Page 21 - 《中国药房》2021年第4期

ABSTRACT OBJECTIVE：To evaluate the current situation and implementation effect of the pilot project of electronic
prescription and remote pharmaceutical care in social pharmacy from the perspective of consumers，and to provide reference for
improving and optimizating the electronic prescription and remote pharmaceutical care in social pharmacy. METHODS：Totally 264
consumers in 6 counties and 36 drugstores of Chengdu were randomly selected for the questionnaire survey. Descriptive statistics
were conducted by using SPSS 23.0 software. Compare the distribution and differences of various. The influential factors in
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consumer satisfaction based on χ test and ordinal multiple Logistic regression analysis. Consumers were randomly selected for
semi-structured interviews. Text analysis was conducted by Nvivo 12.0 software to refine the problem of this service. RESULTS：A
total of 271 questionnaires were distributed to consumers in various districts of Chengdu，and 264 valid questionnaires were
collected，with an effective recovery rate of 97.4％. Among 264 respondents，178（67.9％）knew about electronic prescription and
remote pharmaceutical care；197（74.6％）received electronic prescription and remote pharmaceutical care service in pharmacies；
202（76.5％）said they needed this service，and 63（23.9％）expressed that they would like to pay for it. Of the 197 respondents
who had received the service，163（82.2％）were satisfied or very satisfied with the service，and only one（0.5％）was dissatisfied
with the service. Waiting time，satisfaction of drug demand，staff attitude，service platform configuration，the qualifications of
tele-practice pharmacists and service quality were the main influential factors of satisfaction；while the service also suffered from
difficulties in electronic prescription circulation，inadequate service monitoring measures，insufficient certification of physicians and
pharmacists，cultural lag，and irregular service processes. CONCLUSIONS：Electronic prescription and remote pharmaceutical care
service in social pharmacy is inadequate in terms of technical level，institutional design and social acceptance. It is recommended
that relevant departments implement incentive policies，optimize technology；follow up supporting policies in time，strengthen
supervision； and increase social publicity and supervision， so as to promote the continuous improvement and long-term
development of electronic prescription and remote pharmaceutical care in social pharmacy.
KEYWORDS Social pharmacy；Electronic prescription；Remote pharmaceutical care； Consumer satisfaction；Questionnaire；
Semi-structured interview；Chengdu

随着知识社会创新 2.0 时代的逐步推进，互联网与 目前，已有较多学者开展了关于社会药房电子处方
传统行业的融合逐步加深，创造新的发展生态已成为药 服务的研究，多集中于对电子处方的应用前景和实施模
[1]
学发展的新趋势 。2017年2月，《国务院办公厅关于进 式分析，大多肯定了电子处方的发展趋势为打通医院、
一步改革完善药品生产流通使用政策的若干意见》提 零售药店、药企壁垒以构建系统的电子处方流转平
出，鼓励有条件的地区依托现有信息系统，开展药师网 台 [9－11] ，但尚且缺乏对其应用效果的实证研究。尽管已
上处方审核、合理用药指导等药学服务 。国务院颁布 有学者分析了零售药店的远程电子处方及审方服务的
[2]
[12]
的《国家药品安全“十二五”规划》对零售药店配备执业 系统设计和实施模式 ，并对处方外配现状进行了调
药师提出了更高的要求，但从目前实际执行情况来看， 查 ，但鲜有关于配备电子处方系统的社会药房远程药
[13]
现有的执业药师注册数量仍远无法满足实际需求，短期 学服务实施成效的研究。
内执业药师不足仍将是零售药店面临的难题之一 。同 作为最早试点社会药房电子处方及远程药学服务
[3]
时，处方外流困难的现状使消费者难以在零售药房买到 的城市，成都市具有多年的相关实践经验，形成了较为
所需的处方药，极大地影响了患者用药的可及性和便捷 成熟的服务模式和行业生态，在当前诸多试点省市中具
性 。基于此，社会药房电子处方及远程药学服务应运 有一定代表性，可在一定程度上反映我国社会药房电子
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而生。社会药房电子处方服务，是指零售连锁总部或第 处方实施现状及效果。故本研究以成都市为例，采用定
三方平台机构与具备合法资质的医疗机构或执业医师 性与定量相结合的方法，对社会药房电子处方及远程药
对接，消费者在承接服务的零售药店接受线上诊断，执 学服务的开展情况、实施效果和存在问题进行调研和分
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业医师在线开具电子处方 ；社会药房远程药学服务则 析，进而评估社会药房电子处方及远程药学服务的可推
是指执业药师通过应用远程通信及信息技术向消费者 广性和发展前景，旨在为相关决策机构和医药行业完善
提供的线上审方等药学服务 [6－7] 。2013 年，四川省成都 和优化该服务提供参考，为促进社会药房电子处方及远
市率先在药品零售连锁企业中开始执业药师远程药学 程药学服务的发展奠定基础。
服务试点，并于2016年开展电子处方服务试点。经本课 1 资料与方法
题组统计，截至 2020 年 7 月，我国陆续已有黑龙江、山 1.1 问卷调查
东、陕西、山西、湖南、江西、福建、海南、四川等23个省份 1.1.1 问卷设计 基于格罗鲁斯的顾客感知质量模型
陆续开展了相关试点工作 。 及患者满意度的相关文献 [14－18] 设计初始问卷，而后向来
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中国药房 2021年第32卷第4期 China Pharmacy 2021 Vol. 32 No. 4 ·399 ·