社区药师抗凝药物知识与服务能力调查研究

Investigation on Anticoagulant Knowledge and Service Competence of Community Pharmacists

关键词:  社区药师  抗凝药物  直接口服抗凝药  知识评估  服务信心  横断面研究

Key words:  community pharmacists  anticoagulants  direct oral anticoagulants  knowledge assessment  service confidence  cross-sectional study

摘要:

目的　调查社区药师抗凝药物知识水平与服务信心现状,分析其影响因素及两者关联,为优化社区抗凝药学服务提供依据。方法　采用横断面调查设计,于2025年10—11月对上海市浦东新区48家社区卫生服务中心的198名药师进行问卷调查,评估抗凝药物知识(满分46分)和服务信心(满分64分)水平。采用t检验、方差分析进行单因素分析,Spearman相关分析知识与信心的关联,多元线性回归分析信心的独立预测因素。结果　社区药师总知识得分为(28.89±6.78)分,得分率62.8%；综合服务信心得分为(35.95±9.87)分,得分率56.2%。利伐沙班为社区最常用抗凝药(46.0%高频接触),华法林几乎退出社区应用(91.9%很少接触)。知识薄弱环节集中于直接口服抗凝药(DOACs)肾功能不全用药调整(38.9%)、药物相互作用识别(41.4%)等。59.6%的药师从未接受过抗凝专业培训。总知识得分与综合信心呈正相关(rs=0.612,P<0.001)。多元线性回归显示,总知识得分(β=0.687)、培训经历(β=3.234)和工作年限(β=2.567)是服务信心的独立预测因素(均P<0.05)。结论　社区药师抗凝知识和服务信心均有待提升,应以DOACs为重点构建系统化培训体系,强化肾功能评估、药物相互作用识别等薄弱环节教学。

Abstract:

OBJECTIVE To investigate the knowledge level and service confidence of community pharmacists regarding anticoagulant medications, analyze influencing factors and their associations, and provide evidence for optimizing community anticoagulation pharmaceutical services. METHODS A cross-sectional survey was conducted among 198 pharmacists from 48 community health service centers in Pudong New Area, Shanghai from October to November 2025. Anticoagulant knowledge (full score 46) and service confidence (full score 64) were assessed using a structured questionnaire. Independent t-test and ANOVA were used for univariate analysis. Spearman correlation analyzed the association between knowledge and confidence. Multiple linear regression identified independent predictors of confidence. RESULTS he total knowledge score was (28.89±6.78), with a score rate of 62.8%; the comprehensive confidence score was (35.95±9.87), with a score rate of 56.2%. Rivaroxaban was the most commonly used anticoagulant (46.0% high-frequency contact), while warfarin had almost withdrawn from community use (91.9% rarely contacted). Knowledge weaknesses concentrated on DOACs dosing in renal impairment (38.9%) and drug interaction identification (41.4%). A total of 59.6% pharmacists had never received anticoagulant training. Total knowledge score positively correlated with comprehensive confidence (rs=0.612, P<0.001). Multiple linear regression showed that total knowledge score (β=0.687), training experience (β=3.234), and work experience (β=2.567) were independent predictors of service confidence (all P<0.05). CONCLUSION Both anticoagulant knowledge and service confidence of community pharmacists need improvement. A systematic training program focusing on DOACs should be established, with emphasis on renal function assessment and drug interaction identification.