2017-2018年上海市金山区延伸处方开具现状调查及患者执行依从性分析  

Investigation on the Situation of Prescribing Extended Prescription and Analysis of Patient’s Compliance in Execution in Jinshan District of Shanghai from 2017 to 2018

作　　者：冒长青 沈卫华 郭澄[2] MAO Changqing;SHEN Weihua;GUO Cheng(Dept.of Pharmacy,Jinshan Branch of the Shanghai Sixth People’s Hospital,Shanghai 201599,China;Dept.of Pharmacy,Sixth People’s Hospital of Shanghai,Shanghai 200233,China)

机构地区：[1]上海市第六人民医院金山分院药剂科,上海201599 [2]上海市第六人民医院药剂科,上海200233

出　　处：《中国药房》2019年第21期2886-2889,共4页China Pharmacy

基　　金：国家自然科学基金资助项目（No.81873042）;金山区卫生和计划生育委员会青年项目（No.JSKJ-KTQN-2018-06）;上海市药学会科研基金（No.2018-YY-23）

摘　　要：目的:为社区延伸处方的管理和药学服务开展提供理论依据和数据支持。方法:从上海市金山区整体及其管辖的11个街镇的卫生信息系统数据库中导出2017-2018年所有使用延伸处方患者的数据,采用回顾性调查方法,分析延伸处方患者的基本医疗信息、延伸处方执行依从性(2年内坚持通过延伸处方进行就诊配药)信息等数据,并分析影响依从性的因素。结果:2017-2018年金山区开具延伸处方的患者4835例,开具率(延伸处方开具人数/开具处方人数)为2.08%,以60岁以上(4038例,83.51%)、常见慢病患者[4793例次,83.18%(4793/5763)]为主,不同街镇延伸处方开具率之间比较,差异有统计学意义(P<0.05);金山区延伸处方患者执行依从率总体为81.62%(62.02%~88.84%),不同性别患者的延伸处方执行依从率差异无统计学意义(P>0.05),年龄、疾病种类、延伸处方药品种类数等因素对延伸处方患者执行依从率有影响,以年龄在40岁以下、高血压、慢性气道疾病患者、开具1种药品的患者的延伸处方执行依从率低于同组其他患者(P<0.05)。结论:未来可探索利用大数据对延伸处方的执行依从性进行监测,同时在家庭医生团队中加入药师的工作,针对依从性低的群体制订相应的指导和宣教,提高延伸处方患者用药的合理性、有效性。OBJECTIVE:To provide theoretical basis and data support for community extended prescription management and pharmaceutical care.METHODS:Data of all patients using extended prescription from 2017 to 2018 were derived from the health information system database of Jinshan district of Shanghai and 11 streets towns under its jurisdiction.Retrospective survey was used to analyze the basic medical information of extended prescription patients and the compliance with extended prescription execution(insisting on dispensing drugs through extended prescription within 2 years),and the factors affecting compliance were analyzed.RESULTS:From 2017 to 2018,there were 4835 patients with Jinshan district extended prescription,with prescribing rate(number of extended prescriptions/number of prescriptions)of 2.08%,mainly patients over 60 years old(4038 cases,83.51%)and patients with common chronic diseases[4793 casetimes,83.18%(4793/5763)];there was statistical significance in the prescribing rate of extended prescription among different streets and towns(P<0.05).The overall compliance rate of extended prescription patients in Jinshan district was 81.62%(62.02%-88.84%).There was no significant difference in compliance rate of extended prescription execution between male and female patients(P>0.05).Age,type of disease and types of extended prescription drugs had influence on compliance rate of extended prescription patients.Compliance rate of extended prescription in patients under 40 years of age or hypertension and chronic airway disease or those who were given one kind of drug was lower than other patients in same group(P<0.05).CONCLUSIONS:Big data can be used for monitoring the compliance of extended prescription in the future.At the same time,pharmacists participating in family doctor team formulate relevant guidance and education for poor compliance group so as to improve the rationality and effectiveness of extended prescription for patients.

关 键 词：上海市 金山区 延伸处方 依从性 药学服务 大数据 

分 类 号：R197.1[医药卫生—卫生事业管理]