慢病患者长处方的安全性评价  

Safety of long-term prescriptions for chronic diseases

作　　者：王彧杰[1] 原永芳[1] WANG Yu-jie;YUAN Yong-fang(Department of Pharmacy,Shanghai Ninth People’s Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200011)

机构地区：[1]上海交通大学医学院附属第九人民医院药剂科,上海200011

出　　处：《中南药学》2021年第10期2189-2193,共5页Central South Pharmacy

基　　金：上海交通大学医学院新型冠状病毒感染肺炎抗疫相关药事管理与合理用药研究专项课题(No.JDYX2020KYZX006);上海市“医苑新星”青年医学人才培养资助计划(No.沪卫计人事[2019]72号)。

摘　　要：目的建立慢病患者处方安全性评价量表,评估长处方对患者药物治疗安全性的影响。方法根据知信行理论,利用德尔菲法设计评价量表。对量表的信度和效度进行检验后,对2020年4月1日至6月30日门诊慢病长处方患者用药安全性进行调查。结果此次专家设计的量表权威程度为0.882,信度为0.813,各问题的支持率大于70%,变异系数均小于0.25,具有良好的内容效度。慢病患者对慢病药物治疗的知识、认同度以及依从性方面的认同均超过80%。但长处方组中有20%患者自行调整过药物或用法用量,显著高于正常处方组(11.7%);长处方组患者维持率高于正常处方组。长处方患者中认真阅读药品说明书的患者控制率高,约登指数达到0.83。结论长处方对患者的治疗控制率高,疫情期间对于慢病稳定期的患者可开具长处方,但应重点提示患者治疗期间勿自行调整药物剂量,用药前应重视阅读药品说明书。Objective To evaluate the prescription safety for patients with chronic diseases and assess the safety of long-term prescriptions.Methods Safety evaluation scale was designed with Delphi method by knowledge-attitude-behavior theory.After establishing the reliability and validity of the scale,a survey was conducted on the safety of medication for the outpatients with chronic diseases from April 1,2020 to June 30,2020.Results The authority of the scale was 0.882 and the reliability was 0.813.The approval rate of each question was higher than 70%,and the coefficient of variation was lower than 0.25,indicating good efficacy of the scale.More than 80%of the patients showed good knowledge,attitude and compliance.However,20%of the patients in the long-term prescription group adjusted their medication plan,versus 11.7%in the normal prescription group.The maintenance rate of patients in the long-term prescription group was higher than that in the normal prescription group.Among the longterm prescription patients,those who carefully read the drug instructions had a high control rate,and the Youden index was 0.83.Conclusion During the COVID-19 epidemic,long-term prescriptions is useful for the patients with stable chronic diseases.Patients with long-term prescriptions are prone to selfadjusting the drugs dosage.It is recommended that pharmacists strengthen the guidance in this regard.

关 键 词：慢病 德尔菲法 长处方 安全性评价 

分 类 号：R96[医药卫生—药理学]