Register      Login
Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Current status of pharmacy services in primary healthcare institutions in Jiangsu Province, China

Yuankai Huang A * , Dongning Yao B * , Xiaoyu Xi A , Yitao Wang B C and Wenbing Yao A C
+ Author Affiliations
- Author Affiliations

A National Development Research Center of Licensed Pharmacist, China Pharmaceutical University, Longmian Avenue 639, Jiangning District, Nanjing 211198, China.

B State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, N22-2057, Taipa, Macau, China, 999078.

C Corresponding authors. Email: ytwang@umac.mo; yaowenbing_001@163.com

Australian Journal of Primary Health 26(5) 424-430 https://doi.org/10.1071/PY20038
Submitted: 24 February 2020  Accepted: 17 June 2020   Published: 9 September 2020

Abstract

China is attempting to establish a pharmacy services network in primary healthcare (PHC) institutions. This study investigated the current status of pharmacy services in China. Following a conceptual framework derived from the structure–process–outcome model, a questionnaire was sent to a sample of 700 administrators, 2000 GPs, 2000 pharmacy service providers, 2000 patients with chronic diseases and 2000 patients receiving antibiotic transfusion treatment, selected using a multistage sampling strategy, from PHC institutions in Jiangsu Province, China, in July and August 2016. The installation of pharmaceutical facilities and devices, staffing by pharmaceutical professionals, patterns of pharmacy service provision and the outcomes of these services were assessed using descriptive statistics. There were 8346 respondents from 665 institutions (response rate 95.9%). Pharmaceutical department (63.0%), dispensary (50.2%) and pharmacy intravenous admixture services (54.1%) were not established in many PHC institutions. Dispensing (22.9%), pharmacotherapy consultation for patients (19.3%), drug management (17.4%) and prescription checking (16.5%) were the most important tasks for pharmacy service providers. Patients reported lower satisfaction with the dissemination of information regarding medication use (mean (±s.d.) 8.85 ± 1.00%), the treatment of adverse drug reactions (5.65 ± 0.50%), medical insurance reimbursement (15.25 ± 2.45%) and the convenience of buying drugs (6.35 ± 0.65%). Several issues regarding the facilities and devices related to pharmacy services, the quality and responsibilities of pharmacy service providers and the outcomes of pharmacy services may hamper the development of a pharmacy service system in PHC in China.

Additional keywords: structure–process–outcome model.


References

American College of Clinical Pharmacy (2008) The definition of clinical pharmacy. Pharmacotherapy 28, 816–817.
The definition of clinical pharmacy.Crossref | GoogleScholarGoogle Scholar | 18503408PubMed |

American College of Clinical Pharmacy (2014) Standards of practice for clinical pharmacists. Pharmacotherapy 34, 794–797
Standards of practice for clinical pharmacists.Crossref | GoogleScholarGoogle Scholar | 25534672PubMed |

American Society of Health-System Pharmacists (ASHP) (1996) ASHP guidelines on a standardized method for pharmaceutical care. American Journal of Health-System Pharmacy 53, 1713–1716.
ASHP guidelines on a standardized method for pharmaceutical care.Crossref | GoogleScholarGoogle Scholar | 8827240PubMed |

American Society of Health-System Pharmacists (ASHP) (1999) ASHP guideline: minimum standard for pharmaceutical services in ambulatory care. American Journal of Health-System Pharmacy 56, 1744–1753.
ASHP guideline: minimum standard for pharmaceutical services in ambulatory care.Crossref | GoogleScholarGoogle Scholar | 10512507PubMed |

American Society of Health-System Pharmacists (ASHP) (2013) ASHP guidelines: minimum standard for pharmacies in hospitals. American Journal of Health-System Pharmacy 70, 1619–1630.
ASHP guidelines: minimum standard for pharmacies in hospitals.Crossref | GoogleScholarGoogle Scholar | 23988605PubMed |

ASHP Expert Panel on Medication Cost Management (2008) ASHP guidelines on medication cost management strategies for hospitals and health systems. American Journal of Health-System Pharmacy 65, 1368–1384.

Campbell C, Braund R, Morris C (2017) Beyond the four walls: an exploratory survey of location, employment and roles of pharmacists in primary health care. Journal of Primary Health Care 9, 297–310.
Beyond the four walls: an exploratory survey of location, employment and roles of pharmacists in primary health care.Crossref | GoogleScholarGoogle Scholar | 29530142PubMed |

Delcher MC (1988) Pharmacy department reorganization: the managerial and clinical challenges. Current Concepts in Hospital Pharmacy Management 10, 11–14.

Ding M (2016) Research on the prevention and treatment of medical negligence crimes – taking the judicial practice of the crime of medical accidents from 1997 to the present as the entry point. Journal of Railway Police College 26, 79–84. [In Chinese]

Farris KB, Kirking DM (1993) Assessing the quality of pharmaceutical care. II. Application of concepts of quality assessment from medical care. The Annals of Pharmacotherapy 27, 215–223.
Assessing the quality of pharmaceutical care. II. Application of concepts of quality assessment from medical care.Crossref | GoogleScholarGoogle Scholar | 8439702PubMed |

Hazen AC, Wal AW, Sloeserwij VM, Zwart DL, Gier JJ, Wit NJ, Leendertse AJ, Bouvy ML, Bont AA (2016) Controversy and consensus on a clinical pharmacist in primary care in the Netherlands. International Journal of Clinical Pharmacy 38, 1250–1260.
Controversy and consensus on a clinical pharmacist in primary care in the Netherlands.Crossref | GoogleScholarGoogle Scholar | 27473710PubMed |

Hepler CD, Strand LM (1990) Opportunities and responsibilities in pharmaceutical care. American Journal of Hospital Pharmacy 47, 533–543.

Hu X (2013) Exploration on the pharmacy service mode of primary medical institutions. China Practical Medicine 8, 275–276. [In Chinese]

Kheir N, Awaisu A, Sharfi A, Kida M, Adam A (2014) Drug-related problems identified by pharmacists conducting medication use reviews at a primary health center in Qatar. International Journal of Clinical Pharmacy 36, 702–706.
Drug-related problems identified by pharmacists conducting medication use reviews at a primary health center in Qatar.Crossref | GoogleScholarGoogle Scholar | 24965594PubMed |

Kosar L, Rémillard A (2011) Integrating a pharmacist into an already-established primary health care team. The Canadian Journal of Hospital Pharmacy 64, 222

Long Z (2015) The status quo and development countermeasures of pharmacy service in primary medical institutions. Contemporary Medicine Forum 13, 151–152. [In Chinese]

National Health and Family Planning Commission of the People’s Republic of China, State Administration of Traditional Chinese Medicine (2011) Medical institution pharmacy management regulations. [In Chinese]. National Health and Family Planning Commission of the People’s Republic of China, State Administration of Traditional Chinese Medicine, Ministry of Health of the General Logistics Department, Beijing, China.

National Health Committee, State Administration of Traditional Chinese Medicine (2018) Opinions on accelerating the quality development of pharmaceutical services. [In Chinese]. National Health Committee, State Administration of Traditional Chinese Medicine, Beijing, China.

Qu J, Liu G, Zhu Z, Sun C (2014) The construction and development of hospital pharmacy in China (Part 1). Zhongguo Yiyuan Yaoxue Zazhi 34, 1237–1246. [In Chinese]

Schneider PJ, Pedersen CA, Scheckelhoff DJ (2018) ASHP national survey of pharmacy practice in hospital settings: dispensing and administration – 2017. American Journal of Health-System Pharmacy 75, 1203–1226.
ASHP national survey of pharmacy practice in hospital settings: dispensing and administration – 2017.Crossref | GoogleScholarGoogle Scholar | 29903709PubMed |

The State Council General Office of the People’s Republic of China (2015) Guiding opinions of the General Office of the State Council on Promoting the Construction of Graded Diagnosis and Treatment System. [In Chinese]. The State Council General Office of the People’s Republic of China, Beijing, China.

Xi X, Yao D, Huang Y, Wang X, Wang Y, Yao W (2017) National survey on clinical pharmacy services of tertiary hospitals in China: part 1. Introduction of survey and basic conditions of clinical pharmacy service provision. China Pharmacy 52, 1746–1752. [In Chinese]

Xi X, Yao D, Huang Y, Lu M, Wang X, Wang Y, Yao W (2018) National survey on clinical pharmacy services of second-level hospitals in China: part 1. Introduction of survey and basic conditions of clinical pharmacy service provision. China Pharmacy 53, 2058–2064. [In Chinese]

Yamada S, Kuwahara H, Asai R, Kotani H, Kishi R, Hirabayashi A, Mizuno T, Hasegawa M, Mouri A, Kume H (2011) Evaluation of the symptoms, adherence and satisfaction after pharmaceutical care at asthma clinic for outpatient. Yakugaku Zasshi 131, 1629–1638.
Evaluation of the symptoms, adherence and satisfaction after pharmaceutical care at asthma clinic for outpatient.Crossref | GoogleScholarGoogle Scholar | 22041702PubMed |

Yu F, Xu M (2018) Key points and experience of clinical pharmacy work in primary hospitals. Journal of Traditional Chinese Medicine Management 26, 202–203. [In Chinese]

Zhou M (2017) Analysis of influencing factors of chronic diseases in Nanjing with purchasing channel. China Journal of Pharmaceutical Economics 12, 12–17. [In Chinese]