1.Effect evaluation of medical insurance policy for hepatitis C DAA drugs based on patient survey
Yijiao GUO ; Zhaoting GUO ; Ming HU ; Haihuan FENG
China Pharmacy 2023;34(8):907-910
OBJECTIVE To provide reference for the prevention and treatment of hepatitis C and the formulation and improvement of medical insurance payment policy for direct-acting antiviral (DAA) drugs. METHODS An questionnaire survey was conducted among the patients who received hepatitis C treatment in a third-grade class-A hospital in Sichuan province from 2019 to 2020 and enjoyed Chengdu medical insurance policy. The patients’ hepatitis C treatment and satisfaction with the medical insurance policy for DAA drugs were compared before and after DAA drugs were included in the medical insurance list. RESULTS A total of 203 patients effectively responded among 644 investigated patients. In terms of treatment plans, although there were significant differences in the treatment plan between patients who saw a doctor in 2019 and 2020 (P<0.05), the vast majority of patients were cured within the course of treatment (200 cases, 98.52%), and there were no obvious adverse reactions (193 cases, 95.07%). In terms of economic burden, the out-of-pocket costs and economic burden of patients treated with DAA drugs in 2020 were significantly lower than those treated with DAA drugs in 2019 (P<0.05); in terms of patient services, 78.82% of patients received expert consultation services from designated medical institutions, but 9.85% of patients still did not receive any patient services provided by the hospital. In terms of satisfaction with outpatient reimbursement policy, the overall satisfaction of patients who saw a doctor in 2020 (95.37%) was significantly higher than those who saw a doctor in 2019 (81.05%)(P<0.05). CONCLUSIONS The surveyed patients with hepatitis C obtain good efficacy after DAA drugs treatment, and are satisfied with the medical insurance policy of DAA drugs, but the standardized management of patient services in designated medical institutions is insufficient.
2.Evaluation of implementation situation of prescription circulation service in medical institutions based on patient KAP survey
Yijiao GUO ; Deyang LIU ; Ming HU ; Peng ZHANG
China Pharmacy 2023;34(4):397-401
OBJECTIVE To provide reference for perfecting prescription circulation service and related platforms construction and improving online medical service level. METHODS A questionnaire was designed after literature review and consulting expert opinions. Patients who had received prescription circulation service in the prescription circulation platform of a Grade-A third-class hospital in Sichuan Province from November 22, 2019 to May 2022 were randomly selected, and the knowledge, attitude and practice of prescription circulation service were investigated by questionnaires, which were sent through telephone contact and short message. RESULTS A total of 285 patients were investigated, and the number of effective responses was 200. Most of the surveyed patients in prescription circulation service for 1-5 times in the past year (129 cases, 64.50%); 77.0% of the patients had a “general understanding” or “no understanding” of prescription circulation services, and the main prescription circulation services they received were online consultation service (169 cases, 84.50%) and drug delivery service (106 cases, 53.00%). The average waiting time and expected waiting time were 1-5 min. The services with the largest number of demand (145 cases, 72.50%) and the highest demand (3.585 points) were drug delivery services. Most of the respondents’ willingness to pay was “general willingness” (83 cases, 41.50%), and most of the patients were willing to pay less than or equal to 5 yuan per time (92 cases, 46.00%). Totally 73.0% of the surveyed patients were “satisfied” or “relatively satisfied” with the prescription transfer service. The results of univariate analysis showed that the main factors influencing patients’ satisfaction with prescription circulation service were service awareness, service waiting time, patients’ demand satisfaction and patients’ willingness to pay. CONCLUSIONS The surveyed patients are generally satisfied with prescription circulation service, and the service content with high satisfaction is drug distribution service, and patients are willing to pay a lower price for prescription circulation service. It is suggested that relevant departments should strengthen the publicity of prescription circulation service, improve the content of prescription circulation service and reduce the payment price of prescription circulation service, so as to improve the operation efficiency of Chinese medical system while facilitating patients.
3.A qualitative study on the influencing factors of prescription circulation and its platform construction
Yijiao GUO ; Deyang LIU ; Xiaorong TANG ; Ming HU
China Pharmacy 2023;34(11):1307-1312
OBJECTIVE To explore the influential factors for “Internet +” prescription circulation and construction specifications of prescription circulation platform, so as to provide reference for the government to formulate relevant policies and standardized construction of prescription circulation platform. METHODS Stakeholders in the process of prescription circulation service in medical institutions in Sichuan province were selected to conduct key insider interviews, and grounded theory was used to analyze the data. RESULTS The influential factors of prescription circulation could be divided into three aspects: participant factor, administrative decision factor and information technology factor. The influential factors of prescription circulation mainly lay in pharmacy admission and withdrawal mechanism, medical insurance reimbursement service, supporting policies and pharmaceutical care ability. In terms of pharmacy admission and withdrawal mechanism, pharmacy qualification, pharmaceutical service personnel, drug allocation and distribution should be considered to unify pharmacy admission standards; in terms of medical insurance reimbursement service, it should actively connect with social pharmacies to realize the transfer of prescription medical insurance reimbursement from designated pharmacies; in terms of supporting policies, it should pay attention to the construction of the top-level design of prescription circulation; in terms of pharmaceutical care ability, regular training and assessment of licensed pharmacists should be performed in drug consultation, prescription review and other pharmaceutical care. CONCLUSIONS Participants have more influence on prescription circulation, and pharmacy admission and withdrawal mechanism and pharmaceutical care ability need to be improved. There are various types of prescription circulation platform construction, but each has its own advantages and disadvantages. It is suggested that relevant government departments should improve the access threshold of pharmacies, follow up medical insurance reimbursement services and supporting policies, and explore ways to improve pharmaceutical care capacity, leading and issuing relevant policies and measures to promote the prescription circulation service and make the “Internet +” prescription circulation develop in an orderly manner.
4. Therapeutic effect of dihydroartemisinin on pulmonary fibrosis in rats with dust
Yijiao ZHENG ; Xia LI ; Lin SUN ; Jingwen GUO
Chinese Journal of Industrial Hygiene and Occupational Diseases 2019;37(2):96-103
Objective:
To observe the therapeutic effect of dihydroartemisinin on pulmonary fibrosis in rats exposed to dust, and compare the therapeutic effects of dihydroartemisinin and tetrandrine.
Methods:
Sixty male Sprague-Dawley rats were randomly divided into control group, model group, treatment group 1 and treatment group 2, with 15 rats in each group. The model group and the treatment group were stained with disposable non-exposure silica tracheal instillation method. The drug was administered on the second day after the dust was applied. The treatment group was given with dihydroartemisinin 75 mg/kg, the treatment group was given tetrahexine 22 mg/kg, model group and control group were intragastrically administered with 1 ml of normal saline per 100 g of body mass. The drug was administered for 6 days per week for 28 days. Rats were sacrificed on the 7th, 14th and 28th day after dusting, and the lung tissues of rats were taken, detection of rat lung coefficient, ELISA was used to detect transforming growth factor-1(TGF-1)and Smad 2/3 in rat lung tissues, type I collagen (Col-I) expression level, pathological changes of rat lung tissue, immunohistochemical observation of rat lung tissue TGF-1 and Col-I protein expression. Statistial analysis was proformed with SPSS 19.0. The mean cornparis between graups wad perfomed using a completely randonized one-way (ANOVA).
Results:
The expressions of TGF-1, Smad 2/3 and Col-I in the lung tissue of the treatment group were significantly lower than those in the model group (