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      Implementation of a novel train-the-trainer program for pharmacists in China

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          Abstract

          Clinical pharmacy services in North American are well implemented both in community pharmacies and in hospital pharmacies. In 2009 the Chinese government mandated the implementation of clinical pharmacy services in all secondary and tertiary hospitals by 2020. The mandate would require adequately trained clinical pharmacists. However, most pharmacy education programs in China have not yet incorporated clinical pharmacy into their curricula. Many pharmacists have been sent to countries, including the United States and Canada, to receive clinical pharmacy training. Because of different health care systems, medical team dynamics, and language barriers, it became difficult for the returning pharmacists to apply the skills gained from this type of training. As a result, the Second Xiangya Hospital of Central South University initiated an international academic–run train-the-trainer program. The objectives are to provide adequate training for pharmacists to provide pharmaceutical care to patients, conduct clinical pharmacy–related research, and engage in scholarly activities. After evaluation of local readiness, the course commenced in 2014, and to date four trainers have received personalized one-on-one training by an advanced pharmacist with 15 years of experience of delivering similar curricula in North America. We present the initial process evaluation and learning that will contribute to the development of clinical pharmacy courses at Central South University.

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          Most cited references 8

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          Impact of pharmacist intervention on antibiotic use and prophylactic antibiotic use in urology clean operations.

           Y-M Cui,  Y Zhou,  L-Y Ma (2015)
          The use of prophylactic antibiotics in clean operations was routine in China before 2011. Along with the appeal for using antibiotics rationally by WHO in 2011, China launched a national special rectification scheme on clinical use of antibiotics from April that year. The scheme, aimed at achieving rational use of antibiotics, made pharmacists part of the responsible medical team. Our objective was to describe the impacts of pharmacist intervention on the use of antibiotics, particularly in urology clean operations.
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            Clinical pharmacy services, pharmacy staffing, and adverse drug reactions in United States hospitals.

            Adverse drug reactions (ADRs) were examined in 1,960,059 hospitalized Medicare patients in 584 United States hospitals in 1998. A database was constructed from the MedPAR database and the National Clinical Pharmacy Services survey. The 584 hospitals were selected because they provided specific information on 14 clinical pharmacy services and on pharmacy staffing; they also had functional ADR reporting systems. The study population consisted of 35,193 Medicare patients who experienced an ADR (rate of 1.8%). Of the 14 clinical pharmacy services, 12 were associated with reduced ADR rates. The most significant reductions occurred in hospitals offering pharmacist-provided admission drug histories (odds ratio [OR] 1.864, 95% confidence interval [CI] 1.765-1.968), drug protocol management (OR 1.365, 95% CI 1.335-1.395), and ADR management (OR 1.360, 95% CI 1.328-1.392). Multivariate analysis, performed to further evaluate these findings, showed that nine variables were associated with ADR rate: pharmacist-provided in-service education (slope -0.469, p=0.018), drug information (slope -0.488, p=0.005), ADR management (slope -0.424, p=0.021), drug protocol management (slope -0.732, p=0.002), participation on the total parenteral nutrition team (slope 0.384, p=0.04), participation on the cardiopulmonary resuscitation team (slope -0.506, p=0.008), medical round participation (slope -0.422, p=0.037), admission drug histories (slope -0.712, p=0.008), and increased clinical pharmacist staffing (slope -4.345, p=0.009). As clinical pharmacist staffing increased from the 20th to the 100th percentile (from 0.93+/-0.77/100 to 5.16+/-4.11/100 occupied beds), ADRs decreased by 47.88%. In hospitals without pharmacist-provided ADR management, the following increases were noted: mean number of ADRs/100 admissions by 34.90% (OR 1.360, 95% CI 1.328-1.392), length of stay 13.64% (Mann-Whitney U test [U]=11047367, p=0.017), death rate 53.64% (OR 1.574, 95% CI 1.423-1.731), total Medicare charges 6.88% (U=111298871, p=0.018), and drug charges 8.16% (U=108979074, p<0.001). Patients in hospitals without pharmacist-provided ADR management had an excess of 4266 ADRs, 443 deaths, 85,554 patient-days, $11,745,342 in total Medicare charges, and $1,857,744 in drug charges. The implications of these findings are significant for our health care system, especially considering that the study population represented 15.55% of 12,261,737 Medicare patients and 5.71% of the 34,345,436 patients admitted to all U.S. hospitals.
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              Clinical pharmacy education in China.

              Pharmacy education in China focuses on pharmaceutical sciences, with the bachelor of science (BS) of pharmacy as the entry-level degree. Pharmacy practice curricula in these programs are centered on compounding, dispensing, pharmacy administration, and laboratory experiences, which are the traditional responsibilities for pharmacists. Additional graduate-level training is available at the master of science (MS) and the doctor of philosophy (PhD) levels, most of which concentrate on drug discovery and drug development research. Presently, the emphasis in practice is beginning to shift to clinical pharmacy. With this change, additional degree offerings are being developed to meet the growing demand for clinical pharmacists. There is also interest in developing more clinical skills in practicing pharmacists through additional non-degree training. The Ministry of Education is considering a proposal for an entry-level professional degree of master and/or doctor in clinical pharmacy similar to the doctor of pharmacy (PharmD) degree in the United States.
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                Author and article information

                Journal
                FMCH
                Family Medicine and Community Health
                FMCH
                Compuscript (Ireland )
                2009-8774
                2305-6983
                January 2016
                February 2016
                : 4
                : 1
                : 60-63
                Affiliations
                1Faculty of Medicine and Dentistry, Department of Family Medicine, University of Alberta
                Author notes
                CORRESPONDING AUTHOR: Hoan Linh Banh, BSc Pharm, Pharm.D., Faculty of Medicine and Dentistry, Department of Family Medicine, University of Alberta, 6–10 University Terrace, 8303 112 Street, Edmonton, AB T6G 2T4, Canada, Tel.: +1-780-2481835, E-mail: hoan@ 123456ualberta.ca
                Article
                FMCH.2016.0104
                10.15212/FMCH.2016.0104
                Copyright © 2016 Family Medicine and Community Health

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc/4.0/.

                Product
                Self URI (journal page): http://fmch-journal.org/
                Categories
                China Focus

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