上海地区医疗机构开展的药师门诊现状调查与分析

Investigation and analysis of the present status of pharmacist outpatient service in Shanghai medical institutions

目的:了解上海地区各医疗机构开展药师门诊的现状,促进药学服务模式转型,为病人提供更好的药学服务,同时发现目前本市药师门诊存在的问题。方法:采用互联网发放问卷的方式,对上海地区医疗机构中从事医药工作的人员进行问卷调查,收集数据并统计分析。结果:共收回221份问卷,其中有效问卷187份,有效率为84.62%。其中170家医疗机构(90.91%)开设了药物咨询窗口,但仅有48家(25.67%)开设了药师门诊。药师门诊开设时间较短,每周咨询次数较少。药师门诊主要集中在慢性病综合门诊和慢性病专科门诊;药师门诊出诊人员大多数是临床药师;绝大多数药师门诊不收取费用,且病人的就诊时间大多在30min以内。药师门诊的记录方式多样:有纸质版、office软件、医院信息系统(HIS)、专用单机版电子记录系统,以及不记录。对病人的用药指导形式多种多样:为病人提供宣传资料,门诊病历记录,书面专业建议和口头咨询。结论:大部分医疗机构开设了药物咨询窗口,但药师门诊开设少且时间短。医疗机构以及国家医保对药学服务的投入需要增加。前来咨询的病人主要来源于医师转诊和导医推荐;咨询的问题过于简单;同时缺乏简单有效的记录咨询软件,应督促医院开发药师门诊软件系统,为门诊药师提供发挥专业作用的平台,更好地利用有限的医疗资源保障人民健康。

Objective：To investigate the present status of pharmacist outpatient service（POS）in Shanghai medical institutions,so as to promote transformation of pharmaceutical care mode,provide patients with better pharmaceutical care and at the same time find out existing problems concerning POS.Methods：A questionnaire survey was conducted among medical workers in Shanghai medical institutions through distribution of questionnaire forms viaInternet,and the obtained data were collected and analyzed.Results：Retrieved were 221 questionnaire forms,of which 187 were valid,accounting for 84.62%.Of all the medical institutions investigated,170 institutions（90.91%）opened a window for pharmaceutical consultation and only 48 medical institutions（25.67%）offered POS.The time for POS was not only short,but the number of weekly consultation was relatively few.POS mainly concentrated on comprehensive outpatient service and specialized outpatient service of chronic diseases;POS was mostly offered by clinical pharmacists;in most cases POS was free of charge;and the service time was mostly within30 minutes for a patient.Records of POS were as wide as varied：the paper form,the Office software,the hospital information system（HIS）,the special standalone version electronic recording system,and non-recording.Ways of medication supervision for patient were also varied：provision of propaganda materials to patients,data recording in patient medical history,specialized recommendations and consultations in both verbal and oral forms.Conclusion：Most medical institutions have offered pharmacist consultation service,but with less POS and for a relatively short time.The input into pharmaceutical care by medical institutions and national health insurance should be increased.Patients coming for outpatient consultation service are mostly referrals and those directed by consultation doctors.Mostly,the problems consulted are too simple and simple and effective recording software system is insufficient.For this reason,efforts should be made by hospitals for the development of POS,so that the platform for pharmacists to play their role in this respect could be provided,and better health service could be offered by utilizing limited medical resources.