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OBJECTIVE To provide ideas and reference for the anti-infection treatment and pharmaceutical care for severe pneumonia caused by Chlamydia psittaci. METHODS Clinical pharmacists participated in the whole process of the treatment for a patient with C. psittaci-induced severe pneumonia. According to the patient’s medical history, clinical symptoms and test results, clinical pharmacists assisted the physician to dynamically adjust the anti-infective scheme; for C. psittaci infection, the patient was treated with tigecycline combined with azithromycin successively, and other infection therapy plans were dynamically adjusted according to the results of pathogen examination. During the treatment, the patient suffered from suspicious adverse drug reactions such as prolonged QTc interval, elevated lipase and amylase; the clinical pharmacists conducted pharmaceutical care and put forward reasonable suggestions. RESULTS The physician adopted the pharmacists’ suggestion, and the patient was discharged after treatment. CONCLUSIONS For the treatment of severe pneumonia caused by C. psittaci, the characteristics of patients, drugs and pathogens should be taken into account to develop individualized anti-infective treatment. Tetracyclines and macrolides have a definite effect on C. psittaci infection, but attention should be paid to the possible ADR caused by drugs in clinical application.
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Objective To analyze and discuss the current research status,hotspots,frontiers,and progress in work practice of family pharmacists both in domestic and abroad by Citespace.Methods The database of Web of Science Core Collection and CNKI were selected for data extraction.They searched for literature from the database from establishment to April 1,2023 using the topic words"family pharmacist"and"home pharmaceutical care"both in Chinese and English.The network diagrams of essential nodes such as authors,countries,institutions,and key words were analyzed and drawn Results A total of 439 Chinese and 572 English literatures were included in the study.Scholars such as Mei Shen,Shihui Bao,Zhongzhuang Wang,Hughes Carmel M,Jamieson Hamish A,and Chen Timothy F have significantly contributed.The UK and the United States were leading countries in family pharmacists.Most of China's top ten research institutions were from Shanghai,Beijing.The top five Chinese literature keywords were pharmaceutical care,community,pharmacist,rational drug use,family pharmacist.The top five English literature keywords were pharmaceutical care,care,management,older people,and impact.Conclusions According to keyword clustering and burst analysis,research hotspots in foreign countries mainly focus on pharmaceutical services,adverse drug reactions,adherence,etc.,which is consistent with the development direction of pharmaceutical services in China.However,domestic pharmacy's development and literature publication are slightly behind those of foreign countries,and there is still some development space for pharmaceutical services in China.
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To explore the thinking and working mode of clinical pharmacists of traditional Chinese medicine participating in clinical,the drug treatment was analyzed by an acute hyperkalemia patient suspected of CKD 5 caused by traditional Chinese medicine.This case is a CKD 5 patient.Since proteinuria was found for 8 years,bilateral lower limb edema was intermittent for 4 years,and the recurrence was aggravated for 1 week,the patient was admitted to the hospital.In the Department of Traditional Chinese Medicine,the patient received standard and reasonable antiplatelet,lipid regulation,kidney protection,anemia improvement,blood pressure reduction,and heart load reduction,Traditional Chinese medicine decoction,traditional Chinese patent medicines.The patient's condition improved,but the newly emerging hyperkalemia prolonged the patient's hospital stay.After the treatment of blood potassium lowering drugs,the blood potassium still increased repeatedly.For this reason,clinical Chinese pharmacists assisted clinicians to find out the factors that caused the repeated increase of blood potassium in combination with existing domestic and foreign literature.Finally,considering the high possibility of traditional Chinese medicine,they stopped using traditional Chinese medicine and continued to use blood potassium lowering drugs,and the blood potassium returned to normal.Hyperkalemia caused by traditional Chinese medicine is not common in clinical practice and often is ignored.It can be seen that clinical pharmacists can participate in pharmaceutical care to find adverse drug reactions as soon as possible and ensure the safety of drug use.
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Objective To conduct content analysis of competency assessment indicators for clinical pharmacists both domestically and internationally,thereby providing reference for the construction of competency for clinical pharmacists.Methods Literature related to the competency of clinical pharmacists at home and abroad was retrieved.Content analysis was applied to literature that met the criteria.Results Ultimately,22 articles and 14 competency frameworks were included.From these,5 primary categories including personal qualities,knowledge,individual abilities,pharmaceutical services,teaching and research,15 secondary categories and 61 tertiary categories were extracted.Conclusion The competency indicator system for clinical pharmacists was initially constructed,providing reference for clinical pharmacists in practical work.
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Objective To provide pharmaceutical monitoring using the Pharmaceutical Care Network Europe(PCNE)for patients with respiratory diseases,to explore effective pharmaceutical monitoring models in the department of respiratory,and to promote clinical rational drug use.Methods Inpatients diagnosed with chronic obstructive pulmonary disease(COPD)and lung infections in 2022 at the First Affiliated Hospital of Anhui University of Science and Technology were selected and divided into a simple group and an intervention group.According to the PCNE classification system,the types,causes,interventions,acceptance of interventions,and resolution status of drug-related problems(DRPs)were analyzed.Results A total of 120 cases were included,60 cases in the simple group and 60 cases in the intervention group.Regarding the number of DRPs,there were 15 cases in the simple group and 45 cases in the intervention group,and there was a significant difference between the two groups(P<0.05).There were a total of 82 DRPs,which were mainly related to therapeutic efficacy(51.22%)and safety(46.34%),and the reasons for this were that patients'incorrect medication usage method,inappropriate usage and dosage,and unscheduled safety monitoring,etc.The pharmacist interventions were 75(91.46%)at the drug level,38(46.34%)at the physician level,and 43(52.44%)at the patient level;after the pharmacist interventions,the acceptance rate was in the range of 97.56%,and 74.39%of the DRPs were resolved.Conclusion PCNE classification system helps clinical pharmacists to enhance their ability to find and deal with DRPs,reduce the risk of clinical adverse events and promote reasonable and safe drug use.Meanwhile,it is conducive to the standardization of pharmaceutical care records for patients with respiratory diseases and provides reference for pharmaceutical service models for patients in the department of respiratory.
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OBJECTIVE To explore the pharmaceutical care of reactivating anthracycline chemotherapy in patients with advanced breast cancer complicated with thyroid cancer. METHODS Clinical pharmacists participated in the whole treatment process of a patient with advanced breast cancer complicated with thyroid cancer and provided personalized medication recommendations. Considering that the patient currently has multiple primary anti-tumor drug resistance, clinical pharmacists recommend reactivating the EC rescue protocol (intravenous infusion of epirubicin hydrochloride 140 mg+cyclophosphamide 1 g, d1, 21 days for a cycle). The cumulative lifetime dose of epirubicin and the optimal course of chemotherapy was estimated according to the body weight change of the patient. Given the issue that abnormal fluctuation of thyroid stimulating hormone (TSH) level during chemotherapy may increase the risk of cardiac toxicity, clinical pharmacists suggest adopting a dose adjustment strategy of “fast first and slow later” for Levothyroxine sodium tablet according to the target range of TSH and test results. RESULTS The doctors adopted the pharmacists’ suggestion; the clinical pharmacists assisted the doctors in reactivating the anthracycline-based 7-cycle combination regimen, during which the patient had no significant cardiac adverse events and was repeatedly evaluated as stable. TSH decreased steadily after Levothyroxine sodium tablets were added, and no adverse reaction related to TSH inhibition was observed. CONCLUSIONS Patients with primary drug-resistant breast cancer complicated with thyroid cancer may be reactived anthracyclines if necessary, but baseline cardiac function and thyroid hormone levels should be tested before initiation, and cardiac toxicity risk assessment should be performed in combination with the patient’s history. Clinical pharmacists should actively exert their professional advantages to carry out whole-process pharmaceutical care for such patients, so as to ensure the safety of drug use for patients.
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OBJECTIVE To explore a multimodal analgesia regimen based on spinal cord electrical stimulation for children with primary erythromelalgia and the key points of pharmaceutical care. METHODS Clinical pharmacists participated in the treatment of a child with primary erythromelalgia complicated with skin infection. After reviewing domestic and foreign literature, multimodal analgesia was formulated and pharmaceutical care was carried out to address the difficulties in treating the patient’s illness. RESULTS The treatment team applied multimodal analgesia based on spinal cord electrical stimulation for the child, including a multi-drug combination involving different analgesic pharmacological targets, multiple administration routes (oral, intravenous, epidural, percutaneous), multiple technologies (spinal cord electrical stimulation, local nerve block, patient- controlled analgesia), individualized schemes of adjuvant therapy, and the child was monitored for the safety of drug use. The pain was controlled during the treatment and follow-up period, the wound was healed, and no serious adverse drug reactions occurred. CONCLUSIONS Multimodal analgesia based on spinal cord electrical stimulation is a safe and effective treatment for children with primary erythromelalgia.
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OBJECTIVE To compare the general status of training programs for geriatric clinical pharmacists in China and the United States, and provide a reference for further optimizing training programs of geriatric clinical pharmacists in China. METHODS Retrieved from the American Society of Health-System Pharmacists (ASHP) website and the Chinese Hospital Association website, the detailed information and data on training outline, institution type/scale, enrollment number, training contents, project application conditions and graduation assessments for clinical pharmacists in geriatric field were collected and statistical analysis was performed using Excel software. RESULTS & CONCLUSIONS As of January 12, 2024, ASHP provided 24 geriatric clinical pharmacist training programs and 25 positions available for application in the postgraduate year two training, which provided compensation. The training base involved hospitals and pharmaceutical colleges, with varying scales. Applicants needed to obtain a doctor of pharmacy and complete postgraduate year one training. ASHP had designed detailed training objectives for the four essential skills of basic patient care, advanced patient care, leadership and management skills, and knowledge education and teaching dissemination. Each training base could appropriately add optional skills such as academic skills, long-term care skills and other skills according to its characteristics, developed a student rotation plan, and conducted assessments and evaluations at multiple time points during the training process. There were 5 training programs for geriatric clinical pharmacists in China, with 15 positions, which didn’t provide compensation; training bases were all third-grade class A hospitals with relatively large scale. The applicant needed to obtain a bachelor’s degree or above, and different years of work were required based on their major and degree level. The Pharmaceutical Specialized Committee of the China Hospital Association had established a detailed training outline, proposing specific training objectives on theoretical knowledge, practical skills, scientific research thinking, etc. The training base organized assessments and evaluations at the time of enrollment, completion of specified content training, and graduation. According to the experience of the US, it is recommended to provide differentiated knowledge and skills training for students at different levels, flexibly arrange rotating departments, require students to work independently and deeply participate in clinical teaching and research work, conduct multiple and various forms of assessments, and adjust learning plans in a 13264273306@126.com timely manner to comprehensively enhance their abilities.
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Objective: Contrast media side effects range from minor ones such as itching and vomiting to life-threatening ones such as hypotension and loss of consciousness. The purpose of this study was to determine how contrast media side effects are actually managed in hospitals nationwide, as well as to identify opportunities for the pharmacy department to be involved in contrast media administration, and pharmacists’ awareness of the risk of contrast media side effects. Methods: A self-administered, unmarked questionnaire survey was conducted in the pharmacy departments of 2,000 hospitals nationwide. The survey asked about the existence of internal rules and manuals regarding contrast media at each facility, how to deal with patients at risk for side effects, opportunities for intervention with patients by the pharmacy department, and opportunities for discussion among pharmacists and other professionals regarding the administration of contrast media. Results: Of the 2,000 facilities, 96 responded to the questionnaire, among which 69 had internal regulations or manuals. In those with manuals, the manuals stipulated measures such as not administering contrast media or administering premedication in the case of patients with a history of contrast media side effects. In facilities where the manual recommended premedication, it was found that premedication was administered in both inpatient and outpatient settings. Regarding the role of the pharmacy department, it was found that intervention in all items related to risk factors for adverse drug reactions was achieved for only about 10% of the outpatients. Conclusion: This study revealed that many facilities are involved in the management of contrast media side effects. The results indicate that there is scope for pharmacy departments to intervene more proactively in outpatient settings to ensure appropriate contrast media use in the future.
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In November 2025, Japan will host the 100th Deaflympics. As the first hearing-impaired pharmacist in Japan responsible for the pharmaceutical care of the Japanese Deaflympics team, I have compiled a summary of the essential information that healthcare professionals need to know when providing medical services to hearing-impaired individuals, drawing upon my experience with the Deaflympics.
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OBJECTIVE To investigate the current situation of pharmaceutical management in compact medical consortium of Guangdong province, and to provide decision-making basis for promoting the high-quality construction and sustainable development of the provincial medical consortium. METHODS A self-designed questionnaire was used to select 50 compact medical consortiums in Guangdong province. The survey was answered by the heads of the pharmacy department of the general hospitals. The survey covered the basic scale of the consortium, the appointment of chief pharmacists, the implementation of pharmaceutical management and pharmaceutical care homogenization within the consortium, the difficulties in promoting the homogenization, and the expected provincial support. Descriptive statistical analysis was performed on the survey results. RESULTS A total of 50 questionnaires were collected, and the effective recovery rate was 100%. There were 16 chief pharmacists (32.00%) in charge of the pharmacy department of the general hospital in the medical consortium. Thirty-seven medical consortiums (74.00%) had established a drug supply support system within the consortium, 35 medical consortiums (70.00%) had carried out pharmaceutical management and coordination work within the medical consortium, 23 medical consortiums (46.00%) had established a clinical medication guidance system, 25 medical consortiums chenwenying2016@163.com (50.00%) had established a bidirectional communication mechanism, and only 8 medical consortiums (16.00%) had developed new models of pharmaceutical care. At present, the difficulties in promoting the homogenization of pharmaceutical management and pharmaceutical care within the medical consortium were mainly found in three aspects: the wide gap in management level of each member unit, the lack and uneven level of pharmaceutical personnel, and insufficient policy support and implementation. Most medical consortiums hoped that relevant departments could promote the homogenization of pharmaceutical work by holding special training courses or special supervision. CONCLUSIONS At present, the compact medical consortium in Guangdong province has achieved initial results in the implementation of the chief pharmacist system, the homogenization of pharmaceutical management and pharmaceutical care. However, it is still necessary to improve the coverage of chief pharmacist appointments in the medical consortium, implement the homogenization of pharmaceutical management, and accelerate the homogenization process of pharmaceutical care.
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OBJECTIVE To provide a reference for the early diagnosis, drug treatment and medication monitoring for patients with Lemierre’s syndrome. METHODS The doctors confirmed the diagnosis of the patient as having Lemierre’s syndrome based on the patient’s condition and the results of metagenomic next-generation sequencing (mNGS), and the clinical pharmacists participated in the treatment process of the patient. During the treatment process, the clinical pharmacists suggested using piperacillin sodium and tazobactam sodium combined with metronidazole for anti-infective treatment against Fusobacterium necrophorum infection; clinical pharmacists recommend anticoagulant treatment with Enoxaparin sodium injection for left internal jugular vein thrombophlebitis. RESULTS The doctors accepted the suggestion of the clinical pharmacists, and the patient’s condition improved after treatment and was allowed to be discharged with medication. CONCLUSIONS By interpreting the results of mNGS, combined with the patient’s condition, the clinical pharmacists assist doctors in formulating individualized anti-infective and anticoagulant plans for the patient and provide medication monitoring, ensuring the safety and effectiveness of the patient’s medication.
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Abstract There are a limited number of studies examining the effects of the pandemic on the daily lives of Turkish community pharmacists, and no research investigating the impact on the lives of Turkish hospital pharmacists has been found. This study aimed to examine the effects of the pandemic on the personal and professional lives of Turkish community pharmacists and hospital pharmacists. In this qualitative study design, a comprehensive set of interviews was conducted with a total of 13 community pharmacists and 7 hospital pharmacists, employing a semi-structured interview guide. Through thematic content analysis of the interviews, four main themes, 1) long-term impacts, 2) dealing strategies, 3) professional life impacts, 4) personal life impacts, have emerged for both community pharmacists and hospital pharmacists. In addition to the psychological impacts and supply chain issues commonly mentioned in the literature, the study revealed ongoing effects such as the inability to sell available products and economic difficulties. Also, the increased demand for over-the-counter products during the pandemic highlights the need for the government to develop policies to address this issue.
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Humans , Male , Female , Pharmacists/classification , Basic Health Services , COVID-19/pathology , Pandemics/classification , Occupational Groups/classificationABSTRACT
Background: Over the counter (OTC), drugs are found to be safe and appropriate for use without supervision of a healthcare professional such as physician and they can be purchased by consumers without prescription. The study gains its importance because of the spreading of misuse of antibiotics and various drugs adverse drug reactions in the society. Aims and Objectives: The main aim of the study is to observe as to how many pharmacists/chemists/drug store sellers follow or violate the drug cosmetic act. Materials and Methods: It is an observational and cross-sectional study conducted among pharmacies of Udaipur city, urban areas of Southern Rajasthan. The study includes a sample size of 200 pharmacies selected through convenient random sampling. A detailed semi-structured questionnaire is administered to the pharmacists. The set of questions include types of drugs, reason for dispensing, knowledge, and attitude of pharmacist toward dispensing non-OTC drugs. All the private pharmacies willing to participate were included in the study. Data are entered in Microsoft Excel and statistically analyzed. Results: The results throw light on the behavior and pattern of dispensing habits of the drug store sellers of the city of Udaipur, Southern Rajasthan. It was observed that many pharmacists are in fact in the habit of dispensing non-OTC drugs in almost all the areas. Conclusions: Results give insights about the groups of drugs, logic, behavior, and knowledge level of pharmacists involved in dispensing practices in the city of Udaipur. There should be structured educational campaigns (or use of media, internet, newspaper, radio, television, advertisements, mobiles, etc.) for both pharmacists and public.
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ABSTRACT Background: To examine the impact of pharmacist counseling and follow-up on patient's medication compliance and Helicobacter Pylori (H. pylori) eradication and evaluate the efficiency of an eradication regimen consisting of Clarithromycin 500 mg, Amoxicillin 1 g, and Lansoprazole 30 mg, twice daily for 14 days. Methods: Two hundred patients undergoing endoscopy and positive rapid urease tests were included in the present study. Patients were randomly divided into two groups: an intervention group (n=100) and a control group (n=100). The intervention patients obtained their medications from the hospital pharmacist and received sufficient counseling and follow-up. On the other hand, the control patients received their medications from another hospital pharmacist and went through the routine hospital procedure without good counseling and follow-up. Results: The intervention resulted in a statistically significant improvement in outpatient compliance with medication (45.0% vs 27.5%; P<0.05) and eradication of H. pylori (28.5% vs 42.5%; P<0.05) among those patients. Conclusion: This study reflects the importance of pharmacist counseling and patient compliance to medication, as the patients who received pharmacist counseling exhibited perfect compliance to medication, which led to the successful eradication of H. pylori.
RESUMO Contexto: Analisar o impacto do aconselhamento e acompanhamento farmacêutico na adesão medicamentosa do paciente e na erradicação do Helicobacter Pylori (H. pylori) e avaliar a eficiência de um regime de erradicação composto por Claritromicina 500 mg, Amoxicilina 1 g e Lansoprazol 30 mg, duas vezes ao dia por 14 dias. Métodos Duzentos pacientes submetidos à endoscopia e testes rápidos de urease positivos foram incluídos no presente estudo. Os pacientes foram divididos aleatoriamente em dois grupos: um grupo intervenção (n=100) e um grupo controle (n=100). Os pacientes de intervenção obtiveram seus medicamentos do farmacêutico do hospital e receberam aconselhamento e acompanhamento suficientes. Por outro lado, os pacientes do grupo controle receberam seus medicamentos de outro farmacêutico hospitalar e passaram pelo procedimento hospitalar de rotina sem um bom aconselhamento e acompanhamento. Resultados: A intervenção do farmacêutico resultou em melhora estatisticamente significativa na adesão ambulatorial à medicação (45,0% vs 27,5%; P<0,05) e na erradicação de H. pylori (28,5% vs 42,5%; P<0,05) entre esses pacientes. Conclusão Este estudo reflete a importância do aconselhamento farmacêutico e da adesão do paciente à medicação, uma vez que os pacientes que receberam aconselhamento farmacêutico apresentaram perfeita adesão à medicação, o que levou à erradicação bem-sucedida da H. pylori.
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OBJECTIVE To explore the role of clinical pharmacists in the treatment of critical patients with acute heart failure after percutaneous coronary intervention (PCI), and to provide reference for drug treatment and monitoring of such patients. METHODS Clinical pharmacists participated in the treatment of a critical patient with acute heart failure after PCI, and assisted physicians to jointly develop individualized medication plans based on domestic and foreign literature: it was suggested to give imipenem and cilastatin for anti-infective therapy, adjust drug dose according to renal function, and timely descend step therapy; Levetiracetam tablets were selected to prevent epilepsy; the differential diagnosis and treatment of rhabdomyolysis possibly caused by Atorvastatin calcium tablets were performed; the whole process of pharmaceutical care was conducted. RESULTS Physicians adopted the suggestions of clinical pharmacists. The acute heart failure of the patient was controlled, the pulmonary infection was improved, the adverse reaction symptoms were relieved, and the patient was successfully transferred out of the ICU. CONCLUSIONS For severe patients, when giving imipenem and cilastatin for anti-infection treatment,the clinical pharmacist should adjust the dose according to the patient’s renal function and be alert to the possible neurotoxicity. During the treatment with Atorvastatin calcium tablets,the clinical pharmacist should comprehensively analyze the risk of rhabdomyolysis. For the adverse reactions that have occurred, clinical pharmacist should promptly address symptomatic issues to ensure the safety and effectiveness of medication for patients.
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In view of the current situation of the construction of clinical pharmacist system and the teaching and training of clinical pharmacist training base in China, this paper provides a reference for perfecting and improving the training mode of clinical pharmacists in China. By establishing a clinical pharmacist system that develops a "two-focus" model, it takes the "trinity" of "hierarchical teaching-innovative practice-stage assessment" as the operating mechanism of teaching management, and the innovative mode of training clinical pharmacist talents with diversified information service platform as the technical support system, thereby providing an effective model for training excellent clinical pharmaceutical care talents.
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Objective:To explore the application and effect of flipped classroom in community clinical pharmacist training.Methods:Seventeen pharmacists trained in 2017-2018 were used as the control group and received traditional teaching mode. Fourteen pharmacists trained in 2019-2020 were used as the experimental group and received the flipped classroom teaching mode. Finally, the teaching effect was evaluated through the trainees' graduation examination results and satisfaction degree. The SPSS 25.0 was used to conduct the t test and chi-square test. Results:The task performance, prescription audit scores, clinical practice scores, and total scores in the experimental group were significantly higher than those in the control group ( P<0.05). However, there was no significant difference in usual performance between the two groups ( P>0.05). For satisfaction survey, the total score of Likert scale in the experimental group was (20.1±3.4), which was significantly higher than that in the control group (16.9±3.4). However, there was no significant difference in the satisfaction of clinical practice and teachers' level between the two groups ( P>0.05). Conclusion:Flipped classroom can improve the enthusiasm of community clinical pharmacist trainees to participate in learning, increase the level of the trainees' theoretical knowledge and professional practice, and is conducive to the cultivation of high-quality community clinical pharmacists.
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Objective:This study aims to summarize the achievements of the research wards in a large grade A tertiary hospital in Beijing, discuss the important role of pharmacists, and provide a reference for improving the functions and responsibilities of pharmacists in the research ward construction.Methods:Combining the practice of research ward construction in a grade A tertiary hospital in Beijing, the important role of pharmacists in the construction and operation of research wards were analyzed in system construction, information construction, analysis laboratory construction, and project management.Results:The participation of pharmacists with professional pharmaceutical knowledge and familiarity with the relevant policies and regulations of clinical research can greatly improve the quality and efficiency of research ward construction and operation.Conclusions:Pharmacists' participation in the construction of research wards is beneficial to improving clinical research ability and quality, and is of great significance to the development of China′s pharmaceutical health industry.
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With the acceleration of China′s economic and social development and aging process, the construction of the pharmacist team was increasingly valued.By combing and analyzing the status of pharmacist allocation in Japanese medical institutions, the path of pharmacist career development, and the content of pharmaceutical services and the training mode, the author proposed that China should learn from relevant mature experience to further strengthen the allocation of pharmacists in medical institutions, improve the Professional certification system of clinical pharmacists, establish a standardized pharmacist training mode, so as to provide a reference for building a standardized, professional and sustainable team of pharmacists in medical institutions.