基于中成药说明书【禁忌】完善的临床药学服务策略

Strategies for clinical pharmaceutical care based on the improvement of “contraindications” in Chinese patent medicine instructions

中成药说明书【禁忌】是指导药学服务、临床合理用药的重要依据。由《上市中成药说明书安全信息项目修订技术规范禁忌》(T/CACM 1370.3-2021)引发思考,系统梳理了示例中成药说明书【禁忌】内容,发现存在信息缺失、范围不清晰、同品种间表述不一等问题,结合专家访谈论证分析后提出中成药说明书【禁忌】的完善思路,探讨基于【禁忌】完善的药学服务策略。该策略以传统与现代结合为原则,以医师、药师、患者及家属、药品上市许可持有人为主体,包括了禁忌情形的发现、禁忌情形的规避、【禁忌】的应用实践等内容,指导药学服务的开展,提升药学服务水平。基于中成药说明书【禁忌】完善的药学服务策略,能够在实际临床用药中体现传承与创新的中药使用特色,促进临床合理用药。

The “contraindication” section in the instructions of Chinese patent medicine is crucial in guiding pharmaceutical care and rational clinical use of medicines. This paper was derived from Technical Specification for Revision of Safety Information of Listed Proprietary Chinese patent medicines(T/CACM 1370.3-2021). After systematically combing the contents of “contraindications” in the instructions of Chinese patent medicine, we found that there are problems such as lack of information, unclear scope, and inconsistent expressions of the same varieties. We then advised on how to improve “contraindications” in the instructions of Chinese patent medicine based on expert interview, demonstration and analysis, on the basis of which we explored the strategies for improving clinical pharmaceutical services. The strategies are based on the principle of combining tradition and modernity, and include the discovery, avoidance, and application of contraindications with doctors, pharmacists, patients and their families, and pharmaceutical marketing authorization holders as the main subjects to guide and improve the development of pharmaceutical care. The improved pharmaceutical care strategy based on the “contraindication” in the instructions of Chinese patent medicine embodies inheritance and innovation of Chinese patent medicine use in the actual clinical use, and promotes the rational clinical medication.