我院儿童合理用药数据库的构建与应用  

Construction and application of rational drug use database for children in our hospital

作　　者：蒋志平[1] 彭骞[1] 王方杰[1] 周志红[1] 胡外光[1] JIANG Zhiping;PENG Qian;WANG Fangjie;ZHOU Zhihong;HU Waiguang(Dept.of Pharmacy,Hunan Children’s Hospital,Changsha 410007,China)

机构地区：[1]湖南省儿童医院药学部,长沙410007

出　　处：《中国药房》2023年第8期1005-1009,共5页China Pharmacy

基　　金：湖南省科学技术厅临床医疗技术创新引导项目(No.2020SK50511);湖南省卫生健康委员会科研项目(No.202213043925)。

摘　　要：目的 构建我院儿童合理用药数据库,为保障儿童用药安全提供参考。方法 通过搭建知识库基本架构、制定儿童用药证据质量等级参考标准,提炼儿童用药循证证据,完成儿童合理用药知识库的构建与填充。从患者信息初步判定规则、药品基本信息规则、处方适宜性审核规则、结果标记及后处理规则四方面设计和构建儿童合理用药规则库。将数据库嵌入我院处方审核系统并上线应用,检验其效果。结果 构建了1套包含672个儿科常用药品、15 000多条儿童合理用药规则的数据库。数据库应用后(2021年12月-2022年5月)的住院儿童不合理医嘱拦截率平均值为2.03%,高于数据库应用前(2021年6月-2021年11月)的0.80%(χ^(2)=5 784.389,P<0.001);经事后抽样和处方点评,数据库应用后的儿童出院病历用药医嘱平均合格率为99.10%,高于数据库应用前的94.58%(χ^(2)=301.237,P<0.001)。结论 基于循证证据自主构建的儿童合理用药数据库,贴近医疗机构儿科临床实际需求,能有效减少儿科临床不合理用药行为,提高处方合格率,保障儿童用药安全。OBJECTIVE To establish a database of rational drug use for children in our hospital,and to provide reference for ensuring the safety of drug use in children.METHODS The construction and filling of the knowledge base of rational drug use for children were performed by establishing the basic structure of the knowledge base,formulating reference standards for the quality level of pediatric medication evidence,and refining evidence-based evidence of pediatric medication.The rule base of rational drug use for children was designed and built from four aspects:preliminary determination rules for patient information,basic drug information rules,prescription suitability review rules,result labeling and post-processing rules.The database was embedded into prescription review system of our hospital and was applied online to test its effectiveness.RESULTS A set of database containing 672 commonly used pediatric medicines and more than 15000 rules for rational drug use for children was initially constructed.The average interception rate of unreasonable medical orders for hospitalized children after database application(from December 2021 to May 2022)was 2.03%,and was higher than 0.80%before database application(from June 2021 to November 2021)(χ^(2)=5784.389,P<0.001);after post-sampling and prescription review,the average qualified rate of medication orders in discharged medical records for children after the application of the database was 99.10%,and was higher than 94.58%before the application of the database(χ^(2)=301.237,P<0.001).CONCLUSIONS Self-constructed evidence-based rational drug use database for children is close to the actual clinical needs of pediatrics in medical institutions,which can effectively reduce clinical irrational drug use behaviors in pediatrics,improve the pass rate of prescriptions,and ensure the safety of children’s drug use.

关 键 词：儿童 合理用药 数据库 处方前置审核 

分 类 号：R95[医药卫生—药学]