今日药学

2022, v.32(05) 387-391

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处方前置审核对提高某院中成药临床合理使用的效果评价
The Effect Evaluation of Prescription Pre-review on Improving the Clinical Rational Use of Chinese Patent Medicine in A Hospital

何莹;薛建文;徐钊;谢灵波;
HE Ying;XUE Jianwen;XU Zhao;XIE Lingbo;The Seventh Affiliated Hospital,Sun Yat-sen University;

摘要(Abstract):

目的 探究处方前置审核对提高某院中成药合理用药水平的影响。方法 选取某院门急诊2019年、2020年、2021年同期5月11日~12月31日(上述时间在后文用2019年、2020年、2021年依次替代)共88 490张中成药处方,采用对照、回顾性研究方法分析中成药不合理处方情况。结果 该院于2019年5月使用天际健康临床合理用药智能管理系统开始处方前置审核试运行。处方前置审核开展前期,中成药不合理处方问题突出,主要涉及适应证不适宜、用法用量不适宜、重复用药不适宜。目前该院中成药处方不合理使用情况显著减少,不合理处方的比例由2019年13.85%降低至2021年5.73%。其中适应证不适宜处方数由2019年的3 680张(总处方31 232张,适应证不合理占比11.78%)下降至2021年1 116张(总处方31 221张,适应证不合理占比3.57%);用法用量不适宜处方数由2019年的538张下降至2021年的23张。儿科不合理处方比例由2019年的15.53%下降到2021年的1.56%,妇科不合理处方比例由2019年的11.45%下降到2021年的2.16%。结论 处方前置审核可有效规范临床开具中成药处方,实时审核处方的合理性,确保合理的处方才能进入收费环节,显著减少不合理用药,提高患者用药安全。
OBJECTIVE To analyze the influence of prescription pre-review on improving the rational drug use of Chinese patent drug in a hospital.METHODS A total of 88,490 Chinese patent prescriptions were selected from the hospital during May 11 th to December 31 th of 2019,2020 and 2021(replaced by 2019,2020 and 2021 in the article) to analyze the rational drug use of Chinese patent drug by comparative,retrospective research methods.RESULTS In May 2019,our hospital started the prescription pre-review with the help of intelligent management system for clinical rational use of drugs from Tianji Health company.In the early stage of the prescrip tion pre-review,the problem of unreasonable prescription of Chinese patent medicine was prominent,mainly involving inappropriate indications,inappropriate usage and dosage,and repeated drug use.At present,the unreasonable use of Chinese patent drug in the hospital had decreased significantly.The proportion of irrational prescriptions had decreased from 13.85% in 2019 to 5.73%in 2021,while the prescriptions' number of inappropriate indications decreased from 3 680 in 2019(total prescriptions were 31 232,proportion of total prescriptions was 11.78%) to 1 116 in 2021(total prescriptions were 31 221,proportion of total prescriptions was3.57%),and the prescriptions' number of inappropriate usage and dosage decreased from 538 in 2019 to 23 in 2021.The proportion of irrational prescription of pediatric decreased from 15.53%(2019) to 1.56%(2021).Meanwhile,the proportion of irrational prescription of gynecology decreased from 11.45%(2019) to 2.16%(2021).CONCLUSION The prescription pre-review can effectively standardize the clinical prescription of Chinese patent medicine,check the rationality of the prescription in time,ensure only the reasonable prescription can be charged,and significantly reduce the unreasonable drug use and improve the drug safety of patients.

关键词(KeyWords): 合理用药;处方前置审核;慢性病管理;基础规则库;中成药知识培训
reasonable drug use;prescription pre-review;chronic disease management;basic rule database;Chinese patent medicine knowledge training

Abstract:

Keywords:

基金项目(Foundation): 广东省医院协会药学科研专项基金(恒瑞)(2021YSQN01)

作者(Authors): 何莹;薛建文;徐钊;谢灵波;
HE Ying;XUE Jianwen;XU Zhao;XIE Lingbo;The Seventh Affiliated Hospital,Sun Yat-sen University;

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