging process, the construction of the pharmacist team was increasingly valued.By combing and analyzing the status of pharmacist allocation in Japanese medical institutions, the path of pharmacist career development, and the content of pharmaceutical services and the training mode, the author proposed that China should learn from relevant mature experience to further strengthen the allocation of pharmacists in medical institutions, improve the Professional certification system of clinical pharmacists, establish a standardized pharmacist training mode, so as to provide a reference for building a standardized, professional and sustainable team of pharmacists in medical institutions.

The Medical Economic Effects of Two Pharmacists Checking Patient Medications Brought to Hospitals by Part of Inpatient Pharmaceutical Services / 医薬品情報学

Objective: Pharmacists in inpatient pharmaceutical services are required to evaluate the medications that patients bring with them to the hospital when admitted and to make recommendations to physicians about these medications' proper use. Many hospitals perform such inpatient pharmaceutical services. Studies have found that pharmacists with insufficient years of experience are often put in charge of this practice. This has resulted in patients continuing to take inappropriate medications. We hypothesized that the involvement of another pharmacist in checking outpatient medications brought to the hospital might lower the rate of inappropriate use. We initiated the rechecking of medications brought to the hospital by the drug information (DI) pharmacist, based on the need for cooperation between the DI pharmacist and ward pharmacists.Methods: We initiated rechecks by DI pharmacists of medications brought to the hospital and first checked by ward pharmacists, and estimated the medical economic impact of pharmaceutical intervention between 1 May 2019 and 30 April 2020.Results: Within one year, the DI pharmacist suggested 15 interventions, including four interventions related to digitalis products and three related to direct oral anticoagulants. The medical economic impact was estimated to be 10,175,000 yen.Conclusion: Our findings suggest that checking by another pharmacist of outpatient medications brought to the hospital is a useful addition to the check by ward pharmacists.