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埃塞俄比亚公立医院临床药学服务的现状、挑战与未来发展方向

Current status, challenges and the way forward for clinical pharmacy service in Ethiopian public hospitals.

作者信息

Bilal Arebu Issa, Tilahun Zelalem, Gebretekle Gebremedhin Beedemariam, Ayalneh Belete, Hailemeskel Bisrat, Engidawork Ephrem

机构信息

Departement of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

Departement of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, P.O. Box: 1176, Addis Ababa, Ethiopia.

出版信息

BMC Health Serv Res. 2017 May 19;17(1):359. doi: 10.1186/s12913-017-2305-1.

Abstract

BACKGROUND

Clinical pharmacy service has evolved steadily over the past few decades and is now contributing to the 'patient care journey' at all stages. It is improving the safety and effectiveness of medicines and has made a significant contribution to the avoidance of medication errors. In Ethiopia, clinical pharmacy service is in its initial phase, being started in July 2013. This study therefore aimed at assessing the status, challenges and way forward of clinical pharmacy service in the country.

METHODS

A cross-sectional survey was conducted in six regional states and one city- administration in September 2014. A total of 51 hospitals were included in the study. Both qualitative and quantitative methods were employed for data collection.

RESULTS

A total of 160 pharmacy graduates, and 51 pharmacy heads participated in the study. Internal Medicine and Pediatric wards were the major wards where the graduates provide clinical pharmacy service. Almost 94% of the new graduates were found to be involved in clinical pharmacy service, but 47% of them rated their service as poor. The overall satisfaction of the graduates was close to 36%. Thirteen hospitals discontinued and two hospitals not even initiated the service largely due to shortage of pharmacists and lack of management support. About 44% of the surveyed hospitals documented the clinical pharmacy service provided using either developed or adopted formats. Lack of awareness by the medical fraternity, high attrition rate, lack of support from the management as well as from the health care team, readiness of the graduates to deliver the service, and shortage of pharmacists were identified by the key informants as the major stumbling block to deliver clinical pharmacy service.

CONCLUSION

Clinical pharmacy service is initiated in most of the surveyed hospitals and a large proportion of the graduates were involved in the service. Although there is a great enthusiasm to promote clinical pharmacy service in the surveyed hospitals, efforts made to institutionalize the service is minimal. Thus, concerted efforts need to be exerted to promote the service through organizing awareness forums as well as revisiting the curriculum.

摘要

背景

在过去几十年中,临床药学服务稳步发展,目前在患者护理的各个阶段都发挥着作用。它提高了药物的安全性和有效性,并为避免用药错误做出了重大贡献。在埃塞俄比亚,临床药学服务于2013年7月开始,尚处于初始阶段。因此,本研究旨在评估该国临床药学服务的现状、挑战及未来发展方向。

方法

2014年9月在六个地区州和一个市辖区开展了一项横断面调查。共有51家医院纳入研究。采用定性和定量方法收集数据。

结果

共有160名药学专业毕业生和51名药房负责人参与了研究。内科和儿科病房是毕业生提供临床药学服务的主要病房。几乎94%的新毕业生参与了临床药学服务,但其中47%的人认为自己的服务质量较差。毕业生的总体满意度接近36%。13家医院停止了该服务,两家医院甚至从未开展过该服务,主要原因是药剂师短缺和缺乏管理支持。约44%的受访医院使用自行制定或采用的格式记录所提供的临床药学服务。关键信息提供者指出,医学界缺乏认识、人员流失率高、缺乏管理层和医疗团队的支持、毕业生提供服务的意愿以及药剂师短缺是提供临床药学服务的主要绊脚石。

结论

大多数受访医院已启动临床药学服务,且很大一部分毕业生参与其中。尽管受访医院对推广临床药学服务热情高涨,但将该服务制度化的努力却微乎其微。因此,需要通过组织宣传论坛以及修订课程等方式共同努力来推广该服务。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6fea/5437556/4968cfb44e55/12913_2017_2305_Fig1_HTML.jpg

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