我国社区药师对慢性疾病患者药学服务的范围综述  

Scoping review of pharmaceutical service provided by community pharmacists for patients with chronic diseases in China

作　　者：胡源晖 李果霖 Feng Chang 裴毓瑶 郑玉粉 HU Yuanhui;LI Guolin;FENG Chang;PEI Yuyao;ZHENG Yufen(School of Basic Medicine and Clinical Pharmacy,China Pharmaceutical University,Nanjing 210009,China;School of Pharmacy,University of Waterloo,Ontario N2L 3G1,Canada)

机构地区：[1]中国药科大学基础医学与临床药学学院,南京210009 [2]加拿大滑铁卢大学药学院,加拿大安大略省N2L 3G1

出　　处：《中国药房》2024年第20期2559-2564,共6页China Pharmacy

基　　金：江苏省高等教育教改研究一般课题(No.2023JSJG485);中国药科大学校级教学改革课题(No.2023XJZD10)。

摘　　要：目的总结和分析我国社区药师实施慢性疾病(以下简称“慢病”)药学服务的概况。方法检索中国知网、万方数据、PubMed(Medline)、Embase和Scopus数据库等,收集社区药师为慢病患者提供药学服务的研究,描述性总结社区药师实施慢病药学服务的方式与内容。结果共纳入75项研究,包括49项试验研究和26项横断面研究。研究地点主要分布在我国经济较发达地区,研究涉及的患者疾病类型主要为糖尿病(n=31)和高血压(n=28),多数研究采用疾病症状及相关指标变化情况(n=35)、患者依从性改善情况(n=34)、药物不良反应(不合理用药)发生情况(n=25)等评价药学服务。社区药师向慢病患者提供的药学服务项目包括用药教育(84.0%)、监测与随访(64.0%)、识别和解决药物相关问题(58.7%)等。38项研究提及药学服务是通过团队合作实现的,其中16项研究提到了医联体。少数研究报道了分层诊疗服务(n=15)和基于互联网的药学服务(n=10)。结论在我国,社区药师为慢病患者提供的药学服务仍主要局限于经济较发达地区,且服务范围局限于少数疾病和基本药学实践。在未来,针对不同疾病及患者疾病状态实施精准药学服务、建立基层医联体及开展互联网药学服务,应成为药学服务的重点。OBJECTIVE To summarize and analyze the profile of the implementation of pharmaceutical service by community pharmacists for patients with chronic diseases in China.METHODS Literature was searched from CNKI,Wanfang database,PubMed(Medline),Embase,and Scopus to collect studies about community pharmacists providing pharmaceutical services for patients with chronic diseases.The ways and contents of the implementation of pharmaceutical services for chronic diseases by community pharmacists were summarized descriptively.RESULTS A total of 75 studies were included,involving 49 trial studies and 26 cross-sectional studies.The study sites were mainly located in the developed regions of China,and the types of disease involved in the studies were mainly diabetes mellitus(n=30)and hypertension(n=28);most studies used the following indexes to evaluate pharmaceutical services,such as changes in disease symptoms and related indicators(n=35),improvement of patient compliance(n=34),and the occurrence of adverse drug reactions(irrational drug use)(n=25).The pharmaceutical service provided by community pharmacists included medication education(84.0%),monitoring and follow-up(64.0%),and identifying and solving medication-related problems(58.7%).Thirty-eight studies mentioned that pharmaceutical services were achieved through teamwork,16 of which mentioned healthcare alliances.A few studies investigated stratified healthcare systems(n=15)and internet-based pharmaceutical services(n=10).CONCLUSIONS In China,pharmaceutical services provided by community pharmacies for patients with chronic diseases are still mainly confined to economically developed areas,and the scope of services is limited to a few diseases and basic pharmaceutical practices.In the future,the implementation of precise pharmaceutical services for different diseases and patients’disease status,the establishment of medical alliances,and the development of internet-based pharmaceutical services should become the focus of pharmaceutical services.

关 键 词：社区药师 社区药房 慢性疾病 药学服务 

分 类 号：R95[医药卫生—药学]