Reasonable and correct medication can achieve the expected therapeutic purpose. On the other hand, if used improperly, it will weaken the curative effect and even cause serious adverse reactions. Therefore, it is the key for clinicians to choose drugs reasonably, and it is also very important for patients to master the medication methods correctly. It is very important for outpatient pharmacies to provide drug consultation services and provide patients with rational drug use. I have worked in outpatient pharmacy for many years and accumulated some experience in consulting service and rational drug use.
1 the significance of pharmacist consultation service in outpatient pharmacy
1. 1 is the need for pharmacists to guide patients to use drugs rationally. With the rapid development of medical science, there are more and more varieties of drugs, more and more complicated prescriptions and more and more adverse reactions of drugs. How to use drugs safely, effectively and economically has been widely concerned by people. Because doctors focus on clinical work, it is impossible to master all the information of drugs. As a pharmacist, his advantage lies in explaining the correct usage and dosage of drugs in detail, explaining all kinds of potential adverse reactions of drugs, and applying pharmacoeconomics knowledge according to the patient's economic situation, recommending drugs with good curative effect and low cost to patients, so that patients can take drugs with confidence.
1.2 improves the compliance of patients with rational drug use. With the reform of medical and health system, the traditional working mode of prescription dispensing in outpatient pharmacy has not adapted to the development of pharmacy in the new century, and the work of outpatient pharmacy has changed from "supply-centered" to "patient-centered". Drug consultation is the change of pharmacist's function. All the actions of pharmacists are for the basic interests of patients, and gradually change from the passive service of "you ask me and answer me" to the active guidance of patients in rational drug use. Through drug consultation service, patients can better follow the doctor's advice and cooperate with treatment. Through drug consultation, enhance patients' drug knowledge and improve patients' compliance. Acne is a common dermatological disease, which has been treated with drugs for a long time, and most of them are combined drugs. These drugs have some side effects, such as cimetidine, an old drug for acne, which patients often mistake for treating gastroduodenal ulcer. Because the side effects may produce diarrhea, bloating, dry mouth, bitter taste, drug fever, drug eruption and so on. Patients are prone to non-compliance. Therefore, pharmacists should explain to patients the importance of taking drugs on time, in sufficient amount and according to the course of treatment, and explain the possible adverse reactions and countermeasures, so as to enhance patients' confidence in overcoming diseases and medication compliance.
1.3 Promote rational drug use through consulting services. Pharmacists can accumulate rich practical experience in drug use, monitor and find new adverse drug reactions through consultation and give timely feedback to the clinic. At the same time, pharmacists, as medical professionals, can reflect suggestions and opinions on drug use to the pharmaceutical affairs Committee of the hospital or the drug administration. Thereby playing the role of information bridge.
Through consulting service, we can also find out the reasons why patients don't cooperate with clinicians and propose solutions. It can also provide life and psychological services for patients and expand the extended functions of the hospital. Provide patients with all levels and all-round drug knowledge propaganda, and promote the safety, effectiveness, applicability and economy of rational drug use.
2. Strategies for improving and strengthening consulting services to promote rational drug use
2. 1 Improving quality and civilized service With the development of medicine, pharmacists are required to have strong prescription analysis ability, drug consultation ability and drug guidance ability. Because consulting service is one of the departments that have the most contact with patients in the hospital. The service quality of its pharmacists' working attitude, words and deeds, civilized cultivation and service art directly reflects the service level of the hospital. Therefore, it is urgent and important to improve the comprehensive quality of pharmacists. As a pharmacist, we should strengthen our sense of morality, dedication and professionalism, and also improve our professional quality. To serve others with science, we should enrich ourselves with science, and constantly enrich our pharmaceutical knowledge and medical knowledge, so as to be a good consultant for doctors and guide patients to use drugs rationally. 2.2 Responsibility, compassion and quality service diseases need not only drug treatment, but also psychological benign influence. The patient has a disease and has a heavy psychological and spiritual burden. In the process of consulting service, pharmacists serve patients wholeheartedly with a strong sense of responsibility, compassion, dedication, and thoughtfulness, so that patients can reduce their psychological burden. Convey psychological care to patients. Give patients good psychological hints and support. Urge them to treat diseases correctly. So as to eliminate their emotional, behavioral and physical symptoms caused by psychological barriers. Make the psychological reaction of patients in the treatment of diseases develop in a direction conducive to the rehabilitation and prognosis of diseases.
2.3 Suggest time pharmacology, and medication time is one of the most concerned issues for patients in consulting services. Patients are not satisfied with the simple answer of "several times a day, a few tablets at a time", but want to know more about when it is best to take medicine. For example, in the treatment of chronic urticaria, the best time to take indomethacin, an old drug, is 7: 00 in the morning, when the blood concentration of indomethacin is the highest, and the time to reach the highest blood concentration (peak time) is also faster than other times. If you take medicine at 7 pm, the peak time is the longest, which is about 40% worse than that in the morning. Anti-allergic drug cyproheptadine has the best effect when taken at 7: 00 in the morning, and it can last for 15 ~ 17h. If you take it at 7 pm, it can only last for 6 ~ 8 hours. In the treatment of herpes zoster, drugs are often combined, among which the dose of prednisone prescribed by clinicians is 15mg per day 1 time. According to the obvious circadian rhythm of adrenocortical hormone secretion, the secretion is high in the morning and the lowest at midnight, so it is suggested that the best time to take prednisone is 5 am. This kind of hormone therapy, which takes the total dose three times a day and once in the morning, not only has good curative effect, but also minimizes the side effects caused by taking hormones.
Three suggestions
3. 1 there is a special person who is responsible for arranging the pharmacists in charge or pharmacists with good professional skills to sit in the clinic, and configuring computers and related professional books, so that pharmacists can inquire about all aspects of information at any time and answer all kinds of questions of patients and medical staff in time. And make original records of all consultation questions, including gender, age, questions and answers raised by patients, etc. Drug consultation: including drug usage, dosage, adverse reactions, compatibility, recommended drugs, etc.
3.2 Strengthen information collection. According to the content of consultation, we will regularly publish pharmaceutical affairs newsletters, recommend new drugs to clinic, introduce common knowledge of drug use, report adverse drug reactions, and collect doctors' feedback on the use of new drugs in various departments. Put forward suggestions for eliminating varieties to the Pharmaceutical Affairs Committee.
3.3 Provide remote service, set up drug consultation telephone, and accept personalized pharmaceutical services in the whole process of drug use for patients in our hospital. At the same time, it also provides services such as rational drug use, new drug recommendation, adverse reaction handling and information collection for social groups and other objects.