Shen Qian, Kang Limin, Ye Dan, Li Youjia, Zhang Kanghuai
Department of Pharmacy, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Department of Pharmacy, Xi'an No.3 Hospital, The Affiliated Hospital of Northwest University, Xi'an, China.
Front Public Health. 2025 Aug 20;13:1616534. doi: 10.3389/fpubh.2025.1616534. eCollection 2025.
Since 2019, the Chinese government has been fully implementing the National Centralized Drug Procurement (NCDP) policy, with the core objective of reducing drug costs and alleviating the medical burden on patients. As the practitioners of this policy, healthcare professionals (HCPs) play a crucial role in its implementation. Therefore, it is necessary to evaluate their knowledge, attitudes, and practices (KAP) regarding the implementation of the (NCDP) policy and the factors influencing these aspects.
We conducted a cross-sectional online survey on HCPs from public hospitals in Shaanxi Province from 2022 August to September. A structured self-administered questionnaire was used to collect data on demographics, knowledge of NCDP, attitude toward NCDP policy, and practice of policy implementation. KAP adequacy was dichotomized at the 70% cut-off (Knowledge: adequate vs. inadequate, Attitude: positive vs. negative; Practice: good vs. poor). All the variables were descriptively analyzed, and multivariate logistics regression analysis was used to explore the factors associated with KAP level.
A total of 1,257 valid responses were received. Of these, 58.4% demonstrated adequate knowledge, 63.2% held positive attitudes, and 35.2% exhibited good practices. Significant occupational disparities emerged, with pharmacists outperforming physicians across all KAP domains ( < 0.01). Multivariate logistic regression analysis showed that professional title, being a pharmacist, and attending the training were independently associated with adequate knowledge. Positive attitudes were significantly associated with 11-20 years of working experience, having a bachelor's degree, being a pharmacist, and attending training. Proactive practice was associated with longer working years, being a pharmacist, and training attendance. The main concerns of HCPs regarding the NCDP policy were guaranteeing medicine quality (93.2%), strengthening clinical outcomes research (80.0%), and strengthening monitoring of adverse reactions (79.6%).
Our study found that HCPs in Shaanxi Province possessed a moderate level of knowledge and generally positive attitudes toward the NCDP policy, yet demonstrate room for enhanced practice. Pharmacists play a pivotal role in policy implementation. To strengthen HCPs' policy endorsement and ensure faithful implementation, targeted training on therapeutic effectiveness and safety evaluation is essential, as it can alleviate clinical concerns and bridge the gap from evidence to actionable competence. Future research should concentrate on generating high-quality clinical evidence, analyzing long-term policy impacts, identifying implementation barriers, and designing educational interventions to bolster HCPs' knowledge and positive attitudes regarding the NCDP policy.
自2019年以来，中国政府一直在全面实施国家集中带量采购（NCDP）政策，其核心目标是降低药品成本，减轻患者医疗负担。作为该政策的执行者，医疗保健专业人员（HCPs）在政策实施中发挥着关键作用。因此，有必要评估他们对NCDP政策实施的知识、态度和实践（KAP）以及影响这些方面的因素。
我们于2022年8月至9月对陕西省公立医院的HCPs进行了一项横断面在线调查。使用结构化的自填式问卷收集有关人口统计学、NCDP知识、对NCDP政策的态度以及政策实施实践的数据。KAP充足性以70%的临界值进行二分法划分（知识：充足与不足；态度：积极与消极；实践：良好与不佳）。对所有变量进行描述性分析，并使用多因素逻辑回归分析来探索与KAP水平相关的因素。
共收到1257份有效回复。其中，58.4%表现出充足的知识，63.2%持积极态度，35.2%表现出良好的实践。出现了显著的职业差异，药剂师在所有KAP领域的表现均优于医生（<0.01）。多因素逻辑回归分析表明，职称、作为药剂师以及参加培训与充足的知识独立相关。积极态度与11至20年的工作经验、拥有学士学位、作为药剂师以及参加培训显著相关。积极的实践与更长的工作年限、作为药剂师以及参加培训有关。HCPs对NCDP政策的主要担忧是保证药品质量（93.2%）、加强临床结局研究（80.0%）以及加强不良反应监测（79.6%）。
我们的研究发现，陕西省的HCPs对NCDP政策的知识水平中等，态度总体积极，但实践方面仍有提升空间。药剂师在政策实施中发挥着关键作用。为了加强HCPs对政策的认可并确保忠实实施，针对性的治疗效果和安全性评估培训至关重要，因为它可以减轻临床担忧，并弥合从证据到可操作能力的差距。未来的研究应集中于生成高质量的临床证据、分析长期政策影响、识别实施障碍以及设计教育干预措施，以增强HCPs对NCDP政策的知识和积极态度。
