北京市19家试点社区卫生服务机构处方集中点评效果分析  

Analysis of the Effect of Centralized Prescription Comment in 19 Community Health Service Institutions from Beijing

作　　者：陈世财[1,2] 杨悦[2] 刘洋[1] 刘宪军[1] 李海燕[1] 

机构地区：[1]首都医科大学潞河教学医院药剂科,北京101100 [2]沈阳药科大学工商管理学院,沈阳110016

出　　处：《中国药房》2014年第28期2662-2665,共4页China Pharmacy

摘　　要：目的:为提高北京市社区卫生服务机构合理用药水平提供参考。方法:依据《处方管理办法》《医院处方点评管理规范(试行)》《中药处方格式及书写规范》等文件要求,对北京市19家试点社区卫生服务机构进行处方集中点评(内容包括处方的一般点评和合理性点评),并对实施处方集中点评干预前、干预1年后、干预2年后3个时间段的处方点评数据进行统计、对比和分析。结果:平均用药品种数从干预前的2.9种降到干预1年后的2.5种,干预2年后仍保持在2.5种;抗菌药物使用率从25.5%下降到18.3%和11.7%;注射剂使用率从8.6%下降到7.5%和6.2%;药品通用名使用率从83.8%上升到96.9%和99.8%,以上指标干预前后比较差异均有统计学意义(P<0.05)。不规范处方比例由干预前的9.7%下降到干预后的4.3%和2.1%;不适宜处方比例由干预前的7.1%下降到3.1%和2.3%;总计不合理处方比例从干预前的16.8%下降到干预后的7.4%和4.4%,干预前后比较差异均有统计学意义(P<0.05)。结论:处方集中点评措施的实施,使北京市试点社区卫生服务机构处方合理率显著提高,合理用药水平和能力得到了持续改进,值得进一步推广。但是,试点社区卫生服务机构在基本药物使用率、平均处方金额等方面仍存在一些不足,有必要加大对医务人员合理用药知识的培训力度,尽可能剥离掉药师所承担的与药学专业无关的工作,进一步提高合理用药监控信息化程度。OBJECTIVE：To provide reference for the improvement of rational drug use in community health service institutions from Beijing. METHODS：Based on＂Prescription Management Method＂,＂Hospital Prescription Review Management Practices（trial）＂and＂TCM Prescription Format and Writing Standards＂,centralized prescription comment（including general comment and rationality comment）was carried out in 19 community health service institutions from Beijing. The data of prescription comment were compared and analyzed statistically before centralized prescription comment,1 and 2 years after intervention. RESULTS：The average number of drug types decreased from 2.9 types before intervention to 2.5 types 1 year after intervention,and that maintained at 2.5 types 2 years after intervention. The percentage of antibiotics use decreased from 25.5% to 18.3% and11.7%;the percentage of injections decreased from 8.6% to 7.5% and 6.2%;the percentage of generic drug name increased from83.8% to 96.9% and 99.8%,respectively. Above index had no statistical significance before and after intervention（P〈0.05）. The percentage of non-standard prescriptions decreased from 9.7% before intervention to 4.3% and 2.1% after intervention. The percentage of inappropriate prescriptions decreased from 7.1% before intervention to 3.1% and 2.3% after intervention. The percentage of unreasonable prescription decreased from 16.8% before intervention to 7.4% and 4.4% after intervention. There was statistical significance before and after intervention（P〈0.05）. CONCLUSIONS：The implementation of centralized prescription comment improve the rationality of prescriptions in Beijing community health service institutions and the ability of rational drug use in community,which is worthy of spreading. There are still some problems in respects of utilization rate of essential medicine,average prescription amount in pilot community health service institutions. It is necessary to strengthen medical staff training about rational drug use,remove

关 键 词：社区卫生服务机构 处方集中点评 效果分析 合理用药 

分 类 号：R969.3[医药卫生—药理学]