美国临床药学的发展与实践

Development and Practice of Clinical Pharmacy in the United States

目的:介绍美国临床药学的发展史及其实践领域的拓展。方法:简要总结20世纪美国临床药学发展史及其临床实践领域从住院部拓展到门诊,并描述临床药师的主要职责。结果与结论:美国临床药学的重心已从用药和药物调剂向"以患者为中心"、以提高用药安全和有效为目标的临床实践上倾斜。20世纪初,在大多数医院尚无雇佣药师时,一些药师中的有识之士就已开始参加患者监护查房。此后,出现了更多开创性临床实践模式,昭示着药学职业的巨大潜力。这一系列改变也催生了药学博士项目发展,将药师更好地培养为临床人员,运用其药学专长优化患者监护。虽然临床药学的进步并非一蹴而就和一帆风顺,但经过药师和专业组织的努力,临床药学发展方向发生转变,药师已成为多学科团队中不可或缺的一员。

OBJECTIVE：To introduce the development of clinical pharmacy in the United States,and to develope practice field. METHODS：Some highlights of the history of clinical pharmacy practice over the past century were summarized briefly,and clinical pharmacy practice expanded from inpatient department to outpatient department;some typical responsibilities of clinical pharmacists in the United States were described. RESULTSCONCLUSIONS：The practice of clinical pharmacy has evolved from a focus on medication and product delivery to＂a patient centered＂,with the goal of improving the safe and effective use of medications. Beginning in the early 1900 s,during a time when most hospitals did not employ a pharmacist,forward-thinking pharmacists first participated in patient care rounds. This was followed by the other innovative clinical practice models,which demonstrated the potential of the pharmacy profession. These changes led to the development of the Doctor of Pharmacy degree program to better train pharmacists to be clinicians,using their expertise of pharmacy to optimize patient care. This evolution did not occur quickly or without challenge,but through the effort of pharmacists and professional organizations to change the direction of pharmacy practice,pharmacists are now recognized as an essential component of a multidisciplinary care team.