处方点评管理制度对提高签约家庭医生用药规范性的效果评价  

The effect of prescription review management system on improving the standardized drug use by contracted family doctors

作　　者：应文光 陈维达 蔡贤丽 YING Wenguang;CHEN Weida;CAI Xianli(Health Service Center in Gaoqiao Township,Haishu District,Ningbo,Zhejiang 315174,China)

机构地区：[1]宁波市海曙区高桥镇卫生院,浙江宁波315174

出　　处：《中国农村卫生事业管理》2021年第6期421-423,429,共4页Chinese Rural Health Service Administration

摘　　要：目的探讨处方点评制度对提高社区签约家庭医生的用药规范性的效果。方法选取实施处方点评制度前社区家庭医生开具的2 316张处方为点评前组,选取实施处方点评制度后社区家庭医生开具的2 482张处方为点评后组,对实施制度前后家庭医生开具处方的合格情况、一般情况以及不合理用药情况等进行比较。结果处方点评制度实施后,家庭医生在书写处方时没标明年龄、临床诊断未规范标注、未规范签名、修改处方没签名、没标注需做皮试、药物用量超标等情况的发生率低于实施前,差异存在着统计学意义(χ^(2)1、2、3、4、5、6=11.569、13.233、9.958、7.739、8.750、12.747,P<0.05);实施处方点评制度后,在没有使用国家基本药物的处方、没有使用药品通用名的处方以及使用抗生素处方等情况的发生率低于实施前,差异存在着统计学意义(χ^(2)1、2、3=14.007、9.808、25.904,P<0.05);实施处方点评制度后,在用量或用法错误、用药与临床诊断不符、存在着配伍禁忌、存在着用药禁忌以及属于重复用药等方面的发生率低于实施前,差异存在着统计学意义(χ^(2)1、2、3、4、5=16.520、19.254、11.499、12.172、10.683,P<0.05)。结论实施处方点评管理制度,有效地规范了家庭医生处方的书写,减少了抗生素的使用量,显著地降低了不合理用药的发生,值得推广。Objective To explore the effect of prescription review management system on improving the standardized drug use of contracted family doctors. Methods A total of 2316 prescriptions made by community family doctors before the implementation of the prescription review system were selected as the pre-review group, and 2482 prescriptions made by community family doctors after implementation of the prescription review system were selected as the post-review group. A comparison was made of the qualified situation, general situation, and irrational drug use among prescriptions of family doctors before and after the implementation of the system. Results After the implementation of the prescription review system, the incidence of family doctors who did not indicate age when prescribing, did not write the clinical diagnosis in a standard way, did not sign in a standard way, did not sign when revising prescription, did not prescribe a skin test, and prescribed excessive drug dosage was lower than that before the implementation with statistical significance(χ21、2、3、4、5、6=11.569, 13.233, 9.958, 7.739, 8.750, 12.747,P<0.05). After the implementation of the prescription review system, the incidence of prescription which did not use national essential medicines, did not use generic names of medicines, and used antibiotics was lower than that before the implementation with statistical significance(χ21、2、3=14.007, 9.808, 25.904, P<0.05). After the implementation of the prescription review system, the incidence of mistake of dosage or usage, the discrepancy between medication and clinical diagnosis, incompatibility, medication contraindications, and repeated medication was lower than that before the implementation with statistical significance(χ21、2、3、4、5=16.520, 19.254, 11.499, 12.172, 10.683, P<0.05). Conclusions The implementation of the prescription review management system effectively standardized the prescribing of family doctors, reduced the use of antibiotics, and reduced irrational drug use. It is w

关 键 词：处方点评 家庭医生 用药规范性 效果比较 基本药物 抗生素处方 重复用药 

分 类 号：R197[医药卫生—卫生事业管理] R49[医药卫生—公共卫生与预防医学]