Studies On The Influence Factors And Effect Evaluation Of Pharmaceutical Care In Community Pharmacies

Pharmaceutical care(PC) in community pharmacy in China, as an important part of community health service, is still on its initial stage for which need to be improved both in theory and practice. Based on this national condition, we aimed at the hot spot of international researchs in this field and stressed on the basic and advanced investigation about the content and form of PC studies in community pharmacy in China and abroad, related influence factors and their relationships, and the evidences to the effect of PC in community pharmacy. This study was significant to the PCpractice in community pharmacy, the development of health system reform and drug supplying system reform, the protection of drug safety of people and the harmony of relationship between professionals and patients. The results are as follows:(1)Comparison of researches on pharmaceutical care in community pharmacy in China and abroadTo analysis the progess on the PC studies in China and abroad, related studies aborad included aspects such as diseases prevention and controlling, health promotion, drug uses counseling, effect evaluation of PC, factors influening PC and so on. To compare the contents and forms of pharmaceutical care researches in community pharmacy in China and abroad, the pharmaceutical care researches in community pharmacy abroad featured abundant in theories, scientific in methodology, definite in object, and rich in content, which will be beneficial for similar researches in China. To summarize the factors influencing PC in community pharmacy, the factors in China included policies, business development stage, pharmaceutical professionals quality, and social evaluation of PC; the factors aborad emerged as shortage of pharmacists, deficiency of pharmacists’ PC skill and sense, pharmacists’ unreasonable structure of knowledge, and weak continuing education and so on.(2)Delphi study on the PC in community pharmacyDelphi method was used to study the situation of PC in community pharmacy. An comprehensive evaluation indicators of PC in community pharmacy, being comprised of present condition, influence factors, strategies and prospects, were formed. The four parts included 4,3,10,6 indicators respectively, adding up to 23 indicators. The evaluation indicators revealed that the development of PC in community pharmacy is an irresistible trend, the factors that restrict PC most are the shortage of pharmacists and their low quality. Measures from the perspectives of professional, policy, drugstore itself and concept are needed to promote PC further so as to benefit the development of community pharmacies in China. The indicators are significant to the fulfillment of PC regulations and the PC practice.(3)Factors affecting pharmaceutical care in community pharmacy in Xi’ an on the basis of SEMAfter understanding the general conditions of PC in China, we used structural equation modeling (SEM) to set up 11 hypotheses to explore the pharmacist’ s perspective on the factors affecting the community pharmacy-based PC and their relationships in Xi’an. An questionnaire investigation was conducted among pharmacists in community pharmacies in Xi’an, SPSS 13.0 for Windows was used to statistic data and LISREL 8.70 was used to simulate the SEM. According to SEM testing results, development of industry is positively related to community pharmacy; community pharmacy has a directpositive impact on social evaluation, the providing of basic PC, and senior PC; the quality of pharmacists has a direct positive impact on the social evaluation, and the providing of senior PC. The SEM method was used to construct the factor model, which is the first empirical analysis in this research field in China.(4)Study on the construction of laws & regulations concerning Chinese PC in drugstoresThis paper put forward that laws & regulations concerning Chinese PC in drugstores was comprised of two parts, one is related regulations in pharmacist law, pharmacy law, and Good Pharmacy Practice(GPP) from macroscopic perspective, the other is operating strandards in PC practice from microscopic perspective. 16 laws and regulations were sorted and analyzed by content analysis method, and following suggestions were put forward: the status of the current laws & regulations need to be improved, meanwhile, the contents of pharmaceutical care should be added to some regulations, and the guided regulations concerning the enforcement, checking and evaluation, supervising and administration of pharmaceutical care items should be formulated, the pharmaceutical care in Chinese drugstores should be promoted through the construction of legal system.A meta-analysis of effect of pharmaceutical care program in asthma patients in community pharmacyEvidences on the effect of pharmaceutical care program in asthma patients in community pharmacy are insufficient, so we used systematic review and meta-analysis, the most scientific and comprehensive evaluation method, to conduct a meta-analysis of randomized controlled trials (RCTs) of pharmaceutical care(PC) program in asthma patients and its effect on peak expiratory flow rates(PEFRs) in community pharmacies. We searched 5 electronic databases (CNKI, Academic Search Premier, Blackwell, Elsevier, John Wiley) ranging from 1997 to 2006. A meta-analysis was conducted by means of Review Manager 4.2 software using a fixed effects model as appropriate (homogeneityte test x~2=1.28, P=0.73). We included 4 RCTs, 1298 asthma patients. As compared with the control group, the PC program increased patients’ PEFRs in PC group significantly(the combined SMD=0.19, 95% confidence interval:0.08-0.30, P=0.0006). PC program in community pharmacies is an effective option in asthma prevention and treatment.