我院门诊药房退药处方分析及改进策略  

Analysis and strategy of drug return in out-patient pharmacy of our hospital

作　　者：王先利[1] 杨振宇[1] 曾涛[1] 

机构地区：[1]复旦大学附属妇产科医院药剂科,上海200011

出　　处：《中国临床药学杂志》2014年第3期173-176,共4页Chinese Journal of Clinical Pharmacy

基　　金：上海医院药学科研基金(编号2010-YY-02-13)

摘　　要：目的分析我院退药具体情况及原因,提出相关改进措施,以减少退药和促进合理用药。方法收集本院2012年1月1日至12月31日门诊中西医药房退药处方1 876张,从退药率、退药药品分类、退药原因三方面进行分析。结果本院门诊药房总退药率为0.25%,所退药品西药占66.91%,中成药占33.09%。西药退药按用途分为:诊断辅助用药(25.81%)、口服抗菌药物(22.79%)、外用药(18.55%)、门诊手术用药(14.23%)、口服性激素类(8.55%)、其他(10.06%)。通过门诊退药登记分析退药原因有:药品不良反应(24.63%)、医患沟通不够(20.42%)及治疗方案更改(17.32%)等。结论重视药品不良反应,加强医师-患者-药师沟通,提高医师、药师服务质量和业务水平,从而促进患者用药依从性的提高,减少门诊退药;同时完善现有的退药制度,保障所退药品的质量,确保患者用药安全、有效、经济。AIM To analyze the characteristics and reasons of outpatient drug return in our hospital, so as to put forward relevant countermeasures to reduce drug return and guarantee the safety of drug use. METHODS A total of 1 876 pieces of returned prescriptions were collected in our out-patient pharmacy from January 1, 2012 to December 31, 2012. The ratio of drug return, the classification of returned drugs and the reasons of drug return were analyzed. RESULTS The ratio of drug return in our hospital was 0.25 %. Two kinds of drugs leading to drug return were western medicine up to 66.91% and Chinese Patent Drugs up to 33.09 %. The returned western medicine were classified into six kinds by usage ： drug for diagnostic aids （ 25.81% ）, antimicrobials for oral use （ 22.79 % ）, drugs for external use （18.55 % ）, drugs for outpatient surgery （ 14.23 % ）, sex hormones for oral use （8.55 % ） and others （ 10.06 % ）. The main reasons of drug return were adverse drug reaction （ADR） （24.63 % ）, insufficient communication between doctors and patients（20.42% ）, change of therapy regimens（17.32% ） and so on. CONCLUSION We should pay attention to ADR, strengthen the communication among the doctors, patients and phamareists, and enhance the level of medical staff＇s service and professional skills so as to improve patient drug compliance and to reduce drug return. Meanwhile, the system of drug return shoud be modified to guarantee the quality of return drugs and final ensure drug use safely, effectively and economically.

关 键 词：门诊药房 退药 药品不良反应 医患沟通 

分 类 号：R95[医药卫生—药学]