title: Hospital pharmacists' knowledge of and attitudes towards the implementation of the National Essential Medicines System: a questionnaire survey in western China.
abstract: In 2009, Chinese government launched a new healthcare reform, one of the key points of which is to establish National Essential Medicine System (NEMS). Hospital pharmacists are directly related to the implementation of NEMS. This study is to examine knowledge of and attitudes towards the implementation of the NEMS among hospital pharmacists in western China.
  
  
  
  We conducted a questionnaire survey of pharmacists from different types of medical institutions in Shaanxi Province in November 2014. We gathered demographic information about the participants, collected the data about their knowledge of and attitudes towards the implementation of NEMS, and identified the influencing factors of cognitive level. We analyzed the data and compared public secondary/tertiary hospitals and primary healthcare institutions.
  
  
  
  Of the 704 participants (response rate = 70.2 %), the majority had positive and moderate knowledge (39.2 and 53.3 %) and attitudes (35.8 and 62.9 %) towards NEMS. The most participants were aware of the implementation time of NEMS (89.8 %) and zero mark-up policy (85.5 %) while the least learned of the adjustment time of National Essential Medicines List (NEML). Pharmacists from public secondary/tertiary hospitals tended to know more and have more positive attitudes. There was no statistical correlation between knowledge and attitude scores. The education level (p = 0.022) and number of training sessions attended (p = 0.028) were the only demographic variables linked to knowledge scores.
  
  
  
  Hospital pharmacists in Shaanxi Province had moderate knowledge of and attitudes towards the implementation of NEMS. Pharmacists from public secondary/tertiary hospitals showed better understanding. The government should therefore focus on improving the understanding of pharmacists in primary healthcare institutions and also address existing problems, especially the supply and distribution systems.
authors.affiliation: Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, No. 76 West Yanta Road, Xi'an, Shaanxi, 710061, China.|Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Shen
authors.affiliation: Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, No. 76 West Yanta Road, Xi'an, Shaanxi, 710061, China.|Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China.
authors.forename: Caijun
authors.initials: C
authors.lastname: Yang
authors.affiliation: Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, No. 76 West Yanta Road, Xi'an, Shaanxi, 710061, China.|Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Chang
authors.affiliation: Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, No. 76 West Yanta Road, Xi'an, Shaanxi, 710061, China.|Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China.
authors.forename: Lina
authors.initials: L
authors.lastname: Wu
authors.affiliation: Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, No. 76 West Yanta Road, Xi'an, Shaanxi, 710061, China.|Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China.
authors.forename: Wenwen
authors.initials: W
authors.lastname: Zhu
authors.affiliation: Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, No. 76 West Yanta Road, Xi'an, Shaanxi, 710061, China.|Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Lv
authors.affiliation: Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, No. 76 West Yanta Road, Xi'an, Shaanxi, 710061, China.|Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Ye
authors.affiliation: Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, No. 76 West Yanta Road, Xi'an, Shaanxi, 710061, China.|Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China.
authors.forename: Shimin
authors.initials: S
authors.lastname: Yang
authors.affiliation: Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, No. 76 West Yanta Road, Xi'an, Shaanxi, 710061, China. yufang@mail.xjtu.edu.cn.|Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China. yufang@mail.xjtu.edu.cn.
authors.forename: Yu
authors.initials: Y
authors.lastname: Fang
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002681:China; D018954:Drugs, Essential; D005260:Female; D018166:Health Care Reform; D007722:Health Knowledge, Attitudes, Practice; D006779:Hospitals, Public; D006801:Humans; D008297:Male; D008875:Middle Aged; D010595:Pharmacists / Q000523:psychology*; D010607:Pharmacy Service, Hospital; D011320:Primary Health Care; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D018954:Drugs, Essential
keywords: Attitudes; Knowledge; National Essential Medicines System (NEMS); Pharmacists; Primary healthcare institution; Public secondary/tertiary hospital