基于9省(区、市)调查的全国基层药学人员药学服务现状及其培训需求研究

Status Quo of Pharmaceutical Care and Training Needs Research of Primary Pharmaceutical Staff Based on 9 Provinces(Regions,Cities)Investigation

目的:为探索提高基层药学人员药学服务能力的途径提供参考。方法:采用问卷调查方法,抽取全国9个省(区、市)的部分基层医疗卫生机构的药学人员(包括药剂科主任),主管药学工作的院长/副院长、医护人员、患者,分别从不同的角度进行调查,并就调查结果进行统计和分析。结果:共77家基层医疗卫生机构参与本调查,共计发放问卷2 273份,回收有效问卷2 248份,有效回收率为98.9%;有效问卷中药学人员填写的有278份(包括药剂科主任填写的68份),主管药学工作的院长/副院长填写的有48份,医护人员填写的有771份,患者填写的有1 151份。调查结果显示,受访基层医疗卫生机构药学人员中取得药学专业技术职务任职资格的仅140人,占50.4%;受访基层医疗卫生机构开展的药学服务项目有限,开展比例较高的是用药交待(85.7%)和用药咨询服务(84.4%),而为老年患者建立《健康服务记录卡》(19.5%)、开展慢病管理(23.4%)、在基层开展慢病相关药学知识宣传(37.7%)等项目开展比例则较低。受访医护人员对药学人员药学服务的总体满意度一般(77.2%);受访患者对药学人员服务态度的总体满意度较高(85.5%),对其专业知识水平的总体满意度一般(78.2%);受访药学人员对药学培训内容的需求比例较高的项目依次为用药交待(74.5%)、用药咨询服务(71.9%)和提供药学信息(64.0%),而对开展慢病管理(22.3%)、生活方式指导(27.0%)等项目的培训需求比例则较低,较偏爱的药学培训形式从高到低依次为去上级医疗卫生机构进修(65.4%)、专家讲座(60.1%)和基层培训基地的进修培训(57.9%)。结论:基层医疗卫生机构开展的药学服务项目很局限,需进一步拓展并统一服务标准;基层医护人员和患者对药学人员药学服务的总体满意度不高,尚需进一步提高;基层药学人员的相关药学培训仍需加强,可根据其偏爱的培训形式组织实施培训,以提升其药学服务能力。

OBJECTIVE：To provide reference for exploring the way to improve the ability of pharmaceutical care in primary pharmaceutical staff. METHODS：Questionnaire survey was conducted among pharmaceutical staff（including head of pharmacy department）,director/vice-director of hospital in charge of pharmacy,medical staff and patients from primary medical institutions in 9 provinces（regions,cities）. The results of investigation were analyzed statistically. RESULTS：A total of 77 primary medical institutions involved in the survey. Totally of 2 273 questionnaires were sent out,and 2 248 effective questionnaires were collected with effective recovery rate of 98.9%. Among effective questionnaires,278 questionnaires were filled out by pharmaceutical staff（68 by head of pharmacy department）,48 by director/vice-director of hospital in charge of pharmacy,771 by medical staff and 1 151 by patients. Results of survey showed that only 140 pharmaceutical staff had obtained pharmacy practice qualification,accounting for 50.4%. The surveyed primary medical institutions provided limited pharmaceutical care projects,and the projects with high proportion were medication explanation（85.7%） and medication consultation（84.4%）. The establishment of Health Service Record Card in elderly patients（19.5%）,the development of chronic disease management（23.4%） and the development of chronic disease related pharmaceutical knowledge publicity at the primary level（37.7%）took up low proportion relatively. Overall satisfaction of surveyed medical staff to pharmaceutical care of pharmaceutical staff was general（77.2%）. Surveyed patients greatly satisfied with the attitude of pharmaceutical staff（85.5%） but overall satisfaction of them to professional knowledge of pharmaceutical staff（78.2%） was general. Surveyed pharmaceutical staff training needs in descending order were medication explanation（74.5%）,medication counseling（71.9%） and providing pharmaceutical information（64.0%）. However,the projects which had low proportion of training needs included chronic disease management（22.3%） and lifestyle guidance（27.0%）,etc. The more favorite training forms in descending order were further study in medical institution at higher level（65.4%）,expert lectures（60.1%）and training in the training base（57.9%）. CONCLUSIONS：The primary medical institutions provided limited pharmaceutical care. It is necessary to further explore and standardize pharmaceutical care criteria. The overall satisfaction of medical staff and patients on pharmaceutical care of pharmaceutical staff is not high in primary institutions,and it needs to be further improved. The related pharmacy training for primary pharmaceutical staff still needs to be strengthened,and can be conducted according to the favorite form of training so as to improve the ability of pharmaceutical care.