1320份重点监控药物病历合理用药集中评价与分析  

Centralized Evaluation and Analysis of 1 320 Medical Orders of Key Monitoring Drugs

作　　者：刘丛海 罗荔 吴美霖[1] 彭绍贤[1] 张琳[1] 冯靖雄[1] 谭尧月 冯亚男 韩倩 张丽君 黄纯友[1] LIU Conghai;LUO Li;WU Meilin;PENG Shaoxian;ZHANG Lin;FENG Jingxiong;TAN Yaoyue;FENG Yanan;HAN Qian;ZHANG Lijun;HUANG Chunyou(Dept.of Clinical Pharmacy,Dazhou Central Hospital,Sichuan Dazhou 635000,China;Dept.of Medical Administration,Health Commission of Dazhou City,Sichuan Dazhou 635000,China)

机构地区：[1]达州市中心医院临床药学科,四川达州635000 [2]达州市卫生健康委员会医政科,四川达州635000

出　　处：《中国医院用药评价与分析》2019年第9期1134-1136,共3页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：达州市2018年市级医学科研立项课题(No.2018003)

摘　　要：目的:了解四川省达州市(以下简称“该市”)重点监控药物使用情况,分析其合理性,为规范重点监控药物管理提供参考依据。方法:该市卫生健康委员会组建合理用药评价专家组,制定符合区域特点的重点监控药物目录,建立制度体系、评分细则、评价流程和排序规则。采取系统抽样方法,抽取2018年3月该市22家二级以上医疗机构中住院时间为5~30d、使用了重点监控药物的出院病历1320份,进行合理用药集中评价,采用Excel 2017软件对评价结果进行统计与分析。结果:1320份重点监控药物病历中,不合理用药病历351份,占26.59%,中医院和民营医院不合理用药较突出;不合理用药共710例次,其中,无指征用药237例次(占33.38%),用法与用量不适宜263例次(占37.04%),联合用药不适宜185例次(占26.06%),药物遴选不当25例次(占3.52%)。结论:该市重点监控药物的临床应用还存在不合理现象,建议医疗机构加强人才培养,行政主管部门加强监管,促进临床合理用药。OBJECTIVE:To investigate the application of key monitoring drugs in Dazhou,Sichuan (hereinafter referred to as “the city”),the rationality of this method was analyzed,so as to provide reference for standardization of key monitoring drug management.METHODS:Health commission of the city set up a group of rational drug evaluation experts to develop a list of key monitoring drugs in line with regional characteristics,and established the institutional system,scoring rules,evaluation procedures and ranking rules.Systematic sampling method was adopted to extract 1 320 medical orders from 22 secondary medical institutions in the city in Mar.2018,which had been hospitalized for 5-30 d and used key monitoring drugs.Centralized evaluation of rational drug use was conducted.Excel 2017 software was used to make statistics and analysis of the evaluation results.RESULTS:Among the 1 320 medical orders of key monitored drugs,there were 351 irrational medical orders accounted for 26.59%,and the irrational use of drugs mainly concentrated in Chinese medicine hospitals and private hospitals.There were 710 case-times of irrational drug use,among which 237 case-times (33.38%) were without indication,263 case-times (37.04%) were inappropriate in use and dosage,185 case-times (26.06%) were inappropriate in combination,and 25 case-times (3.52%) were improper in drug selection.CONCLUSIONS:There are still some irrational phenomena in the clinical application of key monitoring drugs in the city.It is recommended that medical institutions should strengthen the personnel training,and administrative departments should strengthen supervision and promote clinical rational drug use.

关 键 词：重点监控药物 合理用药 处方点评 评价模式 

分 类 号：R969.3[医药卫生—药理学]