Papers on drug safety and pharmaceutical service 1
Effective implementation of pharmaceutical care can achieve ideal therapeutic effect and ensure patients' safe and rational drug use.
Keywords: drug safety; Drugs; Pharmaceutical care
In our daily life, drugs provide an important guarantee for people's health.
In addition to the professional use of drugs by doctors in hospitals, we choose drugs ourselves more often in life.
Scientific and rational drug use is of great significance to people's health.
How do people choose and apply drugs scientifically and reasonably? It is necessary to strengthen the understanding of drug safety knowledge and improve pharmaceutical services.
1 drug safety
First of all, we must correctly understand drugs. Drugs have two sides, which can prevent and cure diseases, and improper application can also lead to diseases.
Only scientific and reasonable application can achieve the function of preventing and treating diseases.
1. 1 Master scientific and correct drug knowledge. How should ordinary patients actively understand drugs and use them safely and reasonably? Generally speaking, there are nothing more than three aspects: ① scientific medication habits; ② Scientific health care habits; ③ Pay more attention to the knowledge of medication and health care, and choose medical treatment and medication reasonably.
According to the variety, specifications, indications, dosage and route of administration of drugs, drugs in China are managed according to prescription drugs and over-the-counter drugs respectively.
Prescription drugs can only be prepared, purchased and used by licensed doctors or licensed assistant doctors; Over-the-counter drugs can be judged, purchased and used by themselves without the prescription of medical practitioners or assistant medical practitioners.
OTC drugs for short.
1.2 Common drug abuse
1.2. 1 insomnia, so more people take antipsychotics.
But taking antipsychotic drugs for a long time will lead to people's dependence and tolerance to drugs. The dosage of antipsychotics is getting bigger and bigger, and it is more and more inseparable. If it is serious, it will be addictive. Therefore, it is necessary to avoid taking antipsychotic drugs for a long time and adjust sleep with good living habits and psychological adjustment.
1.2.2 Clinical abuse of antibiotics is quite common at home and abroad. In the United States,1.500 million prescriptions are antibiotics every day, and relevant experts think that 50% of them are unnecessary, which is more serious in China.
According to some data, the utilization rate of antibiotics in inpatients in tertiary hospitals in China is about 70%, 80% in secondary hospitals and 90% in primary hospitals [1].
The abuse of antibiotics not only leads to the high utilization rate of drugs and the sharp rise of medical expenses, but also brings serious consequences to clinical treatment.
For a long time, people have become accustomed to taking antibiotics as a standing medicine at home when they have a slight headache and brain fever. However, some patients take the initiative to prescribe good drugs and expensive drugs, which leads to waste of resources and bacterial resistance.
Of course, rational drug use is necessary, but sometimes patients just have a cold caused by virus infection, and antibiotics are simply ineffective against the virus. It is enough to use some anti-cold drugs instead of conventional antibiotics.
Improper use of antibiotics often leads to unnecessary economic waste and adverse reactions, some of which are very serious, such as allergic reactions of cephalosporins and penicillins, toxicity of streptomycin and gentamicin to ears and kidneys, and toxicity of erythromycin to liver. In addition, it may also lead to drug resistance of bacteria and increase complications.
1.2.3 antipyretic and analgesic drugs are the most widely used drugs. In daily life, when people often encounter headache, brain fever, toothache, joint pain, lumbago and leg pain or dysmenorrhea, people often go to pharmacies to buy antipyretic or analgesic drugs, such as aspirin, paracetamol, indomethacin and ibuprofen, without the treatment of doctors. In fact, these drugs are only symptomatic treatment.
Toothache should be treated in stomatological hospital. Pain in joints, waist and legs can be relieved by physical therapy or external plaster, and the adverse reactions of many drugs, such as aspirin and indomethacin, can be reduced. If you take it regularly, it will cause great irritation to the stomach, and in severe cases, it will cause gastric ulcer bleeding.
2. Strengthen pharmaceutical services
2. 1 The purpose of pharmaceutical care is to ensure the safety, rationality and effectiveness of customers' medication and guide patients to use drugs safely and reasonably. In daily work, pharmacists should explain to patients the basic knowledge of drugs used, and explain the usage and precautions of drugs.
2.2 Necessity of medication guidance As a 1 pharmacist working in a pharmacy, I really feel the necessity of providing medication guidance for patients.
It is an important guarantee for the safety and effectiveness of drug treatment to give medication guidance to patients or their families and improve their compliance with treatment.
In daily work, pharmaceutical work is not only about dispensing drugs according to prescriptions, but also paying attention to the medication guidance of patients and their families. It is very important to carry out pharmaceutical consultation.
2.3 patient medication guidance In order to get the best medical care, patients have the right to clearly understand the basic knowledge of the drugs they use, and pharmaceutical sales personnel also have the responsibility to explain the usage of drugs to patients.
The contents of medication guidance should include: correct medication method, appropriate medication time, medication precautions, potential adverse reactions, etc.
2.3. 1 Patient's compliance with drugs Mastering the medication method is the key for patients to take drugs correctly.
In most cases, due to the large number of customers in pharmacies, pharmacists are often limited to taking drugs according to prescriptions, and the method of taking drugs is written on the medicine bag.
When the customer leaves the hospital, he doesn't know how to take his medicine, and the patient doesn't know what to pay attention to when eating, or he doesn't understand, which may lead to the patient not taking the medicine completely or completely according to the doctor's advice.
At work, we often encounter the following situations: because the drug effect is not obvious, the patient feels better, or because of some uncomfortable side effects, the patient may stop taking the drug prematurely, which leads to the patient's non-compliance.
These situations are particularly obvious in internal medicine, especially in the use of antibacterial drugs. When the patient feels that the symptoms are relieved or slightly improved, he stops taking the medicine on his own, which leads to repeated illness, drug resistance, prolonged course of disease and unnecessary pain to the patient.
For the medication method written by the pharmacy staff on the medicine bag: if necessary, it can't be fully understood, which leads to the patient not following the doctor's advice.
For example, when using atropine, if the patient's body temperature is above 39℃, it must be cooled first, otherwise it is difficult to cool down because of inhibiting sweat gland secretion, which may make the body temperature higher.
2.3.2 Usage and dosage of drugs If pharmacists explain some common knowledge of drug health care and medication at the same time, patients will master scientific medication methods and gain medication knowledge, which is conducive to the rehabilitation of diseases.
The above two can play a role in preventing and treating diseases in people's daily life.
With people's increasing concern about health and quality of life, the harm of adverse drug reactions has attracted more and more attention from the whole society.
Therefore, people should take a disease-free attitude, use drugs rationally if they are sick, treat the adverse reactions of drugs correctly, use drugs correctly, keep drugs correctly, and constantly improve the level of drug use. At the same time, pharmaceutical sales departments should also strengthen pharmaceutical services so that people can use drugs safely, effectively, economically and reasonably.
References:
[1] Liu Zhensheng, Jin Dapeng, Chen Zenghui. Hospital infection management [M]. Beijing: Military Medical Science Press, 2000: 3 14.
Present situation of hospital pharmaceutical service II
In recent years, with the deepening of China's medical system reform and the general improvement of people's health awareness and legal awareness, more and more consumers have begun to demand the right to know and choose drugs; In addition, the implementation of drug classification system makes more and more consumers willing to take self-medication for health care and treatment.
In this new situation, how to meet the needs of consumers, ensure the safety and effectiveness of drug use, and provide comprehensive pharmaceutical services has become an important topic for medical workers.
1 current situation of pharmaceutical care
There is no pharmaceutical service system of 1. 1. Some developed countries in the world have relatively perfect pharmaceutical service concepts and systems, and complete legal systems to adapt to them. At the same time, there is a corresponding industry self-discipline management mechanism to make up for the lack of legal provisions.
However, the concept of pharmaceutical care was not introduced to China for a long time. At present, the research on pharmaceutical service is still in its infancy, and everyone's understanding of pharmaceutical service is not enough. The medical service system is still blank in China.
1.2 An important place where pharmaceutical services provided by pharmaceutical service institutions are not perfect is the hospital pharmacy. However, at present, most hospital pharmacies in China are still engaged in simple preparation, prescription preparation and drug distribution, and still stay in the traditional, closed and passive service mode.
Pharmacists in hospital pharmacies lack communication with doctors and patients in their work and cannot actively participate in pharmaceutical services.
As another important place to provide pharmaceutical services, social pharmacies are playing an increasingly important role in developed countries in Europe and America.
In China, relevant data show that the focus of drug supply is gradually shifting from hospital pharmacies to social pharmacies, and half of the drugs used by the people every day come from pharmacies outside hospitals.
In this case, social pharmacies should play a more important role in pharmaceutical services, but the actual situation is far from ideal.
At present, pharmacists in social pharmacies in China mainly focus on drug sales, and they don't know enough about how to do a good job in pharmaceutical service and its significance. The narrow service scope and lack of depth and breadth have affected the quality, effect and safety of public medication to some extent.
1.3 The overall quality of medical service providers is worrying. As a pharmaceutical service provider, the overall quality of pharmacists is worrying.
In a recent survey of licensed pharmacists, 7 1.9% of the respondents were familiar with the use of commonly used OTC drugs; 67.4% people think that they can accurately understand the intention of the prescriber and allocate prescriptions as required; 50.5% people think they are familiar with the incompatibility of commonly used drugs and the interaction between drugs; 47.2% people think they are familiar with the treatment cycle of commonly used antibacterial drugs.
This shows that most of the respondents' work is still in the primary stage of pharmacists' examination and prescription preparation, lacking the ability to provide pharmaceutical services, and there are still considerable difficulties in providing pharmaceutical services.
2. Reasons for poor quality of pharmaceutical care
2. 1 Pharmaceutical care started late in China, lacking institutional guarantee. The traditional concept of pharmaceutical work still has great influence, and the concept of pharmaceutical service has only entered China for a few short years, with little influence.
Until February 25th, 2003, OTC Pharmaceutical Association of China issued the first industry standard related to pharmaceutical services, Good Manufacturing Practice (Trial) (GPP).
Relevant laws and regulations have not yet been formulated.
Without the strong support and guarantee of national laws, it is really difficult to promote the development of pharmaceutical services only by one industry standard.
2.2 Pharmaceutical service providers pay insufficient attention to pharmaceutical services. For a long time, hospitals in China have paid more attention to medicine than medicine. The evaluation standard of hospital pharmacy work quality does not include the quality of pharmaceutical service, but mainly takes the supply of drugs and the economic benefit of pharmacies as the standard.
The evaluation of pharmacists' work also does not consider the effect of drug treatment.
This makes pharmacy managers pay more attention to the supply of drugs in their work, rather than how to provide quality pharmaceutical services.
However, the development of social pharmacies is still in the primary stage, with insufficient understanding of the competition and development law under the market economy system, emphasis on economic benefits in operation, insufficient understanding of the importance of pharmaceutical services and lack of pharmaceutical service atmosphere.
The work of pharmacists in most social pharmacies is mainly sales, and some places even let pharmacists act as "drug holders".
2.3 There are problems in the training mode and selection mechanism of pharmaceutical talents. Pharmaceutical higher education in China has always followed the over-academic training mode of the former Soviet Union. Chemistry is the main course of pharmacy, and the knowledge system mainly serves scientific research.
However, the proportion of biomedical courses is very small, which leads to the lack of biomedical knowledge of students.
At the same time, the clinical practice time of pharmaceutical students is generally insufficient or even missing, which is not conducive to the cultivation of students' ability to cope with rational drug use.
Pharmaceutical service requires pharmacists to know not only pharmaceutical knowledge, but also medical and management knowledge, and have strong communication skills between doctors and patients.
The students trained by the current pharmaceutical model are incompetent in many aspects, which makes them feel powerless in carrying out pharmaceutical services and can only act as "drug salesmen".
In addition, as an important part of the pharmacist selection mechanism, the licensed pharmacist qualification examination also has obvious defects. Its content is biased towards industrial production and macro-chemical knowledge, ignoring the knowledge assessment of clinical medication, pharmaceutical consultation and medication guidance.
This mechanism is not conducive to the selection of professionals with pharmaceutical service ability, and also makes licensed pharmacists not pay attention to clinical practice. As a result, licensed pharmacists in China generally lack the ability to provide pharmaceutical services to patients and to check whether prescription drugs will interact and whether the dosage is correct.
Three Solutions to the Dilemma of Pharmaceutical Care
3. 1 Absorb foreign advanced experience, establish a pharmaceutical service system in line with China's national conditions, and learn from foreign practical experience to establish a set of guiding principles for pharmaceutical service standardization methods.
Based on the main contents and requirements of WHO GPP, referring to the relevant norms of pharmaceutical services in developed countries and combining with the actual situation of medical reform in China, a series of legal norms and industry norms related to pharmaceutical services have been formulated.
According to the respective characteristics of hospital pharmacies and social pharmacies, the corresponding quantitative indicators of pharmaceutical service implementation are determined.
At the same time, strengthen publicity, so that all walks of life can fully understand the role of pharmacists in patient medication and the benefits that pharmaceutical services can bring to patients and society.
Promoting the development of pharmaceutical services in China in all directions.
3.2 Change ideas and establish a new pharmaceutical work system. Hospital pharmacies and social pharmacies should be aware of this. In fact, pharmacies should not only sell medicines, but also provide consumers with health while selling medicines.
Fully realize that improving the quality of pharmaceutical service can not only make consumers get better treatment and health care, but also improve the competitiveness of the unit itself.
Incorporate pharmaceutical service into the evaluation system of pharmacists, and reconstruct the service standard of pharmacies under the guidance of GPP.
According to the different situations of hospital pharmacies and social pharmacies, we should set up their own specialized pharmaceutical service areas, equip them with corresponding facilities, arrange full-time pharmacists and provide corresponding services.
3.3 Reform the training mode and selection mechanism of pharmaceutical talents, optimize the teaching plan and reform the traditional education mode.
Adjust the content and class hours of chemistry courses, add biomedical courses, clinical basic courses and management courses, and change the pharmaceutical education mode from "chemistry mode" to "biomedicine-management-pharmacy" mode.
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