Detección de las necesidades de capacitación de los asistentes de farmacia / Detection of training needs in pharmacy assistants

Introducción: La capacitación es, sin duda, uno de los temas actuales más importantes cuando se habla de competitividad, innovación y mejora continua de una empresa. Este proceso implica: detección de necesidades, planeación, implementación, evaluación, retroalimentación y seguimiento de resultados. El eje fundamental de este proceso es el Diagnóstico de Necesidades de Capacitación, pues señala de manera precisa los aspectos sobre los cuales ha de trabajar el capacitador. Objetivo: Realizar un diagnóstico de las necesidades de capacitación de los asistentes de farmacia del Municipio Santa Clara. Métodos: Para elaborar el Diagnóstico de Necesidades de Capacitación se utilizó el método comparativo. Este método se basa en la identificación de las discrepancias entre lo que es y lo debe ser, lo que posibilita constatar los requisitos que son necesarios cubrir. Se utilizaron como técnicas la entrevista y la encuesta. Resultados: Finalmente, después del análisis de todos los datos obtenidos de las matrices y preguntas abiertas, se elaboró el Diagnóstico de Necesidades de Capacitación final que se entregó a la Empresa Farmacias y Ópticas. Conclusiones: Estos resultados mostraron que esta empresa necesita de manera inmediata implementar actividades de capacitación a sus asistentes de farmacia en lo referente a conocimientos.

Introduction: training is, undoubtedly one of the most important current issues when talking about competitiveness, innovation and continuous improvement of a company. This process involves: detection of needs, planning, implementation, evaluation, feedback and monitoring of results. The fundamental axis of this process is the Diagnosis of Training Needs, since it indicates precisely the aspects on which the trainer must work. Objective: to carry out a diagnosis of the training needs in pharmacy assistants from Santa Clara municipality. Methods: the comparative method was use to prepare the Training Needs Diagnosis. This method is based on the identification of discrepancies between what is and what should be; it made possible to verify the necessary requirements to be met. Interviews and surveys were used as techniques. Results: Finally, after analyzing all the data obtained from the matrices and the open questions, a final Diagnosis of Training Needs was prepared and delivered to the Pharmacy and Optics Company. Conclusions: these results showed that this company needs to immediately implement training activities for their pharmacy assistants in terms of knowledge.

Application progress on in vivo drug analysis technique in clinical pharmacy / 药学实践杂志

Objective To explore the progress on the application of in vivo drug analysis techniques in clinical pharmacy work. Methods Relevant literature was reviewed to provide an overview of the characteristics of clinical samples, common in vivo drug analysis methods used in the clinic, the application and existing problems of in vivo drug analysis in clinical pharmacy. Results and Conclusion In recent years, with the increasing demand for individualized and precise treatment in clinical practice and the continuous development of analytical techniques, in vivo drug analysis techniques have been widely used in clinical pharmacy work, which have become one of the important auxiliary techniques to promote rational clinical drug use, improve individualized treatment and reduce the occurrence of adverse reactions. However, in the actual application, there were still problems such as the invasive blood sampling that hinders sampling, the weak ability to interpret drug monitoring results and clinical testing methods that still need to be improved. These problems should be taken seriously and continuously improved and solved in the subsequent research and application.

Construction of the simulated traditional Chinese medicine pharmacy based on virtual simulation technology and its application evaluation / 中国药房

OBJECTIVE To construct the simulated traditional Chinese medicine pharmacy based on virtual simulation technology， and assist in the development of the new mode of traditional Chinese medicine dispensing education training. METHODS The field research and questionnaire surveys were conducted to identify the needs of Chinese medicine students and practitioners for the content and presentation of knowledge on the construction of simulated traditional Chinese medicine pharmacy. Taking the laws and regulations on the construction of traditional Chinese medicine pharmacy and the related teaching materials and literature on traditional Chinese medicine preparation as the knowledge source， the virtual simulation technology was applied to build a simulated traditional Chinese medicine pharmacy so as to achieve the functions of browsing the traditional Chinese medicine pharmacy， learning the knowledge of traditional Chinese medicine preparation and practical skills training. A multi-site simulated traditional Chinese medicine pharmacy evaluation scale study was conducted based on platform operational testing. RESULTS A simulated traditional Chinese medicine pharmacy was constructed， consisting of four core modules： video teaching， animation video， simulated pharmacy， and simulated experience. The overall score of evaluation scale was 93.31， with all entries scoring above 80； the ones with evaluation scales above 90 accounted for 92.31% （60/65）. CONCLUSIONS Simulated traditional Chinese medicine pharmacy based on virtual simulation technology meets the learning needs of users and enhances the teaching effect of traditional Chinese medicine dispensing technology training.

Application of FMEA model and 6S management method in reducing dispensing errors in PIVAS of children’s hospitals / 中国药房

OBJECTIVE To reduce dispensing errors in pharmacy intravenous admixture service （PIVAS） of children’s hospitals. METHODS The risk of dispensing procedures in our PIVAS was identified by applying failure mode and effect analysis （FMEA） model. Potential failure modes that might lead to dispensing errors in each link were determined， and failure causes were analyzed. The severity， incidence and detection degree of potential failure modes were quantitatively scored， and their risk priority number （RPN） was calculated to screen failure modes that needed to be improved in priority； the corresponding improvement measures were developed by 6S management method from six aspects， namely， finishing （seiri）， rectifying （seiton）， sweeping （seiso）， sanitation （seiketsu）， literacy （shitsuke） and safety. The effect of intervention before and after rectification was evaluated. RESULTS Based on the RPN， 32 potential failure modes were selected， of which a total of 18 critical failure modes that needed to be improved in priority. After implementing corresponding measures according to 6S management method， the RPN of 18 critical failure modes decreased. The total RPN decreased from 497 to 142 with a decrease rate of 71.43%. The error rates of 15 critical failure modes were significantly lower than before implementation （P＜0.05）. CONCLUSIONS Applying FMEA model and 6S management method to the risk control of all aspects of PIVAS workflow can effectively reduce the risk of PIVAS dispensing errors and ensure the safety of children’s intravenous medication.

Construction of performance management system for pharmacy department of tertiary public hospitals under new situation / 中国药房

OBJECTIVE To provide reference for improving the work efficiency of staff and promoting the discipline construction of pharmacy department. METHODS By analyzing the current situation of performance management in the pharmacy department of our hospital， the key successful factors were sorted out， strategic decoding was carried out and key performance indicators were extracted. The quarterly and annual performance appraisal forms were formulated for the departments of pharmacy warehouse， outpatient pharmacy， ward pharmacy， clinical pharmacy department， prescription examination center， laboratory and other departments； the performance management information platform was built. The work efficiency and output of each department were compared half a year before and after the implementation of the performance management plan. RESULTS After the implementation of the program， the average queuing time for drug collection in the outpatient department was shortened from 5 minutes to 3 minutes， the average number of dispensing infusion bags per hour in the pharmacy intravenous admixture services increased from 50 bags to 60 bags， and antibacterial use density of the hospital decreased from 42.7 DDD（defined daily doses） to 40.2 DDD. The number of academic papers published had increased from 8 to 10， and the satisfaction of clinical departments with ward pharmacies increased from 85% to 95%. CONCLUSIONS The performance management system has been successfully established in pharmacy department of our hospital， which can improve the enthusiasm of pharmacists， reflect the value of pharmaceutical care， and promote the discipline construction of pharmacy.

Current situation analysis and suggestions on clinical pharmacy undergraduate internship education in China / 中国药房

OBJECTIVE To provide a reference for the improvement of the clinical pharmacy undergraduate internship education in China. METHODS The status of clinical pharmacy undergraduate internship education in China was briefly summarized， and suggestions on its future development based on advanced methods of domestic and abroad were provided. RESULTS & CONCLUSIONS In China， undergraduate students of clinical pharmacy were required to undergo hospital internships for no less than 42 weeks. The internship took place in both pharmacy and clinical departments in hospitals. Students’ performance was usually assessed at the end of the internship. The mainstream teaching patterns included on-site teaching， simulation teaching， case-based discussion teaching， medical and pharmaceutical joint teaching， team-based teaching， academic exchange， and so on. The form of assessment had also shifted from final evaluations to more dynamic formats. The clinical pharmacy undergraduate internship education in China can adopt teaching models such as the layered teaching approach， establish pre-internship assessment or training， and encourage interns to participate in social pharmacy practice and directly interact with patients， etc.， so as to improve the effect of internship.

Application of narrative pharmacy in cardiovascular pharmacy clinic / 中国药房

OBJECTIVE To explore the effects of narrative pharmacy management on medication compliance， negative emotions， and quality of life in patients with cardiovascular disease complicated with negative emotions. METHODS A total of 49 patients with drug use problems and negative emotions attending the cardiovascular pharmacy clinic of Wuhan First Hospital from February to August 2023 were selected as the study objects， narrative pharmacy model was applied for patient management during their visits； pharmaceutical care and emotional management were performed after 2 weeks of treatment and a follow-up visit was conducted to evaluate and record the management effect one month later. RESULTS Adopting a narrative pharmacy management model， 49 patients were involved in 114 drug related consultation questions. Compared with the visit， after one month of management， the number of medication types taken by patients significantly decreased [4.00 （2.00， 6.00） vs. 3.00 （1.50， 5.00）， P＜0.05]， the incidence of adverse reactions significantly decreased （32.65% vs. 2.04%， P＜0.001）， the rate of blood pressure and lipid compliance significantly increased （30.61% vs. 95.92%， P＜0.001）， and the score of the patient’s medication compliance significantly improved （[ 3.94±2.44） vs. （6.78±2.07）， P＜0.01]. The depression score significantly decreased [3.00 （2.00， 4.50） vs. 2.00 （0.00， 3.00）， P＜0.001]， the anxiety score significantly reduced [3.00 （2.00， 4.50） vs. 1.00 （0.00， 2.00）， P＜0.001]， quality of life score was significantly improved [22.00 （19.00， 22.00） vs. 23.00 （23.00， 24.50）， P＜0.01]. In the satisfaction survey， there was a slight increase in the overall satisfaction proportion （91.84% vs. 97.96%， P＞0.05）. CONCLUSIONS The application of narrative pharmacy in cardiovascular pharmacy clinic can improve patient compliance， reduce adverse drug reactions， enhance the effectiveness of drug treatment， avoid drug interactions， effectively improve the anxiety and depression， and ultimately improve the quality of life.

Quantitative analysis for reform policies of basic medical insurance designated retail pharmacies in China / 中国药房

OBJECTIVE To sort out reform policy for basic medical insurance designated retail pharmacy （referred to as designated retail pharmacy） in China， and to provide reference for the improvement of the policy under the new situation of mutual- aid mechanism for covering outpatient bills. METHODS The policy texts on designated retail pharmacies issued by ministries and commissions of the State Council and departments directly under the State Council were collected from December 1998 to June 2023. The content analysis and social network analysis were adopted to construct a three-dimensional analytical framework based on the policy subject， the policy tool， and the policy process， in order to quantitatively analyze the policies on reforming designated retail pharmacies. RESULTS & CONCLUSIONS The reform policy of designated retail pharmacies can be roughly divided into three stages： germination， exploration and development， and in-depth promotion. The use of policy tools is dominated by environment-oriented tools， and the cooperation network of policy subjects presents a “head-body-tail” chain structure. With the advancement of policy reforms， the number of policy subjects showed a trend of decline followed by growth， the number of policy documents showed an upward trend， emphasizing the use of tools such as the construction of the pharmacist system， the flow of prescriptions， the payment of medical insurance， and the management of “dual-channels” and “outpatient co-ordination”. It is suggested that in terms of policy formulation， all policy subjects should adhere to top-level design， grasp the characteristics of the stage of policy development， and adjust the use of policy tools according to local and timely conditions； we should also strengthen cooperation and communication， improve policy formulation efficiency， achieve policy coordination， and continuously improve policies for designated retail pharmacies.

Investigation and analysis of pharmaceutical management in compact medical consortium of Guangdong province / 中国药房

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.

Development and influential factor analysis of pharmacy outpatient departments in 714 Chinese tertiary healthcare institutions / 中国药房

OBJECTIVE To investigate the basic situation of developing pharmacy outpatient departments in Chinese tertiary medical institutions and analyze the influencing factors. METHODS The research targeted the pharmacy outpatient department managers of hospitals and conducted a survey through Sojump in March 2023. Various independent variables were selected from the hospital’s own characteristics， the management of the pharmacy outpatient departments， and the construction of the pharmacist team for Logistic and linear regression analysis， with the aim of separately analyzing the factors influencing the establishment of pharmacy outpatient departments and the factors affecting the total number of patients served by these departments throughout the year 2022. RESULTS & CONCLUSIONS A total of 1 304 medical institutions of different levels nationwide participated in this survey， with 714 tertiary hospitals. Among the tertiary hospitals， 377 （52.80%） had established pharmacy outpatient departments， including 321 grade-A tertiary hospitals， 48 grade-B tertiary hospitals and 8 other tertiary hospitals. The 377 tertiary hospitals collectively operated 1 739 pharmacy outpatient departments， covering 19 specialized fields， with the highest proportion found in the cardiovascular field （including anticoagulation） at 16.45%. Tertiary hospitals in North China， Central China， East China and South China regions had more pharmacy outpatient departments. The establishment of pharmacy outpatient departments was found to be influenced by tertiary grade-B status （P＝0.010） and the annual outpatient volume of the hospital （P＝0.008）， although the impact was relatively small. The factors influencing the number of patients served by pharmacy outpatient departments were the annual outpatient volume of the hospital （P＝0.042） and the number of pharmacists engaged in clinical pharmacy work （P＝0.004）. The proportion of tertiary hospitals in China that have established pharmacy outpatient departments is insufficient. It is necessary to further accelerate the construction of pharmacy outpatient departments and appropriately expand the talent pool of hospital pharmacy teams based on the needs of pharmacy outpatient departments and patients， in order to meet the requirements of medical practice and patient care.

Perfil das pessoas com diabetes que utilizaram a telefarmácia na pandemia de covid-19: resultados da DIABETES / Profile of people with diabetes who used telepharmacy during the covid-19 pandemic: results from DIABETES / Perfil de personas con diabetes que usaron telefarmacia durante la pandemia de covid-19: resultados de DIABETES

O objetivo foi analisar o perfil das pessoas com diabetes que utilizaram a telefarmácia na pandemia de covid-19. Trata-se de um estudo transversal com dados oriundos da websurvey DIABETESvid que ocorreu nos meses de setembro e outubro de 2020. Verificou-se que 45 participantes recorreram à telefarmácia, sendo que 55,6% eram do sexo masculino, 42,2% tinham idade compreendida entre 18 e 34 anos e 46,7% estudaram 12 ou mais anos. Além disso, 48,9% autorreferiram diabetes mellitus tipo 1. A maioria usava insulina (55,6%) e obteve os medicamentos para o diabetes em farmácias do sistema público de saúde (60%). Ademais, as pessoas que tiveram o diagnóstico de covid-19 buscaram mais pela telefarmácia (RP=2,20; IC95% 1,23­3,94). Sabe-se que os medicamentos são essenciais para o tratamento do diabetes. Logo, no período estudado em que se preconizava o distanciamento físico, os participantes apropriaram-se da telefarmácia a fim de obter a integralidade do cuidado

The objective was to analyze the profile of people with diabetes who used telepharmacy during the covid-19 pandemic. This is a cross-sectional study with data from the DIABETESvid websurvey that took place in September and October 2020. It was found that 45 participants used telepharmacy, 55.6% of whom were male, 42.2% were between 18 and 34 years-old and 46.7% studied 12 or more years. In addition, 48.9% self-reported type 1 diabetes mellitus. Most used insulin (55.6%) and obtained their diabetes medication from pharmacies in the public health system (60%). Also, people diagnosed with covid-19 used telephar-macy more often (PR=2.20; 95%CI 1.23­3.94). It is known that drugs are essential for the treatment of diabetes. Therefore, in the period studied in which physical distancing was advocated, the participants used telepharmacy to obtain comprehensive care

El objetivo fue analizar el perfil de las personas con diabetes que utilizaron la telefarmacia durante la pandemia del covid-19. Estudio transversal con datos de la encuesta por internet DIABETESvid realizada en septiembre y octubre de 2020. Se encontró que 45 participantes recurrieron a la telefarmacia, de los cuales el 55,6% eran hombres, el 42,2% tenían entre 18 y 34 años y el 46,7% estudiaban 12 o más años. Además, el 48,9% se autorrefirió diabetes mellitus tipo 1. La mayoría utilizaba insulina (55,6%) y recibía su medicación antidiabética en farmacias del sistema público (60%). Además, las personas diagnosticadas con covid-19 buscaron telefarmacia con más frecuencia (RP = 2,20; IC 95% 1,23­3,94). Los medicamentos son esenciales para el tratamiento de la diabetes. Por lo tanto, en el período estudiado en el que se propugnaba el distanciamiento físico, los participantes se apropiaron de la telefarmacia para la atención integral

Empirical antimicrobial therapy based on active surveillance cultures in ICU patients

Objetivo: Avaliar o valor preditivo da colonização prévia por Acinetobacter baumannii (CRAB) e Pseudomonas aeruginosa (CRPA) resistente a carbapenêmicos estabelecida em culturas de vigilância para infecção subsequente por esses patógenos em pacientes internados em UTI. Métodos: Foi realizado um estudo de coorte com pacientes internados na unidade de terapia intensiva por pelo menos 48 h. Foram medidos os valores preditivos negativos e positivos, sensibilidade e especificidade das culturas de vigilância em CRAB e CRPA. Resultados: Foram incluídos 693 pacientes infectados. Pacientes previamente colonizados por CRAB e CRPA tiveram maior probabilidade de serem infectados por esses patógenos: OR ajustado: 10,34 (6,58 - 16,45; p < 0,001) e 2,30 (3,88 - 10,26; p < 0,001), respectivamente. Encontramos altos valores preditivos negativos de culturas de vigilância para CRAB (87,18%) e CRPA (88,30%) e alta especificidade 91,96% e 90,13%, respectivamente. Conclusões: Pacientes não colonizados por CRAB e CRPA mostraram-se menos propensos à infecção por esses patógenos. Esses achados podem contribuir para a escolha da terapia antimicrobiana empírica e desencorajar a prescrição de antibióticos contra esses patógenos em pacientes sem colonização prévia.

Objective: To assess the predictive value of prior carbapenem-resistant Acinetobacter baumannii (CRAB) and Pseudomonas aeruginosa (CRPA) colonization established in surveillance cultures for subsequent infection by these pathogens in ICU patients. Methods: A cohort study was performed with patients admitted to the intensive care unit for at least 48 h. Negative and positive predictive values, sensitivity, and specificity of surveillance cultures in CRAB and CRPA were measured. Results: 693 infected patients were included. Patients previously colonized by CRAB and CRPA were more likely to be infected by these pathogens: adjusted OR: 10.34 (6.58 - 16.45; p < 0.001) and 2.30 (3.88 - 10.26; p < 0.001), respectively. We found high negative predictive values of surveillance cultures for CRAB (87.18%) and CRPA (88.30%) and high specificity 91.96% and 90.13%, respectively. Conclusions: Patients not colonized by CRAB and CRPA were less prone to infection by these pathogens. These findings may contribute to the choice of empirical antimicrobial therapy and discourage the prescription of antibiotics against these pathogens in patients without previous colonization.

Trastorno mixto ansioso-depresivo en funcionarios de la salud, durante la pandemia del SARS-CoV-2 / Mixed anxiety-depressive disorder in health workers, during the SARS-CoV-2 pandemic

Resumen Objetivo: Evaluar la existencia del trastorno mixto ansioso-depresivo en funcionarios de la salud de los servicios de Farmacia, Enfermería y personal de apoyo, durante la pandemia del SARS-CoV-2. Métodos: Se llevó a cabo un estudio transversal - analítico, en el periodo de marzo a septiembre 2020, en funcionarios de la salud, quienes estaban expuestos directamente con el SARS-CoV-2, consecuencia de su trabajo. Se realizó una encuesta bajo consentimiento informado, con parámetros como edad, sexo, estado civil, dependencia económica, servicio en que laboran, profesión ejercida, jornada laboral, entre otros; con una participación de 200 voluntarios, mediante un enlace virtual. Resultados: Un total de 127 trabajadores de la salud, es decir un 63.5% de la muestra, presentaron más de cuatro síntomas sugestivos de trastorno mixto ansioso-depresivo. Los síntomas más predominantes fueron preocupación (88,2%), fatiga (88,2%), falta de energía (78,0%) y trastornos del sueño (74,8%). Conclusión: El trastorno mixto ansioso depresivo cobró auge durante la pandemia del SARS-CoV-2, factores como la exposición prolongada a escenarios estresores, así como el sexo femenino, no contar con pareja o pertenecer a un grupo etario menor a los 45 años, pueden propiciar el desarrollo de un trastorno mental. Por lo cual es importante poder identificar a la población de riesgo, brindarle el apoyo y seguimiento necesario, así como la creación de protocolos que brinden una guía sobre como actuar para procurar la integridad del personal de salud.

Abstract Aim: To evaluate for mixed anxiety-depressive disorder in health care workers in the Pharmacy, Nursing and Support Staff during the SARS-CoV-2 pandemic. Methods: A cross-sectional-analytical study was carried out from March to September 2020 in health care workers who were directly exposed to SARS-CoV-2 because of their work. A survey was conducted previous informed consent, with variables including age, sex, marital status, economic dependence, service in which they work, profession, working day, among others; with the participation of 200 volunteers, through a virtual link. Results: A total of 127 health workers, that is, 63.5% of the sample, presented more than four symptoms suggestive mixed anxious-depressive disorder. The most predominant symptoms were worry (88.2%), fatigue (88.2%), lack of energy (78.0%) and sleep disorders (74.8%). Conclusion: mixed anxiety-depressive disorder was prevalent during the SARS-CoV-2 pandemic. Factors such as prolonged exposure to stressful scenarios, as well as female sex, not having a partner or belonging to an age group younger than 45 years old, can lead to the development of a mental disorder. It is therefore important to be able to identify the population at risk, provide the necessary support and follow-up, as well as the creation of protocols that provide guidance on how to act to ensure the integrity of health personnel.

A cross-sectional evaluation of behavior and attitude of pharmacists toward dispensing non-OTC drugs without prescription in a city of Southern Rajasthan

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.

Tratamiento farmacológico para tromboembolismo pulmonar dirigido a pacientes con fibrilación auricular / Pharmacologic treatment for pulmonary thromboembolism in patients with atrial fibrillation / Tratamento farmacológico para tromboembolismo pulmonar em pacientes com fibrilação atrial

La fibrilación auricular es una de las arritmias cardiacas más frecuentes. Afecta a 1 de cada 200 personas de entre 40 y 50 años de edad, pero puede llegar a afectar a más de 1 de cada 10 personas de 80 años. Objetivo. Proponer una guía de tratamiento farmacológico para evitar el tromboembolismo pulmonar en pacientes con fibrilación auricular con respuesta ventricular. Materiales y métodos. Los métodos utilizados fueron de nivel teórico como histórico lógico, modelación, hipotético- deductivo, dialectico, holístico-holográfico y sistémico estructural- funcional. Como métodos empíricos. se aplicaron la revisión de documentos guías, historias clínicas, encuestas a médicos y farmacéuticas, también se realizó la observación científica, los resultados se reflejaron la revisión de las historias clínicas de los 38 pacientes con diagnóstico de fibrilación auricular crónica. Resultados. Se representa el tipo de tratamiento con un predominio de 24 pacientes que toman anticoagulantes (63,16%), los pacientes en su mayoría no estaban anti coagulados, pacientes anti coagulados (34,62%), además se elaboró la propuesta de una guía de tratamiento farmacológico para evitar el tromboembolismo pulmonar en pacientes con fibrilación auricular con respuesta ventricular rápida, de acuerdo a los estándares internacionales para para prevenir las complicaciones tromboembólicas de la fibrilación auricular. Conclusiones. Debido a su prevalencia creciente, al impacto en la supervivencia, la calidad de vida de los pacientes, los elevados costos sanitarios que conlleva su tratamiento y el incesante avance en nuevos tratamientos de la fibrilación auricular con respuesta ventricular rápida, hace que sea necesario actualizar de manera periódica las recomendaciones basadas en la evidencia.

Atrial fibrillation is one of the most common cardiac arrhythmias. It affects 1 in 200 people between 40 and 50 years of age, but may affect more than 1 in 10 people in their 80s. Objective. To propose a pharmacological treatment guideline to prevent pulmonary thromboembolism in patients with atrial fibrillation with ventricular response. Materials and methods. The methods used were of theoretical level as historical-logical, modeling, hypothetical- deductive, dialectical, holistic-holographic and systemic-structural-functional. As empirical methods, the review of guidelines documents, clinical histories, surveys to physicians and pharmacists were applied, as well as scientific observation, the results were reflected in the review of the clinical histories of the 38 patients with a diagnosis of chronic atrial fibrillation. Results. The type of treatment is represented with a predominance of 24 patients taking anticoagulants (63.16%), most of the patients were not anti coagulated, anti coagulated patients (34.62%), also the proposal of a pharmacological treatment guide to avoid pulmonary thromboembolism in patients with atrial fibrillation with rapid ventricular response was elaborated, according to international standards to prevent thromboembolic complications of atrial fibrillation. Conclusions. Due to its increasing prevalence, the impact on survival, the quality of life of patients, the high health care costs involved in its treatment, and the incessant advance in new treatments for atrial fibrillation with rapid ventricular response, it is necessary to periodically update the evidence-based recommendations.

A fibrilação atrial é uma das arritmias cardíacas mais comuns. Afeta 1 em cada 200 pessoas entre 40 e 50 anos de idade, mas pode afetar mais de 1 em cada 10 pessoas em seus 80 anos. Objetivo. Propor uma diretriz de tratamento farmacológico para prevenir o tromboembolismo pulmonar em pacientes com fibrilação atrial com resposta ventricular. Materiais e métodos. Os métodos utilizados foram de um nível teórico, como histórico-lógico, modelagem, hipotético-dedutivo, dialético, holístico-holográfico e sistêmico-estrutural-funcional. Como métodos empíricos, a revisão de documentos de orientação, históricos clínicos, pesquisas de médicos e farmacêuticos foram aplicados, assim como a observação científica, os resultados foram refletidos na revisão dos históricos clínicos dos 38 pacientes com um diagnóstico de fibrilação atrial crônica. Resultados. O tipo de tratamento é representado com uma predominância de 24 pacientes tomando anticoagulantes (63,16%), a maioria dos pacientes não era anticoagulante, anticoagulante (34,62%), e uma proposta de um guia de tratamento farmacológico para prevenir o tromboembolismo pulmonar em pacientes com fibrilação atrial com resposta ventricular rápida foi elaborada, de acordo com as normas internacionais para prevenir complicações tromboembólicas da fibrilação atrial. Conclusões. Devido a sua crescente prevalência, o impacto na sobrevivência, a qualidade de vida dos pacientes, os altos custos de saúde envolvidos em seu tratamento e o incessante avanço em novos tratamentos para fibrilação atrial com resposta ventricular rápida, é necessário atualizar periodicamente as recomendações baseadas em evidências.

Calculating the risk of fire in community pharmacies. Gustav-Purt method

Introduction: Fire is a chemical reaction of combustion, based on the strongly exothermic "oxidation-reduction" phenomena that produce a big detachment of light and heat.Its effects are, generally, harmful, producing personal injuries due to smoke, toxic gasses, and extremely hot temperatures; and damaged materials and buildings. Fire is produced when the three following factors simultaneously coexist in time and space: Fuel; a comburent agent, usually the oxygen in the air; and heat, which contributes the necessary energy to actuate the reaction. Besides, it is necessary, for the production of the flame, the existence of a chain reaction. Method: The Gustav-Purt Method, which aim is to calculate the potential risk in a determinate building and of the means to fight fires should be implemented. Results: After the calculation of the distinct factors, the conclusion that the risk of fire in a pharmacy is high is reached. Discussion: Therefore, strict inspection by sanitary authorities to avert the danger of the fire is necessary.

Introducción: El fuego es una reacción química de combustión, basado en los fenómenos de oxidación-reducción fuertemente exotérmica que se manifiesta por desprender gran cantidad de luz y calor. Sus efectos son generalmente perjudiciales, produciendo daños personales por el humo, gases tóxicos y temperaturas extremas, causando grandes daños a instalaciones y bienes. El fuego se produce cuándo existen simultáneamente en el tiempo y en un mismo lugar los tres factores siguientes: Combustible, Agente Comburente, normalmente el oxígeno del aire y Calor, que contribuye con la energía necesaria para activar la reacción. Además, es necesario, para la producción de la llama, la existencia de reacciones de cadena. Método: El método de Gustav Purt, tiene por objetivo calcular el riesgo potencial existente en un edificio determinado y qué medios de lucha contra incendios son necesarios implementar. Resultados: Tras el cálculo de los distintos factores, se llega a la conclusión que el riesgo de incendio en una farmacia es elevado. Discusión: Por consiguiente, es necesario la estricta inspección de las autoridades sanitarias de la Administración para evitar el peligro del fuego.

Núcleos de Avaliação de Tecnologias em Saúde e Comissões de Farmácia e Terapêutica em hospitais universitários: organização e articulação / Hospital-based HTA Nuclei and Pharmacy and Therapeutics Committee in university hospitals: organization and articulation

Introdução: A atuação dos Núcleos de Avaliação de Tecnologias em Saúde (NATS) e das Comissões de Farmácia e Terapêutica (CFT) em hospitais de ensino pode ser potencializada para o fortalecimento da implementação da política de gestão de tecnologias em saúde no âmbito hospitalar. Entretanto, a organização e as formas como esses grupos se articulam é pouco conhecida. Objetivo: Analisar processos de trabalho de NATS e CFT instituídos em hospitais universitários federais sob a gestão da Empresa Brasileira de Serviços Hospitalares (Ebserh), identificando elementos organizacionais e níveis de articulações entre esses grupos, além das principais dificuldades enfrentadas. Métodos: Trata-se de uma pesquisa qualitativa exploratória, envolvendo estudo de casos múltiplos. As unidades hospitalares foram selecionadas após critério de inclusão. A coleta de dados empregou análise documental e entrevista semiestruturada com pessoas chaves dos processos. Resultados: Os resultados permitiram uma visão geral sobre como estão organizados e estruturados os NATS e as CFTs, bem como a identificação de diferentes níveis de articulação entre eles. Dos 8 hospitais estudados, 3 apresentaram nível alto de articulação, 4 apresentaram nível baixo e em um deles não foi observada a existência de articulação entre o NATS e a CFT. Entre os desafios enfrentados pelos grupos foram relatados a escassez de recursos humanos, incipiente estrutura administrativa ou espaço físico e necessidades de capacitação. Conclusão: Quatro dos hospitais apresentaram nível baixo de articulação entre o NATS e a CFT, indicando a necessidade de maior compreensão dos fatores intervenientes. Os resultados contribuem para o conhecimento institucional de cada grupo estudado e podem orientar ações de melhoria e fortalecimento da cultura da ATS para gestão de tecnologias nos ambientes hospitalares.

Introduction: The hospital-based HTA nuclei (NATS) in teaching hospitals and their interaction with the Pharmacy and Therapeutics Committee (PTC), can be an important strategy for strengthening HTA in the hospital environment. However, this relationship is not well known. Objective: To analyse NATS and PTC work processes that has been established in Federal University Hospitals administrated by Empresa Brasileira de Serviços Hospitalares ­ Ebserh (The Brazilian Company of Hospital Services), identifying how they are organized, possible interfaces and difficulties and points of articulation between them. Methods: This is an exploratory qualitative research involving multiple-case study. Hospital units were selected by applying some inclusion criteria. The data were collected from document analysis and semi-structured interviews with key informants from both groups. Results: The results showed an overview about how the NATS and PTC are organized and structured, identificating different levels of articulation between them, with three of eight hospitals considered of high level. Among the challenges were pointed out the lack of human resources availability, administrative structure or physical space and training. Conclusion: Four hospitals demonstrated low level of articulation between the NATS and the PTC, indicating needs for understanding the intervening factors. This study contributes to the institutional knowledge for guiding actions to improve and strengthen the HTA culture at the hospital level.

El largo y sinuoso camino de la farmacia clinica en Chile / The long and winding road of the clinical pharmacy in Chile

Clinical pharmacy is a health discipline in which pharmacists provide patient care that optimizes rational medication use and promotes health, wellness and disease prevention. The beginnings of clinical pharmacy in Chile were inspired by the origin in the School of Pharmacy of the University of California, San Francisco (UCSF), in the mid-1960s. However, the historical development in our country, both in teaching and in the professional field, was accompanied by difficulties and success, which became a long and winding road. This article shares the events that gave rise to its beginnings in Chile, first through teaching, then in pharmacovigilance and clinical pharmacokinetics, to later describe its professional expansion and recognition as a specialty of pharmacy. This article briefly recounts the history of the Chilean clinical pharmacy to this day. Some names of people or institutions were not mentioned. Therefore the authors apologize in advance to pharmacists and organizations whose contribution cannot be recognized in this way. However, we know that this specialty has not been forged only by the names that appear, but by all those who love and respect the work of the clinical pharmacy.

Investigation and study on pharmaceutical care ability of retail chain pharmacies and licensed pharmacists in Guangdong province / 中国药房

OBJECTIVE To provide reference for strengthening the quality of pharmaceutical care in retail chain pharmacies and the professional capabilities of licensed pharmacists， and to meet the public’s pharmaceutical care needs. METHODS A combination of questionnaire survey and informant interview was used to investigate the general information of licensed pharmacists in retail chain pharmacies in Guangdong province， the implementation of pharmaceutical care， the competence and knowledge status of the surveyed licensed pharmacists， and the factors affecting the development of pharmaceutical care. RESULTS & CONCLUSIONS A total of 444 questionnaires were sent out and 326 effective questionnaires were collected， with an effective recovery rate of 73.42%. Among 326 surveyed licensed pharmacists， a college degree or higher accounted for 40.18%， and the pharmacy major or related accounted for 79.75%. A total of 185 （56.75%） of the surveyed licensed pharmacists indicated that the retail chain pharmacies where they worked had established specified areas of pharmaceutical care； 320 （98.16%）， 137 （42.02%） and 181 （55.52%） of the surveyed licensed pharmacists indicated that the retail chain pharmacies where they worked could provide services such as rational medication guidance for patients， decocting traditional Chinese medicines and establishing health records， etc. The self-assessment scores of the surveyed licensed pharmacists were significantly higher than 3 （median） for competence and knowledge level， but the self-assessment scores for medication therapy management competence and pharmaceutical care practice were relatively low. The surveyed licensed pharmacists believed that the main factors affecting the development of pharmaceutical care in retail chain pharmacies included patients’ lack of trust or cooperation （196， 60.12%）， sales performance requirements （170， 52.15%）， and heavy daily workload （165， 50.61%）. It is recommended that relevant authorities expedite the legislative process of the Pharmacist Law， optimize the continuing education system for licensed pharmacists， and implement a star-rating evaluation system for pharmaceutical care capabilities in pharmacies， so as to encourage retail chain pharmacies and licensed pharmacists to pursue a more specialized development path. At the same time， pharmaceutical retail chain enterprises should shift their business mindset， increase investment in pharmaceutical care， enhance the professional atmosphere in the pharmacies， optimize the compensation structure for licensed pharmacists， and elevate the pharmaceutical care capabilities of both the pharmacies and licensed pharmacists to fulfill the pharmaceutical care needs of the public.

A qualitative study on the influencing factors of prescription circulation and its platform construction / 中国药房

OBJECTIVE To explore the influential factors for “Internet +” prescription circulation and construction specifications of prescription circulation platform， so as to provide reference for the government to formulate relevant policies and standardized construction of prescription circulation platform. METHODS Stakeholders in the process of prescription circulation service in medical institutions in Sichuan province were selected to conduct key insider interviews， and grounded theory was used to analyze the data. RESULTS The influential factors of prescription circulation could be divided into three aspects： participant factor， administrative decision factor and information technology factor. The influential factors of prescription circulation mainly lay in pharmacy admission and withdrawal mechanism， medical insurance reimbursement service， supporting policies and pharmaceutical care ability. In terms of pharmacy admission and withdrawal mechanism， pharmacy qualification， pharmaceutical service personnel， drug allocation and distribution should be considered to unify pharmacy admission standards； in terms of medical insurance reimbursement service， it should actively connect with social pharmacies to realize the transfer of prescription medical insurance reimbursement from designated pharmacies； in terms of supporting policies， it should pay attention to the construction of the top-level design of prescription circulation； in terms of pharmaceutical care ability， regular training and assessment of licensed pharmacists should be performed in drug consultation， prescription review and other pharmaceutical care. CONCLUSIONS Participants have more influence on prescription circulation， and pharmacy admission and withdrawal mechanism and pharmaceutical care ability need to be improved. There are various types of prescription circulation platform construction， but each has its own advantages and disadvantages. It is suggested that relevant government departments should improve the access threshold of pharmacies， follow up medical insurance reimbursement services and supporting policies， and explore ways to improve pharmaceutical care capacity， leading and issuing relevant policies and measures to promote the prescription circulation service and make the “Internet +” prescription circulation develop in an orderly manner.