3000张门诊处方点评与分析  

Review and Analysis of 3000 Outpatient Prescriptions

作　　者：毛俊[1] 刘慧茹[1] 曹靓 胡泊[1] 廖振东 周珂 李帆 金涌[2] 孟祥云[1] MAO Jun;LIU Huiru;CAO Liang;HU Po;LIAO Zhendong;ZHOU Ke;LI Fan;JIN Yong;MENG Xiangyun(Dept.of Pharmacy,the Second People’s Hospital of Hefei,Hefei 230026,China;Key Laboratory of Anti Inflammatory And Immune Drugs Education,School of Medicine,Anhui Medical University,Hefei 230032,China)

机构地区：[1]合肥市第二人民医院药学部,合肥230026 [2]安徽医科大学药学院抗炎免疫药物教育部重点实验室,合肥230032

出　　处：《中国医院用药评价与分析》2022年第4期490-493,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：安徽省自然科学基金项目(No.1808085MH284);合肥市医学重点学科建设资助项目(合卫科教[2019]160号)。

摘　　要：目的:了解合肥市第二人民医院(以下简称“该院”)门诊处方情况,降低门诊处方不合理率。方法:对2021年1—3月该院门诊药房随机抽取的3000张电子处方进行点评和归纳总结,并按照不合理处方类型进行帕累托分析。结果:3000张门诊处方中,合理处方2937张,处方合理率为97.90%。63张不合理处方中,不规范处方28张,占44.44%;不适宜处方26张,占41.27%;超常处方9张,占14.29%。抗菌药物处方738张(占总处方数的24.60%),抗菌药物处方数排序居前3位的科室为妇科、呼吸科和消化科。2021年1—3月,该院门诊处方合理率分别为97.50%、98.90%和97.30%,抗菌药物使用率分别为23.50%、25.80%和24.50%,国家基本药物使用率分别为35.60%、38.70%和36.90%。结论:该院门诊处方总体合理率和抗菌药物使用率未达到三级综合医院评审标准的要求,其中处方超量、用法与用量不适宜、抗菌药物未按规定使用和无正当理由未首选国家基本药物是目前存在的主要问题。定期进行处方点评是规范临床合理用药,保障患者用药有效性和安全性的有效手段。OBJECTIVE:To investigate the status of outpatient prescriptions in the Second People’s Hospital of Hefei(hereinafter referred to as“the hospital”),so as to reduce the irrational rate of outpatient prescriptions.METHODS:From Jan.to Mar.2021,3000 electronic prescriptions randomly extracted from the outpatient pharmacy of the hospital were reviewed and summarized,and Pareto analysis was performed according to irrational prescription types.RESULTS:Among the 3000 outpatient prescriptions,2937 prescriptions were rational,with the rational rate of 97.90%.Of the 63 irrational prescriptions,28(44.44%)were non-standard prescriptions,26(41.27%)were inappropriate prescriptions,and 9(14.29%)were abnormal prescriptions.There were 738 antibacterial prescriptions(24.60% of total prescriptions),and the top 3 departments ranked by antibacterial prescriptions were gynecology department,respiratory department and gastroenterology department.From Jan.to Mar.2021,the monthly prescription qualified rates were respectively 97.50%,98.90% and 97.30%,the proportions of antibiotics were respectively 23.50%,25.80% and 24.50%,and the proportions of national essential drugs were respectively 35.60%,38.70% and 36.90%.CONCLUSIONS:The overall qualified rate of outpatient prescriptions and the proportion of antibiotics in the hospital do not meet the requirements of the evaluation standard of tertiary general hospitals,among them,off-label prescriptions,inappropriate usage and dosage,non-use of antibiotics according to regulations,and non-preferred national essential drugs without justifiable reasons are major problems.Regular prescription review is an effective approach to standardize clinical rational drug use and ensure the effectiveness and safety of patients’drug use.

关 键 词：门诊药房 处方点评 帕累托图 抗菌药物 合理用药 

分 类 号：R97[医药卫生—药品]