Analysis And Thinking On The Current Situation Of Rational Use Of Traditional Chinese Medicine By Grassroots Doctors Based On The Concept Of Pharmaceutical Care

Objective:To analyze the current situation and existing problems of the rational use of Traditional Chinese Medicine(TCM)for grassroots physicians in primary health medical institutions,and provide data support and policy suggestions for the sustainable development of the grassroots career of TCM.Methods:Methods are as follows:(1)Literature research:With the comprehensive retrieve relevant literature and the national related laws,regulations and policy documents,we summarized the current situation and existing problems in the field of rational use of TCM.(2)Expert consulation:Repeatedly consulted,demonstrated and absorbed the reasonable recommendations of the experts and leaders,we repaired and improved the research program and details.(3)Questionnaire investigation:Based on the literature analysis,policy combing,expert consultation,pre-research and other aspects,we designed and formed the final questionnaires.The main contents of the survey included four parts,such as the general situation of grassroots doctors,the use of TCM,adverse drug reactions and continuing education and training.When the site investigation began,all the questionnaire were issued by the researchers after telling the research object about the illustration.Meanwhile,the objects should fill out in the form of anonymous questionnaire survey,and completed answer content within the given time.Then we would entry the questionnaire data to Excel 2010,and set up to the Access database.(4)On-site interview:With modem pharmaceutical service concept,we conducted in-depth interviews around the grassroots physicians in various areas of TCM service characteristics and development status,and transmit the interview information as an aid in the data of the questionnaire survey analysis.(5)Statistical method:SAS9.30 statistical softerwore was used to analyze the data of the survey,the main statistical methods involved include descriptive statistical analysis,reliability and validity test,factor analysis and multivariate logistic regression analysis,etc.Results:A total of 4842 questionnaires were distributed,and 4842 questionnaires were retrieved with recovery rate of 100%,the invalid 30 questionnaires were removed and the questionnaire efficiency was 99.38%.The survey found:(1)Practitioners in primary health medical institutions could not meet the needs of grass-roots residents of TCM services The allocation and distribution of health resources in primary health care institutions was not balanced.Village clinics and individual clinics are significantly more distributed than county hospitals or township hospitals,but it was less than that in the medical service capacity.The main problems of grassroots doctors were that the imbalance of the professional classification,the uneven academic background,low level of professional knowledge and skills,large outpatient workload and so on.Moreover,lacking of the TCM professionals could not conducive to carry out the TCM services in grassroots areas.(2)Grassroots practitioners existed the phenomenon of irrational use of Chinese medicine.Due to the relatively poor in expertise and practice skills,and lack of the awareness of rational drugs use,which caused the existence of medical treatment behavior non-standard phenomena and unreasonable prescriptions for grassroots physicians.Lack of the attention in clinical application for the rational use of TCM and the clinical care of patients after treatment,there must be a certain risk of drug safety.(3)The work for adverse drug reactions monitoring and reporting of grassroots doctors were not standardized.Grassroots physicians generally lacked the awareness of adverse drug reactions,so it was easy for them to ignore the patient during the course of clinical ADR monitoring.Also,they lacked the certain normative to report the adverse drug reactions.(4)Continuing education and training for grassroots physicians remained to be further strengthened.According to the analysis,the grassroots physicians participated in the training might be affected by many factors,while they viewed that the training had yet to be strengthened and improved in the location,time,frequency,content,form,teachers and incentive systemConclusion:Based on the concept of modern pharmacy service and the background of the development of TCM in grassroots aera,we aimed to ensure the scientific and authenticity for this research of the rational application of TCM practitioners in the grassroots area.This study had a deep understanding of the status of practitioners in grass-roots medical institutions,the application of TCM and the actual needs of continuing education for grassroots physicians.With the discussion of the application status of Chinese medicine and the influencing factors in this field,we provided reference and guidance in improving the level of rational use of TCM for grassroots practitioners,but also provide real first-hand data and reference for relevant policies.