Segal R, Grines L L, Pathak D S
Division of Pharmaceuical Administration, College of Pharmacy, Ohio State University, Columbus 43210.
Am J Hosp Pharm. 1988 Mar;45(3):570-7.
The beliefs of representatives of organized pharmacy and medicine and the pharmaceutical industry about the effect of hypothetical therapeutic-interchange legislation on various health-care issues were studied. Questionnaires designed to gauge respondents' beliefs about the impact of two hypothetical bills (A and B) concerning selection of therapeutic alternates by pharmacists were mailed to the directors of 307 organizations in April 1986. Bill A would permit pharmacists in any setting to select therapeutic alternates. Bill B would permit therapeutic interchange by pharmacists within organized health-care settings in accordance with guidelines approved by physicians. Issues addressed included the efficient delivery of health care, professional liability, interprofessional and pharmacist-patient relationships, and competition and profitability in the pharmaceutical industry. The response rate was 63% (194 usable responses). Bill A received some support from representatives of state pharmaceutical associations only. However, bill B was supported by respondents from state pharmaceutical associations, state hospital pharmacy societies, boards of pharmacy, and generic manufacturers. Respondents from medical associations and member companies of the Pharmaceutical Manufacturers Association (PMA) were concerned about the impact of the hypothetical bills on the quality of drug therapy and the efficiency of health-care delivery. Respondents from medical associations also were concerned about the impact of the bills on physician liability. The responses from the medical associations and the PMA-member companies suggest that a program should be developed to educate physicians about the process used by pharmacists and physicians to develop guidelines for therapeutic interchange in various practice settings.
研究了药剂业、医学及制药行业代表对于假设的治疗性替换立法对各种医疗保健问题所产生影响的看法。1986年4月，向307个组织的负责人邮寄了调查问卷，旨在了解受访者对于两项关于药剂师选择治疗替代药物的假设法案（法案A和法案B）影响的看法。法案A将允许任何环境下的药剂师选择治疗替代药物。法案B将允许药剂师在有组织的医疗保健环境中根据医生批准的指导方针进行治疗性替换。所涉及的问题包括医疗保健的高效提供、职业责任、跨专业及药剂师与患者的关系，以及制药行业的竞争和盈利能力。回复率为63%（194份有效回复）。只有州药剂师协会的代表对法案A给予了一些支持。然而，法案B得到了州药剂师协会、州医院药房协会、药房委员会及非专利药品制造商受访者的支持。医学协会及制药制造商协会（PMA）成员公司的受访者担心这些假设法案对药物治疗质量和医疗保健提供效率的影响。医学协会的受访者还担心这些法案对医生责任的影响。医学协会和PMA成员公司的回复表明，应该制定一个项目，向医生介绍药剂师和医生为在各种实践环境中制定治疗性替换指导方针所采用的流程。
