临床药师培训中引入治疗药物监测教学的实践和调查

Practice and Survey of Introducing Therapeutic Drug Monitoring Teaching in the Training of Clinical Pharmacists

目的为临床药师培训中建立治疗药物监测(TDM)教学体系提供参考。方法选取2019年重庆市和四川省7家医院临床药师学员,利用“问卷星”平台进行TDM相关问题线上问卷调查,分析TDM对学员临床水平的影响,以及学员对授课形式和内容的意见和建议。结果共回收154份问卷,其中有效问卷152份,回收率为98.70%。学员以女性(73.03%)为主,年龄集中于26~40岁(99.34%),学历以大学本科(66.45%)为主,所在单位级别以3级(96.71%)为主,临床药学方向分布多于10个科室;均知晓TDM,108名学员(71.05%)所在单位未开展TDM,130名(85.53%)认为有必要开展TDM,149名(98.03%)知晓1种及以上TDM方法;114名学员(75.00%)所在单位未开展基因多态性检测,106名(69.74%)认为有必要开展,126名(82.89%)不知道、不清楚基因检测后如何调整药品品种和剂量;148名学员(97.37%)希望进修科室开展TDM课程,130名(85.53%)希望采取理论授课+现场教学的形式开展。陆军军医大学第一附属医院17名学员均表示深刻认识到了TDM的必要性和重要性,临床水平有所提高,并希望获得全面系统的教学,提出了可采取集中授课和轮转学习相结合的方式等建议。在本次调查的基础上,初步建立了“理论授课-现场实践-理论授课”的教学模式。结论有必要对临床药师学员进行全面系统的TDM教学,可采取理论授课和现场实践相结合的方式进行。

Objective To provide a reference for the establishment of therapeutic drug monitoring(TDM)teaching system in the training of clinical pharmacists.Methods Through the questionnaire star platform based on WeChat applet,a questionnaire survey on TDM related issues was conducted among trainees of clinical pharmacy training in seven hospitals in Chongqing municipality and Sichuan Province,and the impact of TDM on the clinical level of trainees,their opinions and suggestions on the teaching format and content were analyzed.Results A total of 154 questionnaires were collected,of which 152 were effective with a recovery rate of 98.70%.The trainees were mainly female(73.03%),aged from 26 to 40(99.34%),with bachelor′s degree(66.45%),their units were mainly tertiary hospitals(96.71%),and their clinical pharmacy directions were distributed in more than 10 departments.All the trainees knew TDM,108 trainees′units(71.05%)did not carry out TDM,130 trainees(85.53%)thought it necessary to carry out TDM,and 149 trainees(98.03%)knew at least one TDM method.A total of 114 trainees′units(75.00%)did not carry out gene polymorphism testing,while 106 trainees(69.74%)thought it necessary,and 126 trainees(82.89%)did not know how to adjust the variety and dose of drugs after gene testing.A total of 148 trainees(97.37%)hoped that the advanced study department would carry out TDM courses,and 130 trainees(85.53%)hoped to carry out TDM courses in the form of theoretical teaching+on-site teaching.All 17 trainees from the First Affiliated Hospital of the Army Medical University expressed a deep understanding of the necessity and importance of TDM,their clinical level has improved,they hoped to obtain comprehensive and systematic teaching,and put forward suggestions on the combination of centralized teaching and rotational learning.Based on this survey,the teaching mode of″theory teaching,on-site practice and theory teaching″was preliminarily established.Conclusion It is necessary to conduct comprehensive and systematic TDM teaching for clinical pharmacist trainees,which can be carried out by combining theoretical teaching with on-site practice.