Exploring the Contribution of Pharmacists in Addressing the Opioid Crisis through Naloxone Prescriptions and Pharmacist-Led Interventions

The opioid epidemic in the United States continues to take the lives of many individuals, with overdoses continuing to rise every year. Naloxone is an opioid antagonist that is efficacious in temporarily reversing opioid overdoses. Pharmacists play an important role in the accessibility and education of naloxone in both the community and health system settings. Recent efforts, such as co-dispensing naloxone with opioid prescriptions, naloxone training programs, and approval of naloxone to be over-the-counter, have been implemented in hopes to better control the opioid epidemic. Despite the efforts to make naloxone more accessible, there are still some barriers to overcome such as lack of training, cost, stigma, and patient refusal. This review aims to explore the contributions pharmacists have made thus far and define the barriers that still have to be resolved.

Comparison of the Development Model of DTP Pharmacy between China and the United States and Its Enlightenment

Objective To systematically analyze the development status of DTP pharmacy in the United States and China,and to find out the problems in China’s DTP pharmacy and put forward some countermeasures and suggestions.Methods Relevant literature was searched and reviewed to study the history,market scale and development trend of DTP pharmacy in the United States and China.Then,the problems in China’s DTP pharmacy were found out.Results and Conclusion DTP pharmacy model in the U.S.has taken shape and is maturing.The high degree of industry concentration is an important feature of the U.S.pharmacy.In contrast,China’s DTP pharmacy started late,and the industry pattern has not yet been finalized.There are still some problems in the DTP pharmacy certification and quality management.It is recommended to promote the rapid development of DTP pharmacies in China by encouraging the outflow of prescription drugs,establishing a third-party pharmacy accreditation organization and strengthening the team of licensed pharmacists and other personnel.

Simulated patient methodology as a“gold standard”in community pharmacy practice:Response to criticism

The simulated patient methodology(SPM)is considered the“gold standard”as covert participatory observation.SPM is attracting increasing interest for the investigation of community pharmacy practice;however,there is criticism that SPM can only show a small picture of everyday pharmacy practice and therefore has limited external validity.On the one hand,a certain design and application of the SPM goes hand in hand with an increase in external validity.Even if,on the other hand,this occurs at the expense of internal validity due to the trade-off situation,the justified criticism of the SPM for investigating community pharmacy practice can be countered.

Evaluation of the Effectiveness of Community Pharmacy Services on Rational Medication Use in Elderly Patients with Hypertension and Diabetes

Objective:To explore the effect of community pharmacy services on rational medication use in elderly patients with hypertension and diabetes.Methods:Between November 2022 and December 2023,80 elderly patients with hypertension and diabetes were selected and randomly divided into a control group(routine medication guidance)and an observation group(community pharmacy services),with 40 subjects each.The medication effect scores,blood pressure,blood sugar levels,and quality of life scores before and after intervention were compared between the two groups.Results:Comparison of pharmaceutical knowledge,medication compliance,and safe medication behavior scores showed that the observation group had higher scores as compared to the control group(P<0.05);blood pressure(systolic blood pressure,diastolic blood pressure,heart rate)and blood sugar(fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin)index levels were compared,and the observation group’s index levels were lower than those of the control group(P<0.05);the scores of physical health,mental health,social relationships,and environment in the observation group were higher than those in the control group(P<0.05).Conclusion:Community pharmacy services improved the rational medication effect of elderly patients with hypertension and diabetes,and improved their blood pressure,blood sugar control levels,and quality of life.

Reducing the Error Rate of Drug Delivery in Hospital Pharmacies: From the Angle of Pharmacy Quality Control Circle

Objective To explore the effect of applying pharmacy quality control circle to reduce the error rate of drug delivery in inpatient pharmacy,and to improve the service quality of inpatient pharmacy staff.Methods According to the ten standardized steps of pharmaceutical product management and Gantt chart,fishbone diagram and Plato were used to analyze the causes of drug delivery errors in hospital pharmacies,to find countermeasures and confirm the implementation effect.Results and Conclusion The error rate was reduced from 52% before implementation to 27.8%,and the target achievement rate was 100%.The staff’s understanding and application ability of pharmaceutical product circle was further enhanced.The “Training Standard for Newcomers” has reference value for hospital inpatient pharmacies and it can be promoted continuously.Pharmaceutical quality control circle can improve the quality of pharmacy services in hospitals.

The Managerial Role of Pharmacist at Community Pharmacy Setting in Saudi Arabia

In Saudi Arabia community pharmacies by law, be owned and managed by pharmacists. Although these two functions seemed to be the same but in reality, they are not. Some studies showed that in community pharmacy managerial functions account for more than 50% of total routine and critical activity for all managerial position surveyed while other study showed that only 13.6% of the pharmacist’s time spent in administrative activities. This article addressed the role of the pharmacist as manager and the way in which he/she manages the pharmacy to ensure optimum productivity. The main part of this review discussed the managerial role of pharmacist in management of human resources, financial resources, marketing, inventory, information resources and space management of the pharmacy. Additionally, the management process, professional skills of managers, development of managerial skills, problems in management process and their resolution were also discussed. In addition to management functions which also include planning, organizing, leading, and controlling processes. The author concluded that the skills of pharmacy managers may vary because of the lack of formalized management training programs. To bridges a gap in management education, interested pharmacists should be encouraged to shift their career goals from professional to pharmacy administration. In addition, expansion of curricula in pharmacy management to include management training of highest possible caliber in managerial skills is highly demanded. Formalized management training programs for those involved in community pharmacy practice are also warranted.

The Japanese Community Pharmacists’ Perceptions of the Health Support Pharmacy System

A questionnaire survey was conducted employing pharmacists at 350 Japanese Federation of Democratic Medical Institutions (Min-Iren) member pharmacies, evaluating the challenges related to registering as a Health Support Pharmacy (HSP). Completed responses were received from 193 pharmacies (55.1%). Fifty-five (28.5%) of these pharmacies were approved as meeting the HSP criteria. Some difficulties encountered in registering as an HSP included the preparation of the numerous required documents and placing a health support pharmacist. The obstacles that prevented pharmacists from registering were physical, including “placement of two or more health support pharmacists” and “placement of the required over-the-counter drugs (OTCs).” Based on these, 51.8% of supervising pharmacists stated the opinion that the government should “loosen current criteria.” However, a survey conducted among the 724 participant pharmacists, working in a pharmacy, showed no significant difference in their answering tendencies depending on whether or not they worked at an HSP. This could be attributed to the effort that Min- Iren pharmacies have been putting into health support and primary care functions. Overall, 64.5% of pharmacists working at HSPs were proud that the pharmacy they worked had HSP status. The present survey revealed the physical obstacles of HSP registration. Conformity to the criteria of HSP is essential for performing their fundamental functions as pharmacies. The relaxation of the criteria is anticipated.

A Study of Cognition and Demand of Pharmacy Services in Hospitals from the Views of Doctors,Pharmacists and Patients

Objective To study the cognition and demand of pharmacy services in hospitals from the views of doctors,pharmacists and patients and to provide references for improving the quality of pharmacy services.Methods 3 level 2 hospitals and 3 level 3 hospitals in Beijing were selected and questionnaires for doctors,pharmacists and patients were distributed and collected.Results and Conclusion Cognitively speaking,69.85% of doctors and 75.36% of pharmacists believe that pharmacy services are necessary,and 81.1% of patients believe it is helpful for pharmacists being involved in the process of treatment plans.Doctors and pharmacists themselves believe that the current pharmacist’s service ability is still insufficient,mainly due to the lack of clinical knowledge and the knowledge of medication combination.In terms of demand,doctors and patients have higher demand for pharmacy services,which is mainly involved in designing patient treatment plans,providing drug information and giving medication advice,and providing medication counseling.Doctors,pharmacists and patients all recognize and support the development of pharmacy services.However,in the understanding of the meaning of pharmacy services,doctors are better than pharmacists.Doctors and patients have greater demand for pharmacy services,but the supply of pharmacy services is still far from enough.It is recommended to strengthen the construction of related systems,incorporate pharmacy service work into hospital performance appraisal;attach importance to pharmacy professional talent training,improve pharmacy service ability,explore new hospital pharmacy service mode and to promote hospital pharmacy development.

Advancement of Pharmacy Accreditation in the Field of Chinese Higher Education

Background: The last two decades have witnessed the advancement of accreditation of Chinese higher education, with pharmacy programs being one of the most important. The purpose of this research was to review and elucidate the evolution of the pharmacy accreditation system in China. Methods: A literature search was conducted using PubMed, CINAHL, Embase, Cochrane databases and Google Scholar and CKNI databases, the website of the Working Committee for the Accreditation of Medical Education, and related university websites. Search terms used with each database were “accreditation” AND “pharmacy” AND “China”. The search strategy was designed to identify studies that report pharmacy program accreditation in China. Results: The primary outcomes indicate that the timeline of current Chinese pharmacy accreditation can be divided into four distinct chronological periods. Conclusion: After two decades of evolution, the qualification of the pharmaceutical program in China has significantly advanced its committees, criteria, methods, and systems, though with areas for refinement. As China embarks upon the process of pharmacy accreditation, it is simultaneously drawing upon lessons from the developed world, as well as infusing the process with its own distinct cultural identity. To effectively tackle current issues in the field of pharmacy accreditation, a commitment to continual quality advancement is required.

Availability of Antimalarial Medicines in Community Pharmacies of Lusaka District, Zambia: Implications on Compliance to Malaria Treatment Guidelines

Background: Malaria remains a major cause of morbidity and mortality in Zambia, affecting all levels of society, with children under the age of five and pregnant women being most at risk of serious illness. The availability of antimalarial medicines is one of the key interventions of malaria management. This study assessed the availability of antimalarial medicines in community pharmacies in Lusaka district, Zambia. Materials and Methods: This was a cross-sectional study that was conducted among 210 community pharmacies from September to November 2022 using a well-structured checklist in selected areas of Lusaka district. The availability was verified by a physical check of the product. The checklist contained the medicines listed both in the guidelines for diagnosis and treatment of malaria in Zambia as well as in the World Health Organization (WHO) malaria treatment guidelines. Results: This study found that all antimalarials listed in the local treatment guidelines for malaria were available in community pharmacies, though with the varying distribution. Of the 210 community pharmacies, 209 (99.5%) had artemether/lumefantrine in stock. The lowest available antimalarial was quinine/clindamycin, which was only available in 3 (1.4%) of the outlets. Conversely, 3 out of 16 (18.8%) antimalarials that were available in community pharmacies were not listed in the local treatment guidelines of malaria in Zambia, despite being listed in the WHO malaria treatment guidelines. This translated into a compliance level of 81.2% based on the local malaria treatment guidelines. Conclusion: This study concluded that antimalarials were available for all categories of malaria management in community pharmacies, though with a varying distribution. The presence of antimalarials not listed in the Zambian treatment guidelines is of public health concern which may have an impact on antimicrobial resistance in the future.

A Case Analysis of the Influencing Factors of Job Satisfaction of Licensed Pharmacists in Retail Pharmacies Based on SEM-Taking R Retail Pharmacy for an Example

Objective To explore the influencing factors on job satisfaction of licensed pharmacists in R retail pharmacy,and to provide a reference for improving the job satisfaction of licensed pharmacists in China.Methods Through literature research and satisfaction questionnaire,349 licensed pharmacists in R retail pharmacy were investigated.Then,the influencing factor equation model was constructed by factor analysis and structural equation method.Results and Conclusion The overall adaptation of the structural equation model was well established.The job satisfaction of licensed pharmacists in R retail pharmacy was closely related to interpersonal relationship,work characteristics,good management,salary and growth opportunity,and it was not significantly correlated with job environment.Therefore,work characteristics influenced most,followed by salary.Five key factors affecting the job satisfaction of licensed pharmacists in R retail pharmacy are summarized in this paper.It is suggested to adjust corresponding key factors such as work characteristics and salary,so as to improve job satisfaction of licensed pharmacists in the same industry.

Training of clinical pharmacists in psychiatric pharmacy services during the prevention and treatment of COVID-19

A series of pharmacy services of clinical pharmacists at the Wuhan Mental Health Center during the prevention and treatment of Coronavirus disease 2019(COVID-19),such as participation in the formulation of COVID-19 prevention and treatment plans suitable for psychiatric departments,popular science of pharmacy,medical order review,real-time intervention,and medication education are summarized here.Due to the sudden public health incident,the service model of psychiatric clinical pharmacists should be addressed,as clinical pharmacists are an important part of the diagnosis and treatment of psychiatric diseases.Among the majors currently available in the clinical pharmacy training base curriculum,no psychiatry major has been set up in China yet;therefore,in this paper,we provide guidance in psychiatry pharmacy for those who wish to integrate clinical teams.

叙事药学在心血管药学门诊中的应用

目的探讨临床药师通过叙事药学管理对心血管疾病合并负面情绪患者的用药依从性、负面情绪及生活质量的影响。方法选取2023年2-8月武汉市第一医院心血管药学门诊就诊的49例有用药问题伴负面情绪的患者作为研究对象,在传统药学管理基础上,于患者就诊时及治疗2周时对患者加用叙事药学的模式进行管理。记录患者药物咨询相关问题、药物种类,对患者就诊时及管理1个月随访时的不良反应、血压及血脂、依从性、抑郁和焦虑状态、生活质量、患者满意度等变化进行比较。结果采用叙事药学管理模式的49例患者涉及114个药物相关咨询问题;与就诊时比较,管理1个月后患者服药种类显著减少[4.00(2.00,6.00)种vs.3.00(1.50,5.00)种,P<0.05],不良反应发生率显著下降(32.65%vs.2.04%,P<0.001),血压及血脂达标率显著升高(30.61%vs.95.92%,P<0.001),患者用药依从性显著提高[(3.94±2.44)分vs.(6.78±2.07)分,P<0.01],抑郁评分显著降低[3.00(2.00,4.50)分vs.2.00(0.00,3.00)分,P<0.001],焦虑评分显著降低[3.00(2.00,4.50)分vs.1.00(0.00,2.00)分,P<0.001],生活质量评分显著提高[22.00(19.00,22.00)分vs.23.00(23.00,24.50)分,P<0.01],满意度调查中患者的满意总占比稍有提高(91.84%vs.97.96%,P>0.05)。结论叙事药学应用于心血管药学门诊,能够提高患者依从性,减少药物不良反应,加强药物治疗有效性,避免药物相互作用,有效改善患者焦虑抑郁情绪,最终提高患者生活质量。

中药智慧药学服务的实践与技术分析

目的 分析中药智慧药房的发展现状,总结中药智慧药学服务实践经验,概述其技术要求和发展方向。方法 成都中医药大学附属医院自2018年1月启动智慧中药房项目,建立中药智慧药房,承担门诊中药饮片调剂、煎药、配送等药学服务业务。结果 截至2023年5月已完成中药饮片代煎配送557.2万副,2022年度共服务患者23.14万人次。服务环节更简单,无需等候取药,无需二次到院取药,服务效率高,改善了患者就医体验。结论 中药智慧药学服务发展迅速,未来将依托技术进步建立全程化智慧服务体系。

Investigation on the Current Situation of China’s DTP Pharmacy and Suggestions for Its Development

Objective To summarize the main characteristics and development approaches of direct-to-patient(DTP)pharmacies,and to explore its future development trend.Methods Firstly,relevant policies of DTP pharmacies were sorted out based on some documents on the government website,and related articles were studied.Secondly,499 DTP pharmacies were investigated.Finally,the current status of the industry was summarized and analyzed.Results and Conclusion Policies on China’s DTP pharmacy have been constantly improved.According to industry standards,the current compliance rate of DTP pharmacies is about 46.09%.In terms of varieties,the market share concentration rate of biological products is higher than that of chemical drugs.The regional distribution of these drugs is mainly concentrated in the central and eastern provinces.However,63.45%of DTP pharmacies have less than 50 product specifications.DTP pharmacies have an average of 7.3 pharmacy technicians and 2.3 licensed pharmacists,which is higher than that of ordinary pharmacies.Due to the policy promotion,DTP pharmacies will be paid more attention by the public and the government,and the market share will become larger than before.Patients shifting from hospitals to drug-to-pharmacies can make them better layout.Besides,pharmaceutical services will become more specialized,and disease division will be more detailed.With the deepening of medical reform and the continuous improvement of national medical security as well as drug procurement and medical insurance payment methods,DTP pharmacies can play an important role in the national basic medical security system.

“大思政”背景下中药制药专业课课程思政建设体系研究

“大思政”背景下,高校课程思政教学已成势在必行的趋势。在此背景下探索具有中医药特色的课程思政建设与创新路径尤为重要,具有鲜明的时代价值与现实意义。对此,课程组在黑龙江中医药大学“顶层-基层”联动机制的支持下,抓住教师和学生两主体,与中药制药人才培养目标和专业课特色相结合,构建系统的“1+2+3+4”中药制药专业课课程思政教学模式。通过课程思政元素融入专业课程体系,设计多形式、多通道、师生互动的闭环的教学过程,完善学校在课程思政教改中的政策支撑体系,全面提升教师综合素质和人才培养质量。

基于免疫炎症指标探讨帕金森病患者共病及联合用药特点分析

目的基于免疫炎症指标综合分析帕金森病(Parkinson's disease,PD)患者共病及联合用药的特点,为进一步指导和优化PD患者治疗方案提供临床依据。方法以新疆神经系统疾病临床研究中心2020年10月-2023年3月收治的527例PD患者为研究组,随机抽取同期526例体检健康人群为对照组,对比分析PD患者年龄、性别、血小板(PLT)、中性粒细胞(N)、淋巴细胞(LYM)计数,及PD患者共病及联合用药分布特点。进一步对系统性免疫炎症指数(SII)、中性粒细胞/淋巴细胞计数比值(NLR)进行亚组分析。结果与对照组比较,研究组N水平、SII、NLR升高,PLT、LYM降低,差异均有统计学意义(P<0.05)。PD患者共病数量最多达8种,联合用药品种最多达23种。随着患者年龄的增高,共病数量及用药品种数均增加(P=0.000)。PD患者共病数量和用药品种数间存在弱强度相关性(Cramer's V=0.296,P<0.001)。亚组分析显示,长期使用神经营养药、缓泻药及第二类精神药的PD患者共病数量、用药品种数增多,差异有统计学意义(P<0.05)。与不需长期服用营养神经药的PD患者比较,需长期服用营养神经药的PD患者占患者总数的53.42%,SII、NLR及N升高,LYM及PLT降低,差异无统计学意义(P>0.05)。与不需长期服用第二类精神药的PD患者比较,需长期服用第二类精神药的PD患者占患者总数的30.61%,N降低,PLT升高,差异均有统计学意义(P<0.05)。与不需长期服用缓泻药的PD患者比较,需长期服用缓泻药的PD患者占总患者人数的30.61%,LYM及PLT降低,差异均有统计学意义(P<0.05)。结论在PD诊治过程中应关注患者年龄、血细胞炎症因子计数及免疫炎症指数,对及早优化PD患者外周神经营养、调节便秘及睡眠等共病及联合用药具有临床价值。

基于OBE理念的药物临床试验课程教学改革研究

首都医科大学将成果导向型教学(OBE)理念引入药物临床试验课程教学改革中。教师针对课程教学内容更新速度快、教学方式传统陈旧、考评模式较为单一等普遍存在的问题,以学生为中心组织和引导教学过程,优化教学大纲、改善教学方法、提升自身教学能力、完善学生评价体系,有效提升了教学产出和学生的创新性学习能力,可为相关课程教学改革提供借鉴。

Analysis of Combining OBE and CBL in Pharmacy Internship

Talent training has been emphasized in China’s national development.Training an excellent pharmaceutical professional has far-reaching significance for promoting rational use of drugs,ensuring safe drug use,and improving the quality and safety of medical treatment.The internship program is an important part of a pharmacy major that serves to develop students’practical skills.In this paper,we propose a combination of outcome-based education(OBE)and case-based learning(CBL)in pharmacy internships to promote critical thinking and independent learning among students and ensure the sustainable development of pharmacy education.

基于内容分析法的临床药师岗位胜任力指标构建

目的 对国内外临床药师胜任力评价指标进行内容分析,为临床药师岗位胜任力构建提供参考。方法 检索国内外临床药师岗位胜任力相关文献,采用内容分析法对符合标准的文献进行分析。结果 最终纳入22篇文献及14篇胜任力评估框架及模型,提取个人素质、知识、个人能力、药学服务、教研5个一级类目、15个二级类目及61个三级类目。结论 初步构建了临床药师岗位胜任力指标体系,为临床药师开展实践工作提供参考。