重庆市驻科药师工作模式实施效果及其影响因素分析OA

Objective To analyze the implementation effect and influencing factors of the ward-based clinical pharmacist working model in secondary and above public medical institutions in Chongqing.Methods A total of 163 secondary and above public medical institutions in Chongqing,which identified by the Department of Pharmaceutical Affairs of Chongqing Municipal Health Commission,were selected as survey subjects.A questionnaire survey was conducted to collect information on basic institutional data,pharmaceutical talent team composition,and the specific implementation of ward-based clinical pharmacist work.The survey period was from September 2024 to February 2025.Four indicators:the logarithm of the number of medication order reviews,the number of medication consultations,the number of medication reconciliations,and the number of medication guidance encounters were used as dependent variables.Factors from basic institutional data and pharmaceutical talent team information that might affect the dependent variables were selected as independent variables.Multiple linear regression analysis was used to construct models and analyze factors influencing the implementation effect of the ward-based clinical pharmacist working model.Results The effective response rate of the questionnaires was 100.00%(163/163),including 75(46.01%)tertiary medical institutions and 88(53.99%)secondary medical institutions.The majority were under other affiliations(143,87.73%),with general hospitals accounting for the highest proportion(75,46.01%).In terms of scale,institutions with actual open beds≤500(73,44.79%),departments with inpatient beds≤10(62,38.04%),and health technicians≤500(83,50.92%)were more prevalent.A total of 99(60.74%)medical institutions had implemented the ward-based clinical pharmacist working model,including 32(36.36%)secondary and 67(89.33%)tertiary institutions.The total number of clinical departments with ward-based clinical pharmacist services was 579,accounting for 26.33%of all inpatient departments,covering 22 specialty categories.The most common departments were Respiratory Medicine(58,10.02%),Oncology(52,8.98%),and Cardiovascular Medicine(51,8.81%).10 potential influencing factors were selected as independent variables.The multiple linear regression analysis showed that all models constructed by the four indicators were significant(P<0.01).The number of ward-based clinical pharmacists had a significant positive effect on all four indicators(β=0.721,0.501,0.473,0.442,P<0.001).In terms of medication order reviews,tertiary institutions(β=0.263,P<0.001),proportion of pharmacists aged≤35(β=0.110,P=0.020),and proportion of pharmacists with intermediate or above professional titles(β=0.146,P=0.005)showed positive effects,while the number of actual open beds showed a negative effect(β=-0.206,P=0.027).In terms of medication guidance,specialized institutions(β=0.141,P=0.007)and actual open beds(β=0.500,P<0.001)showed positive effects,while tertiary institutions(β=-0.148,P=0.016)and the proportion of permanent pharmacy staff(β=-0.100,P=0.041)showed negative effects.Conclusion The ward-based clinical pharmacist working model has been preliminarily implemented in Chongqing,but issues such as incomplete departmental coverage and uneven distribution across specialties remain.It is recommended to strengthen the construction of ward-based clinical pharmacist teams and optimize resource allocation to meet the growing demand for professional pharmaceutical services.