qttv kê đơn + không kê đơn

Nhà thuốc có biết thị trường dược phẩm ngày nay đã chia thuốc thành 2 nhóm chính là thuốc kê đơn và không kê đơn. Việc phân biệt 2 loại thuốc này rất quan trọng, vì ảnh hưởng rất lớn đến hoạt động kinh doanh cũng như sức khỏe của người đến mua thuốc. Hôm nay, thuocsi sẽ hướng dẫn cho bạn cách phân biệt và hướng dẫn cụ thể quy trình khi có người bệnh đến mua thuốc.

1. Định nghĩa thuốc kê đơn và không kê đơn

Trước tiên, chúng ta cùng tìm hiểu về khái niệm của 2 nhóm này.

Thuốc không kê đơn:

Là thuốc khi cấp phát, bán và sử dụng không cần đơn thuốc. Đồng thời thuốc đáp ứng được các tiêu chí sau:

  • Thuốc có độc tính thấp, không tạo ra các sản phẩm phân huỷ có độc tính, không có những tác dụng có hại nghiêm trọng (là những tác dụng có hại gây hậu quả tử vong, nguy hiểm đến tính mạng, cần phải nhập viện để điều trị hay kéo dài thời gian điều trị, gây tàn tật vĩnh viễn hay nặng nề, sinh con dị dạng, dị tật bẩm sinh và các hậu quả tương đương, …) đã được biết và/hoặc khuyến cáo có tác dụng này.
  • Thuốc có phạm vi liều dùng rộng, an toàn cho các nhóm tuổi, ít có ảnh hưởng đến việc chẩn đoán và điều trị các bệnh cần theo dõi lâm sàng.
  • Thuốc được chỉ định trong điều trị các bệnh thông thường và bệnh nhân có thể tự điều trị, không nhất thiết phải có sự thăm khám, tư vấn và theo dõi của thầy thuốc.
  • Đường dùng, dạng dùng đơn giản (chủ yếu là đường uống, dùng ngoài da) với hàm lượng, nồng độ thích hợp cho việc tự điều trị.
  • Thuốc ít tương tác với các thuốc khác và thức ăn, đồ uống thông dụng.
  • Thuốc không gây tình trạng lệ thuộc.

Thuốc kê đơn:

Là thuốc nếu không sử dụng theo đúng chỉ định của người kê đơn có thể nguy hiểm đến tính mạng và sức khỏe.

2. Quy trình tư vấn

Hiểu được những khái niệm trên, chúng ta có thể dễ dàng đưa ra được quy trình tư vấn cho 2 nhóm này như sau:

a. Nhóm thuốc không kê đơn:

Bước 1: Tìm hiểu, dựa vào từng trường hợp mà đưa ra câu hỏi.

Khi khách hàng hỏi mua một loại thuốc cụ thể:

  • Thuốc được mua dùng để chữa bệnh/ triệu chứng gì?
  • Đối tượng dùng thuốc? (Giới, tuổi, tình trạng sức khỏe, có đang bị mắc các bệnh mãn tính nào không? đang dùng thuốc gì? Hiệu quả? Tác dụng không mong muốn?..)
  • Đã dùng thuốc này lần nào chưa? Hiệu quả?
  • Sau đó xác định việc sử dụng thuốc để điều trị bệnh/ triệu chứng bệnh nhân đang mắc là đúng hay không đúng?


Trường hợp khách hàng hỏi và tư vấn điều trị một số chứng bệnh thông thường:

  • Ai? (Tuổi, giới,) mắc chứng/ bệnh gì? Biểu hiện? Thời gian mắc chứng / bệnh? Chế độ sinh hoạt, dinh dưỡng?
  • Bệnh nhân có đang mắc bệnh mãn tính gì? đang dùng thuốc gì?
  • Bệnh nhân đã dùng những thuốc gì để điều trị bệnh/ triệu chứng này? Dùng như thế nào? Hiệu quả?

Bước 2:  Đưa ra những lời khuyên đối với từng bệnh nhân cụ thể.

Nếu việc sử dụng thuốc của bệnh nhân chưa đúng hoặc chưa phù hợp: Giải thích, tư vấn và hướng dẫn khách hàng chuyển sang loại thuốc khác đúng và phù hợp hơn. Trong trường hợp cần thiết, khuyên bệnh nhân đi khám và mua theo đơn của bác sĩ

Bước 3: Cung cấp các thông tin cụ thể về thuốc (nhà SX, dạng bào chế, giá bán) để khách hàng lựa chọn.

b. Nhóm thuốc kê đơn:

Bước 1: Tiếp nhận và kiểm tra đơn thuốc

Kiểm tra đơn thuốc: 
  • Ghi đủ, rõ ràng và chính xác các mục in trong đơn thuốc hoặc trong sổ khám bệnh của người bệnh.
  • Đối với trẻ dưới 72 tháng tuổi thì phải ghi số tháng tuổi, ghi tên và số chứng minh nhân dân hoặc số căn cước công dân của bố hoặc mẹ hoặc người giám hộ của trẻ.
Ghi tên thuốc theo quy định như sau:
  • Thuốc có một hoạt chất: Theo tên chung quốc tế + tên thương mại (nếu có)
  • Thuốc có nhiều hoạt chất hoặc sinh phẩm y tế thì ghi theo tên thương mại.
  • Nếu đơn thuốc có thuốc độc phải ghi thuốc độc trước khi ghi các thuốc khác.
  • Số lượng thuốc chỉ có một chữ số (nhỏ hơn 10) thì viết số 0 phía trước.
  • Đơn thuốc có giá trị trong 05 ngày kể từ ngày kê đơn.

Kiểm tra tính an toàn, hiệu quả và hợp lý về sử dụng thuốc của đơn.

  • Kiểm tra về dược lâm sàng: liều dùng, tương tác thuốc, các phản ứng có hại khác, kê trùng thuốc, v.v.
  • Trường hợp phát hiện đơn thuốc không rõ ràng về tên thuốc, nồng độ, hàm lượng, số lượng, hoặc có sai phạm về pháp lý, chuyên môn hoặc ảnh hưởng đến sức khỏe người bệnh, phải thông báo lại cho người kê đơn biết.
  • Chú ý các đối tượng như trẻ em, người già, phụ nữ có thai, người suy gan, thận.
  • Giải thích rõ cho người mua và có quyền từ chối bán thuốc theo đơn trong các trường hợp:
  • Đơn thuốc không hợp lệ, đơn thuốc có sai sót hoặc nghi vấn, đơn thuốc kê không nhằm mục đích chữa bệnh.
  • Người mua không có khả năng tiếp nhận những chỉ dẫn cần thiết
  • Thuốc kê đơn mà không có đơn thuốc
  • Thực phẩm chức năng, mỹ phẩm không được kê trong đơn thuốc

Như vậy, các đơn thuốc hợp lệ là đơn đúng theo mẫu quy định như trên và có đủ tên, chữ ký, địa chỉ, dấu của Phòng khám/ Bệnh viện của Bác sĩ kê đơn.

Bước 2: Tư vấn sử dụng thuốc

Tư vấn sử dụng thuốc
Để đảm bảo tính an toàn cho người dùng, dược sĩ bán thuốc kê đơn cần:
  • Hỏi thêm để nắm rõ tình trạng bệnh lý, hỏi tiền sử dị ứng và các biểu hiện tác dụng phụ của những thuốc bệnh nhân đã dùng.
  • Hỏi xem có đang dùng loại thuốc nào không để tránh tương tác thuốc xấu.

Bước 3: Lựa chọn thuốc

Trường hợp đơn thuốc kê tên biệt dược:
  • Dược sĩ cần bán theo đúng tên thuốc đã kê trong đơn. Nếu nhà thuốc không có loại thuốc nào thì đánh dấu vào đơn để khách hàng đi mua ở nơi khác.
  • Hoặc trong các trường hợp khách hàng yêu cầu tư vấn để lựa chọn thuốc phù hợp. Dược sĩ cần giới thiệu các loại biệt dược (Cùng hoạt chất, liều lượng, cùng dạng bào chế, tác dụng, chỉ định). Khi đó, hãy tư vấn kèm theo giá và giới thiệu những loại thuốc phù hợp với khả năng kinh tế của khách hàng.

Bước 4: Lấy thuốc theo đơn

Khi đã hoàn thành bước 3, Dược sĩ tiếp tục lấy thuốc theo đơn đã kê cho khách hàng.

  • Lấy thuốc theo đơn đã kê cho vào bao bì kín khí, ghi rõ tên thuốc, hàm lượng, cách dùng, liều dùng, thời gian dùng theo của từng loại.
  • Cần ghi rõ số lượng thuốc đã bán vào đơn;
  • Nếu có thay thế thuốc, cần ghi rõ vào đơn (Ghi tên thuốc, hàm lượng, số lượng đã thay thế)

Bước 5: Giao thuốc và hướng dẫn sử dụng:

Giao từng khoản cho khách hàng. Đồng thời hướng dẫn sử dụng thuốc bằng lời nói và viết trực tiếp trên bao bì. Hướng dẫn, giải thích cho khách hàng về:

  • Tác dụng, chỉ định, chống chỉ định, tương tác thuốc, tác dụng không mong muốn,
  • Liều lượng và cách dùng thuốc: uống vào thời điểm nào, các tương tác của thuốc với thức ăn đồ uống.
  • Các chú ý về bảo quản thuốc và thời hạn từ lúc mở lọ thuốc đối với thuốc lỏng
  • Lưu ý khách hàng gọi điện hoặc liên lạc lại với nhà thuốc nếu có vấn đề gì chưa hiểu hoặc có tác dụng phụ, dị ứng thuốc.
  • Nhắc nhở người mua thực hiện đúng đơn thuốc.

Trên đây là những kinh nghiệm tư vấn mà thuocsi.vn tổng hợp được. Hy vọng sẽ giúp ích rất nhiều cho các bạn.

Nguồn: Mediphar USA; Báo Nhân dân

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