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关于社区药剂师对就医生开具的处方提出药学问题的认知度调查

[Survey on the awareness of community pharmacists about raising pharmaceutical questions regarding prescriptions issued by physicians].

作者信息

Shikamura Yoshiaki, Takahashi Junichi, Oyama Akiko, Negishi Kenichi, Ijyuin Kazushige, Kamimura Naoki, Aoyama Takao

机构信息

Faculty of Pharmaceutical Sciences, Tokyo University of Science, Noda, Chiba, Japan.

出版信息

Yakugaku Zasshi. 2011;131(10):1509-18. doi: 10.1248/yakushi.131.1509.

Abstract

Community pharmacists can provide effective pharmaceutical care by questioning the physicians about their prescriptions. The regulatory authority (Ministry of Health, Labour and Welfare or the like) has been issuing instructions/advice to health insurance-covered pharmacies about the nature of questions to be asked to physicians under the national health insurance system. However, this practice has been facing similar kind of problems almost every year. To identify the reasons for repetition of the problems and facilitate proper application of drug therapy at hospitals, we recently examined the nature of questions asked to physicians by conducting a survey of 165 health insurance-covered pharmacies belonging to 8 district branches of the Japan Pharmaceutical Association. When the pharmacists were asked to express their view whether each of the 18 sample questions included in the past surveys was actually necessary, the most frequent answer from the respondents (n=1980) was "neutral" (42.9%), followed by "unnecessary" (29.0%) and "necessary" (26.6%). Further, 55.5% respondents answered that it is necessary to refer to publications of the concerned fields (guidelines, etc.) when questioning the prescriptions. However, the responses about the possible reasons for judging the necessity of the questions suggested that sometimes the pharmacists failed to understand the details of such publications. The results from this study suggest that a high percentage of community pharmacists believed that there was little need to ask questions about prescriptions if the suggestions made by the regulatory authority about the relevant questions were taken into account. Further, our study findings suggested that pharmacists working at clinics cannot present a clear-cut rationale for their judgment about the necessity of asking questions about prescriptions under the current circumstances where sufficient information collection and the evaluation of need for asking questions about prescriptions are not possible.

摘要

社区药剂师可以通过向医生询问处方情况来提供有效的药学服务。监管机构(厚生劳动省等)一直在就国民健康保险制度下向医生提问的问题性质向医保覆盖的药店发布指示/建议。然而,这种做法几乎每年都面临类似的问题。为了找出问题反复出现的原因,并促进医院合理应用药物治疗,我们最近通过对日本药剂师协会8个地区分会所属的165家医保覆盖药店进行调查,研究了向医生提问的问题性质。当药剂师被要求表达他们对过去调查中包含的18个示例问题是否实际必要的看法时,受访者(n = 1980)最常见的回答是“中立”(42.9%),其次是“不必要”(29.0%)和“必要”(26.6%)。此外,55.5%的受访者表示,在询问处方时参考相关领域的出版物(指南等)是必要的。然而,关于判断问题必要性的可能原因的回答表明,有时药剂师未能理解此类出版物的细节。这项研究的结果表明,很大一部分社区药剂师认为,如果考虑到监管机构对相关问题的建议,就几乎没有必要询问处方问题。此外,我们的研究结果表明,在目前无法充分收集信息和评估询问处方问题必要性 的情况下,诊所的药剂师无法为他们对询问处方问题必要性的判断提供明确的理由。

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