1.Expert consensus on artificial intelligence-assisted pharmaceutical care
Commission PHARMACY ; Association GERIATRIC ; Society SUB-ASSOCIATION
China Pharmacy 2025;36(13):1553-1562
OBJECTIVE To provide guidance for the scientific and standardized application of artificial intelligence (AI) technology in supporting pharmaceutical care services, and to promote the high-quality development of pharmaceutical care. METHODS Using keywords such as “artificial intelligence” and “pharmaceutical care”, a comprehensive search was conducted across domestic and international databases and relevant policy documents. Drawing upon practical experience in AI-assisted pharmaceutical care services in China, a consensus framework and preliminary recommendations were drafted. Consensus was defined as agreement by 70% or more of expert panel members. RESULTS & CONCLUSIONS Through two rounds of the Delphi method and multiple rounds of discussions, 23 strong recommendations (approval rate >90%) were formulated. These address the definition, scope, objectives, multiple application scenarios (including pharmaceutical outpatient, medication reconciliation, medication education, adverse drug event prediction and monitoring, home-based pharmaceutical care services, and drug supply), ethical considerations and accountability, challenges encountered, and quality control recommendations for AI-assisted pharmaceutical care. Intended for use by professional technical staff engaged in pharmaceutical care, managers, and AI technology developers within healthcare institutions, these recommendations provide guidance for the practice of pharmaceutical care in the era of AI.
2.Cross-sectional study on working mode and human resource setting of PIVAS in national medical institutions
Ke LI ; Hongyan GU ; Dechun JIANG ; Lulu SUN ; Yingbo ZHAO
China Pharmacy 2024;35(18):2199-2202
OBJECTIVE To know about the working mode and human resource status of pharmacy intravenous admixture services (PIVAS) in national medical institutions. METHODS Through questionnaire survey, the national PIVAS was invited to fill out questionnaire and statistical analysis was performed on the effective sample data related to PIVAS working mode and human resources in the questionnaire. RESULTS In this study, 761 PIVAS from 722 medical institutions of 29 provinces were involved in the questionnaire survey, with 471 valid questionnaires for working mode and 441 valid questionnaires for human resources survey. In terms of working mode, among 471 PIVAS, 292 PIVAS (62.0%) were in pharmacist-alone mode, and 176 PIVAS (37.4%) were in pharmacist-nurse cooperative mode; there was no significant difference in the types of medical orders received by PIVAS between these two working modes except for the other medical orders (P>0.05). In terms of human resource setting, among 441 PIVAS, the average number of total staff of single PIVAS was 24(16,33), including 11(6,19) pharmacists, 7(2,13) nursing staff, and 3(1,5) workers; there was a statistically significant difference in the number of personnel among three groups (P< 0.01). The per capita income of PIVAS respondents in 2019 was [7.9(4.8,10.7)]×104 yuan, and in 2021 it was [8.8(5.8,11.7)]× 104 yuan, with an increase of 9.0% compared to 2019. The difference between the two groups was statistically significant (P< 0.01). CONCLUSIONS Medical institutions’ PIVAS in China had not fully implemented the pharmacist-alone work model, and some medical institutions had chosen a pharmacist-nurse cooperative mode. It is suggested that relevant departments formulate corresponding qualification requirements and training standards for nursing personnel as soon as possible based on sufficient research on PIVAS’s demand for nursing professionals.
3.Cross-sectional study on balance of payments in PIVAS of medical institutions nationwide
Ke LI ; Hongyan GU ; Dechun JIANG ; Lulu SUN ; Yingbo ZHAO
China Pharmacy 2024;35(20):2449-2452
OBJECTIVE To know about the pharmacy intravenous admixture charge and operation balance of pharmacy intravenous admixture services (PIVAS) in national medical institutions. METHODS Using questionnaire survey method, the national PIVAS leaders were invited to fill in the questionnaire, investigation and statistical analysis of the drug dispensing charge standard and the income and expenditure situations of PIVAS nationwide were conducted. RESULTS A total of 761 PIVAS completed the questionnaire, among which 466 PIVAS (61.2%) had already started implementing pharmacy intravenous admixture charge, mainly in tertiary hospitals. The charge standards for chemotherapy drugs and parenteral nutrition solutions were relatively high, while the standards for packaged drugs were the lowest, with differences in charge standards among provinces(P<0.05). Among the 25 provinces that reported annual drug preparation fee revenue, Hubei had the highest revenue in both 2019 and 2021. In 2019, the number of PIVAS with a balance of payments was more than that of PIVAS with an imbalance of payments, but the number of PIVAS with an imbalance of payments in 2021 exceeded the number of PIVAS with a balance of payments (P<0.05); among them, eight provinces were unbalanced in 2019 and 2021, such as Tianjin, Chongqing, Guizhou, etc. CONCLUSIONS PIVAS charge standards of the surveyed medical institutions in all provinces are not unified. It is suggested to improve the charge standard further, formulate the charge adjustment cycle, and promote a sustainable development of PIVAS.
4.Current status and development suggestions of PIVAS automated equipment allocation in China
Ruimin DENG ; Yuqi FU ; Wei YANG ; Lulu SUN
China Pharmacy 2024;35(17):2068-2071
OBJECTIVE To investigate the current allocation status of automated equipment in pharmacy intravenous admixture services (PIVAS) of medical institutions in China, and to provide reference for understanding the current status and future direction of PIVAS automation construction. METHODS In the form of a questionnaire survey, a questionnaire was distributed to medical institutions in 30 provinces across the country through the “Wenjuanxing” platform to investigate the four aspects of PIVAS, such as the allocation of automated equipment, intelligent intravenous medication dispensing robots, design and development of workflow software and information integration methods for automated equipment, and conduct statistical analysis. RESULTS A total of 761 PIVAS participated in the survey, 373 PIVAS were equipped with automated equipment. Among 373 PIVAS with automated equipment, automatic finished infusion sorting machines and automatic labeling machines were the main equipment, and 93.56% of PIVAS were not equipped with intelligent intravenous medication dispensing robots; 511 PIVAS used workflow software designed and developed by third-party software companies. In the project of information integration for automated equipment, there was not much difference in the proportion of cases where there was no automated equipment, automated equipment directly interfaced with hospital information systems, and automated equipment interfaced with PIVAS software platform. CONCLUSIONS The automated equipment allocation rate of PIVAS in China is relatively low, and there is still a lot of room for development. We should improve the relevant guidelines for automated equipment as soon as possible, promote standardized and reasonable equipment research and development, and enable PIVAS to more efficiently complete intravenous drug dispensing, in order to provide more dengrm3@mail.sysu.edu.cn comprehensive pharmaceutical services.
5.Research and analysis of the blending types and workload of PIVAS in China
Hongmei LYU ; Jing ZHAO ; Yuqi FU ; Jianzhong ZHANG
China Pharmacy 2024;35(18):2203-2206
OBJECTIVE To assess the blending types and workload of pharmacy intravenous admixture services (PIVAS) in China. METHODS By questionnaire survey, the working status of PIVAS in different levels of hospitals nationwide was investigated, involving the types of blending infusion, daily blending volume of hazardous drugs infusion, parenteral nutrition solution, general and antibacterial drug infusion, intravenous bolus drugs, skin test solution and intravenous agents, as well as the daily packing volume. RESULTS A sample of 750 PIVAS in 30 provinces (autonomous regions, municipalities) across China were surveyed by questionnaire, involving 621 tertiary hospitals and 90 secondary hospitals. The main types of liquid preparation were intravenous infusion, followed by parenteral nutrition solution, and chemotherapy pump (including chemotherapy infusion), accounting for 99.73%, 79.47% and 43.33%, respectively. The daily blending volume of hazardous drugs infusion, parenteral nutrition solution, general and antibacterial drug infusion, intravenous bolus drugs, skin test solution and intravenous agents in PIVAS of tertiary hospitals were 23.00 (9.00, 56.50) sets, 31.00 (13.97, 74.00) bags, 813.00 (375.00, 2 061.75) bags, 426.00 (210.00, 987.00) bags, 30.00 (6.00, 155.00) ampoules, 30.00 (7.13, 136.84) ampoules, 3 200.00 (1 684.50, 5 554.50) ampoules respectively, while the daily packing volume was 218.50 (52.26, 559.00) bags; above indexes of PIVAS in secondary hospital were 4.00(2.00,12.00)sets, 8.90(3.00,23.00)bags, 270.50(108.00, 2 061.75)bags, 157.00(71.00,987.00)bags, 5.85 (3.75,141.00) ampoules, 0 ampoule, 1 349.00(548.10,2 408.00)ampoules, 107.50(33.25,207.00)bags. CONCLUSIONS The scope of blending types of PIVAS has been significantly expanded, and tertiary hospitals are significantly higher than secondary hospitals in the blending and packing volumes of all types of intravenous fluids and drugs dispensed, showing obvious advantages in dealing with complex medications and high-risk treatments.
6.Investigation and analysis of the medical prescription approval in PIVAS in China
Jing ZHAO ; Lulu SUN ; Hongmei LYU ; Jianzhong ZHANG
China Pharmacy 2024;35(19):2340-2344
OBJECTIVE To know about the current status of medical order auditing in pharmacy intravenous admixture service (PIVAS) of medical institutions nationwide, further improve the management of medical orders in PIVAS, and reduce and eliminate the occurrence of intravenous medication administration errors. METHODS Through the questionnaire survey method, to address the problems and current situation of PIVAS medical order auditing in medical institutions nationwide, experts from each province (autonomous region, municipality directly under the central government) in the research group were responsible for organizing the PIVAS directors of relevant medical institutions in their provinces to fill in the questionnaires on medical order audit and inappropriate medical order interventions, and conduct a statistical analysis of the results. RESULTS A total of valid 751 responses were received to the PIVAS questionnaire on the review of medical prescriptions. Our PIVAS medical order audit is mainly carried out by a combination of manual and computer. The median number of medical orders were audited by PIVAS per day were 700.00-771.00; the median number of new medical orders were audited by PIVAS per day were 209.68-215.00; medical order auditing rates were 85.50%-92.44% averagely; the inappropriate doctor’s orders accounted for 1.82%-1.89% averagely; the intervention rates of inappropriate medical orders ranged 74.90%-79.41%, the success rates of intervention were 79.62%-87.28% averagely; the medication refund rates were 2.92%-3.08%. CONCLUSIONS Most of the PIVAS in China’s healthcare institutions use medical order review software to assist in the review of medical orders, and there are cases of individual PIVAS in which medical orders are not reviewed comprehensively and inappropriate orders are not intervened in, and the standards and processes of medical prescription review need to be improved. It is recommended to emphasize the pharmacist’s responsibility system, standardize the use of prescription review software; gradually expand the scope of medical order review, and adopt a multi-departmental collaborative approach so as to increase the success rate of intervention for inappropriate prescriptions and reduce the rate of PIVAS withdrawals.
7.Analysis of the effects of national centralized drug volume-based procurement policy in public medical institutions of the Guangxi Zhuang Autonomous Region
Zheng ZENG ; Liucen WU ; Zhenguang HUANG ; Wenli HE ; Zhengcheng MI ; Xiangwei XIE ; Siduo SU ; Guicheng LIANG ; Yaoling LIAO ; Hongliang ZHANG
China Pharmacy 2024;35(5):518-523
OBJECTIVE To investigate the implementation effects of the national centralized drug volume-based procurement policy (abbreviated as “national centralized procurement policy”) in Guangxi Zhuang Autonomous Region prefecture, and to provide a reference for the future centralized drug procurement work of the medical institution. METHODS Drug procurement data before and after policy implementation were included in the study. The six secondary indicators (such as availability, affordability, and drug safety) and eighteen third-level indicators (such as completion rate of agreed purchase volume, affordability level, drug revenue proportion) were introduced, guided by the policy objectives and issues of concern to policy beneficiaries. Descriptive statistics was adopted to analyze the data before and after policy implementation (in 2019 and 2020) in terms of differences and change trends. RESULTS In terms of accessibility, the participation rate of medical institutions in Guangxi Zhuang Autonomous Region was 92.55%, the proportion of diseases involved and median completed procurement rate were 40.16%, and 287.82% respectively, and the total centralized delivery rate was 97.20%. In terms of affordability, the total reduction amplitude in drug price was 74.80% from 2019 to 2022; the charge for medicine per capita in hospitalization, the proportion of medicine used for outpatient service and hospitalization, decreased by 17.61%, 10.22%, and 20.10% in order; the burden levels on medical fares for patients were all below 1 in addition to chronic diseases, and anti-tumor drugs. In terms of the impact on medicine, the ratio of adverse drug reaction event cases in 2022 was 66.00%, an increase of 1.29% compared to the previous; since the implementation of the policy, 12 drugs from local pharmaceutical enterprises from Guangxi Zhuang Autonomous Region had passed the consistency evaluation, and the market concentration rate of the top 8 pharmaceutical companies was less than 20.00%. In terms of the impact on healthcare and medical insurance, the public medical institutions achieved generic substitution for originator drugs mostly until 2022; about 9.12% of drugs that were non- centrally purchased in the same category were used; 63.39% of people under investigation did not show a need for a second dressing change; drug expenditure decreased by 2.459 billion yuan. CONCLUSIONS The national centralized procurement policy achieves a significant effect in Guangxi Zhuang Autonomous Region. On the other hand, attention should be paid to these suggestions as follows: expanding the category of drugs used in clinic, conducting clinically comprehensive evaluation of selected drugs, and improving reasonable allocation strategy, etc.
8.Effects of Isodon ternifolius extract on TLR 4/NF-κB/NLRP3 pathway in hepatic stellate cells and hepatocytes
Le QIN ; Yong CHEN ; Guidong HUANG ; Ruisheng WU ; Daihua LIU ; Zhipin ZHOU
China Pharmacy 2022;33(20):2448-2453
OBJECTIVE To investigate the effects of Isodon ternifolius extract on Toll -like receptor 4(TLR4)/nuclear factor - κB(NF-κB)/NOD-like receptor protein 3(NLRP3)pathway in hepatic stellate cells and hepatocytes . METHODS Using primary hepatic stellate cells and primary hepatocytes of rats as subjects ,inflammatory injury model was induced by lipopolysaccharide (LPS,100 ng/mL). Using colchicine (1 μmol/L)as positive control and TLR 4 inhibitor(TAK-242,1 μmol/L)as reference ,the contents of transforming growth factor -β1(TGF-β1),α-smooth muscle actin (α-SMA),type Ⅰ collagen(COL-Ⅰ),COL-Ⅲ in the supernatant of hepatic stellate cells ,and the contents of alanine aminotransferase (ALT),aspartate aminotransferase (AST),interleukin-1β (IL-1β) and IL -18 in the supernatant of hepatocytes were detected after intervention with I. ternifolius extract(1 mg/mL). The mRNA expressions of TLR 4,inhibitor α of NF -κB(IκBα),NF-κB p 65,NLRP3,Gasdermin D (GSDMD),apoptosis-associated speck -like protein containing CARD (ASC) and protein expressions of TLR 4, phosphorylated I κBα(p-IκBα),NF-κB p 65,NLRP3,GSDMD,ASC in the above cells were determined . RESULTS Compared with LPS model group ,the contents of TGF -β1,α-SMA, COL-Ⅰ and COL -Ⅲ in the supernatant of hepatic stellate cells and the contents of ALT ,AST,IL-1β and IL -18 in the supernatant of hepatocytes were significantly decreased ;the mRNA expressions of TLR 4,NF-κB p 65,NLRP3,GSDMD,ASC and the protein expressions of TLR 4,p-IκBα,NF-κB p 65,NLRP3,GSDMD,ASC in the two kinds of cells were significantly down - regulated,and the mRNA expression of I κBα was significantly up -regulated in all administration groups (P<0.05). Compared with TLR 4 inhibitor group ,the improvement of most of above indexes was more significant in the TLR 4 inhibitor+I. ternifolius extract group (P<0.05). CONCLUTIONS I. ternifolius extract could inhibit the activation of TLR 4/NF-κB/NLRP3 pathway, reduce the release of fibrosis factors and inflammatory factors ,alleviate the inflammatory injury of liver cells ,and inhibit the activation of hepatic stellate cells ,so as to protect liver cells and resist liver fibrosis .
9. Effect of miR-124a on oxidative stress injury of pancreatic tissue in type 2 diabetic mice
Yi-Ren CHEN ; Ming CHEN ; Ren-Chuan TAO ; Tao LIANG ; Yi-Ren CHEN ; Ming CHEN ; Ren-Chuan TAO ; Tao LIANG ; Xiao-Hui XU
Chinese Pharmacological Bulletin 2023;39(8):1493-1499
Aim To investigate the effect of miR-124a on oxidative stress injury and β-cell function of pancreas in type 2 diabetic mice. Methods The wild-type C57BL/6 mice and the C57BIV6 mice with low expression of miR-124a were randomly divided into two groups, namely wild-type control (WT Con), miR-124a
10.Chemical profiling and rapid discrimination of Blumea riparia and Blumea megacephala by UPLC-Q-Exactive-MS/MS and HPLC.
Hongna SU ; Xuexue LI ; Ying LI ; Yuanlin KONG ; Jianlong LAN ; Yanfei HUANG ; Yuan LIU
Chinese Herbal Medicines 2023;15(2):317-328
OBJECTIVE:
To rapidly identify the two morphologies and chemical properties of similar herbal medicines, Blumea riparia and B. megacephala as the basis for chemical constituent analysis.
METHODS:
UPLC-Q-Exactive-MS/MS was utilized for profiling and identification of the constituents in B. riparia and B. megacephala. Chemical pattern recognition (CPR) was further used to compare and distinguish the two herbs and to identify their potential characteristic markers. Then, an HPLC method was established for quality evaluation.
RESULTS:
A total of 93 constituents are identified, including 54 phenolic acids, 35 flavonoids, two saccharides, one phenolic acid glycoside, and one other constituent, of which 67 were identified in B. riparia and B. megacephala for the first time. CPR indicates that B. riparia and B. megacephala samples can be distinguished from each other based on the LC-MS data. The isochlorogenic acid A to cryptochlorogenic acid peak area ratio calculated from the HPLC chromatograms was proposed as a differentiation index for distinguishing and quality control of B. riparia and B. megacephala.
CONCLUSION
This study demonstrates significant differences between B. riparia and B. megacephala in terms of chemical composition. The results provide a rapid and simple strategy for the comparison and evaluation of the quality of B. riparia and B. megacephala.