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Objective To introduce the improvements of multi-mode outpatient pharmacy services based on the new medical reform policy. Methods The pharmacist’s roles, responsibilities, working procedures and the achievements were discussed. Results and conclusion On-site pharmacy counseling services and online WeChat pharmacy consulting services were established to include collaborative drug therapy management of pharmacists and physicians (Alzheimer's disease and anticoagulation clinic), the outpatient pharmacy services by pharmacists (chemo medication counseling). The multi-mode pharmacy services in our hospital have optimized patient's medication regime, safeguarded patient's medication therapy, improved patient's compliance and reduced medication cost. The individualized medication therapy reduced adverse reactions significantly. The multi-mode outpatient pharmacy services established by our hospital were successful and could serve as a model for other pharmacies in our country.
ABSTRACT
<b>Purpose</b> : This preliminary study was aimed to investigate potentially beneficial changes in prescription of antibiotics by use of Gram staining in an otorhinolaryngology outpatient clinic.<br><b>Methods</b> : This study was done in a single clinic. Changes in the type and amount of antibiotics prescribed, in addition to the clinical outcomes prior to and following introduction of Gram staining, were analyzed retrospectively.<br><b>Results</b> : Following introduction of Gram staining in 2005, the costs for antibiotics per person per year decreased to about one-fifth. The number of prescriptions per 100 patients decreased from 20.9 in 2006 to 3.6 in 2012 for macrolides, from 7.9 in 2005 to 2.4 in 2012 for third-generation cephalosporins, and increased from 1.6 in 2004 to 3.9 in 2012 for penicillins. In addition, for every 50 pediatric cases of acute sinusitis, the number of patients to whom no antibiotics were prescribed increased 9-fold and the number of patients to whom 2 or more types of antibiotics were prescribed decreased from 26 to 9 cases, while the mean period in days until resolution was shortened by 6 days.<br><b>Conclusion</b> : The results of this pilot study suggest that the use of Gram staining for diagnosis and prescription of antibiotics in an otorhinolaryngology outpatient clinic may lead to significantly improved antibiotic prescription practices. Further study through proper controlled studies are felt to be neceesary.
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<b>Introduction</b> : As one of the strategies for the introduction of collaborative drug therapy management (CDTM) into a community healthcare system in Japan, we constructed a ‘positive list’ which was agreed by a family physician in advance, and subsequently validated the effects on healthcare insurance fees, the number of prescription question and the changes of utilization rate for generic drugs.<br><b>Methods</b> : The items that replaced prescription questions with regard to ex post facto approval were defined as ‘Resolved Questions’ in our constructed positive list. By adopting the ‘Resolved Questions’, we then examined the effect on healthcare insurance fees, prescription questions and the changes of utilization rates for generic drugs.<br><b>Results</b> : Among all prescription questions accepted from January through May 2012 inclusive, 178 (22.7%) were ‘Resolved Questions’, without there being change in the therapeutic strategies by the prescribing physicians. During this period, 17,455 healthcare insurance fees were reduced. In addition, the utilization rate for generic drugs were increased up to 46.6%.<br><b>Conclusion</b> : The reduction of healthcare insurance fees, prescription questions and the increased utilization rates of generic drugs were facilitated by prudent pharmacist judgements based on ‘Resolved Questions’.