住院病历合理用药量化评分体系的效果评估  

Performance Assessment of Quantitative Scoring System of Rational Use of Drugs in Inpatient Prescriptions

作　　者：杨水源[1] 梅清华[1] 童艳丽[1] 郑妮[1] 杨妍[1] 吉家兴[1] 吴宏[1] 

机构地区：[1]广东省第二人民医院,广东广州510317

出　　处：《今日药学》2018年第1期63-65,共3页Pharmacy Today

基　　金：广东省医学科学技术研究基金(C2016012)

摘　　要：目的探讨住院病历合理用药量化评分体系在促进合理用药中的效果。方法设置住院病历合理用药量化评分表,内容包括一般性治疗用药、抗菌药物、辅助治疗药物、特殊管理药品、医保用药、基本用药、药占比、药品不良反应及其他项目(如严重配伍禁忌、无正当理由开具高价药品、给药途径不适宜等),进行量化评分。定期随机抽取病历,由临床药师填写住院病历合理用药量化评分表,并就评分结果与主管医生进行反馈及干预。结果 2014~2016年,住院病历合理用药评分不合格率由16.39%下降至7.22%,住院药占比由46.03%下降至35.86%,住院基本药物金额占比由6.65%提高至9.10%,住院抗菌药物使用金额占比由18.11%下降至15.95%,住院抗菌药物使用率由48.24%下降至42.01%,住院抗菌药物使用强度由52.37 DDD/(100人·天)下降至40.88 DDD/(100人·天)。结论住院病历合理用药量化评分体系有助于合理用药整体达标,减少药品滥用,促进合理用药。OBJECTIVE To discuss the effect of rational drug use quantification scoring system in hospital medical records on the promotion of rational drug use index. METHODS To set up a quantitative score table for rational drug use in inpatient records,the content includes general treatment,antibacterial drugs,adjuvant therapy drugs,special management drugs,medical insurance drugs,basic drugs,drug-taking ratio,adverse drug reactions and other（such as serious incompatibility,unreasonable reasons to prescribe high priced drugs, inappropriate routes, etc.）, quantitative grading. The clinical pharmacists were randomly selected to fill in the quantitative score table of the hospital medical record and to provide feedback and intervention on the score results. RESULTS From 2014 to 2016,the utilization rate of rational drug records decreased from 16.39% to 7.22%. The proportion of inpatient drugs decreased from 46.03% to 35. 86%. The proportion of basic drug was increased from 6. 65% to 9. 10%. The amount and the utilization rate of antibiotics was decreased from 18.11% to 15.95% and 48.24% to 42.01%,respectively. The intensity of antibacterial decreased from 52.37 DDD/（100 person·day） to 40.88 DDD/（100 person·day）. CONCLUSION The quantitative scoring system of rational drug use in inpatient medical records is helpful to achieve the reasonable standards of drug use,reduce drug abuse and promote rational drug use.

关 键 词：合理用药 住院病历 量化评分 运行效果 

分 类 号：R969.3[医药卫生—药理学]