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management，follow-up），pharmaceutical knowledge of antitumor medicine，etc. DTP pharmacies in China were inspected on site，
and their pharmaceutical care management were evaluated，and impression of on-site inspection were discribed with questionnaire
survey. The current situation of oncology pharmaceutical care ability of DTP pharmacy in China was evaluated and corresponding
suggestions were put forward. RESULTS：A total of 400 questionnaires were sent out，and 392 valid questionnaires were collected
with recovery rate of 98.0％ . The cancer pharmacists in DTP pharmacy were mainly from East China，mainly in Jiangxi （73
persons，18.62％），Anhui（68 persons，17.35％）. The pharmacists were mainly junior college or below（229 persons，58.42％），
followed by undergraduate （158 persons，40.31％）. The working years were more than 5 years （241 persons，61.48％）. The
majors were mostly pharmaceutics （123 persons，31.38％），followed by pharmacy （including pharmacology）（81 persons，
20.66％）. The regular knowledge sources of pharmacists in DTP pharmacy included learning materials （302 person times，
77.04％），textbooks（250 person times，63.78％）and Wechat push（206 person times，52.55％）；the latest knowledge sources
included training courses（347 person times，88.52％），Wechat push（211 person times，56.38％）and academic conferences（162
person times，41.33％）. The expected training methods included online video courses（344 person times，87.76％）and offline
courses （248 person times，63.27％）. In terms of prescription checking and dispensing，there were mainly problems such as
incomplete medical documents and materials；82.91％ and 64.54％ of pharmacists needed routine medical records and discharge
summary，and 91.58％ of pharmacists took the doctor’s handwritten prescription as the basis for dispensing new anti-tumor drugs；
pharmacists paid less attention to allergy history，genetic history and ADR in the field of drug consultation and guidance. According
to DTP pharmacists，the difficulties in the process of drug treatment management included patient’s ADR monitoring（239 person
times，60.97％），evaluating the rationality of drug use（222 person times，56.63％），making a complete drug use record（219
person times，55.87％）. The main follow-up visits of pharmacists were telephone（334 person times，85.20％）and dispensing site
（313 person times，79.85％）. And 333 pharmacists（84.95％）thought it was necessary to make an appointment for dispensing；the
score rates of professional knowledge examination of antitumor pharmacy for the respondents were 40.56％-84.69％. In the aspect
of pharmaceutical care management，the main points of deduction were drug evaluation，content and process of drug treatment
management，drug follow-up and record，and the proportion of deduction was 93％，86％ and 64％ respectively. In the on-site
inspection，it was found that the pharmacist had a single source of working knowledge，did not fully grasp the contents of the
evaluation forms such as ADR classification standard，and prescription checking did not meet the requirements. CONCLUSIONS：
DTP pharmacy in China develops rapidly under the guidance of relevant policies，but its pharmaceutical care is still in the basic
stage，which is far behind the requirements of providing whole-course pharmaceutical care for patients. It is necessary to improve
the professional service ability of DTP pharmacy pharmacists，establish the corresponding pharmacy quality evaluation system，
continuously improve the pharmaceutical care quality of DTP pharmacy from the personal，supervision and management level of
pharmacists.
KEYWORDS DTP pharmacy；Questionnaire；On-site inspection；Pharmaceutical care ability

恶性肿瘤发生率和病死率逐年攀升 [1-2] ，已成为人类 其中新型抗肿瘤药占据相当的比例。DTP 药房正逐渐
健康的重大威胁。肿瘤药物治疗是国民经济重要支出， 成为解决抗肿瘤新药可及性问题的重要通道，特别是近
抗肿瘤领域的治疗药物研究进展日新月异，2014－2018 年来在医药分开、药品零差率、招标采购、分级诊疗等政
[7]
年期间我国境内通过特别审批、特殊审批、重大专项、优 策的驱动下发展迅猛 。DTP药房的经营品种较新并且
先审评审批4种特殊通道获批的抗肿瘤新药就高达397 专业度要求高，其药事服务逐渐从单纯的药品调配发展
[3]
种 。随着越来越多的抗肿瘤新药、新适应证、新技术和 为建立健康档案、提供用药咨询和用药指导、开展随访
[8]
新疗法获批，肿瘤患者 5 年生存率不断提高 。尽管近 等全程药学服务 。药师是DTP药房药学服务的主要提
[2]
几年医疗改革的推进，有处方外流、医药分家等一系列 供者，是保障合理用药的关键人物，但是我国药店行业
[4]
[9]
提高治疗可及性的相关政策出台 ，但新药进入医院使 药事服务职能尚未健全 。
用的进程仍然严重滞后。 据中国医药商业协会统计数据，截至 2019 年底，我
直销患者药房（Direct to Patient Pharmacy，以下简称 国挂牌 DTP 药房共有 126 家，分布以华东地区（包括上
“DTP药房”） ，即在零售药店通过获得制药公司授予的 海、江苏、浙江、安徽、福建、江西、山东等地区）为主。中
[5]
产品经销代理权，患者在医师处获取处方后，DTP 药房 国医药行业协会在2018年已颁布了《零售药店经营特殊
[10]
即可根据处方信息将相应的药品在规定时间内送至患 疾病药品服务规范》 （以下简称“《服务规范》”），规范
者或由患者自行前往药房取药。DTP 药房提供的药品 了DTP药房人员与培训、经营服务环境、信息系统管理、
主要为高附加值的“特药”，如肿瘤药品、慢病用药等 ， 冷链药品管理、药学服务管理、药物警戒管理以及制度
[6]

中国药房 2020年第31卷第9期 China Pharmacy 2020 Vol. 31 No. 9 ·1133 ·