| 摘要: |
| 全世界的临床医师和患儿家长都认为适合儿童的循证治疗指南、药物治疗的相关知识和可用的人力资源缺乏，这些问题在成人治疗中早已是不存在的问题。促进中国儿童的合理用药存在许多因素，本文着重阐述了部分亟待解决的问题，这必然可以使中国儿童获得相应合理的循证治疗。目前，科研单位正致力建立模型和模拟的研究计划来促进更广泛的适合儿童的和可替代的临床试验。新生儿、神经/精神健康、行为障碍，特别是“孤儿病”的创新治疗方法急需更深入的研究。中国的医学同行们有机会在未来参与或主导创造一个安全和完善的治疗系统，使患儿获得最准确的治疗。因此，优化治疗方法是儿科临床药理学家、所有儿科临床医师和药师的共同首要目标。但是，这些目标和计划必须获得患儿、监护人和家属的认可，最重要的是获得医药管理部门的认可。 |
| 关键词: 儿童健康 儿科 临床药理学 临床药学 治疗选择 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2016.03.003 |
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| 基金项目: |
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| Improving Medicines for Chinese Children: 10 Essential conserderitions |
| Stuart MacLeod |
| ((University of British Columbia, Child & Family Research Institute, Vancouver, Canada) |
| Abstract: |
| Worldwide, clinicians and families requiring medicinal treatment for children have been too accepting of the current gaps in knowledge and in the human resources available to address obvious shortcomings in evidence-based, age-appropriate treatment guidelines. Such gaps have long since been deemed unacceptable in adult care. There are many elements to be considered in improving use of medicines for the benefit of Chinese children. This commentary describes some, but certainly not all, of the most pressing challenges. This must change if children are to gain universal access to the evidence-based treatments that they deserve. Momentum is gathering in the direction of heightened research enterprise leading to more widespread adoption of adaptive and alternative clinical trial designs and more effective use of modeling and simulation as a guide to research planning. Further advances are most urgently needed in neonatology, neurology/mental health, and behavioural disorders. Particular emphasis must be placed on the study of innovative treatments for rare conditions. Chinese colleagues are now presented with an outstanding opportunity to participate or even play a leading role in the future creation of a secure, improved system in which children are optimally treated with accurately labelled therapies. First and foremost this should be a goal of pediatric clinical pharmacologists and all pediatric clinicians in medicine and pharmacy committed to optimal therapeutics. However, the attraction of the concept must be broadened to recognize the concerns of all caregivers, patients, and their families. Perhaps most importantly, the action plan that must emerge will require endorsement by all those responsible for healthcare leadership and regulation of medicines. Nothing less will suffice to meet the needs of the large proportion of the world’s children living in China. |
| Key words: child health paediatrics clinical pharmacology clinical pharmacy therapeutic choice |
