某院系统审核+药师复核模式下处方前置审核的应用效果与典型病例分析  

Application Effect of Prescription Pre-Review Under the Mode of″Systematic Review and Pharmacist Review″in a Hospital and a Typical Case Analysis

作　　者：文静 藕顺龙 罗静 邹昌文[1] 胥亚福 蒋倩[2,3] WEN Jing;OU Shunlong;LUO Jing;ZOU Changwen;XU Yafu;JIANG Qian(Sichuan Aba Tibetan and Qiang Autonomous Prefecture People's Hospital,Aba,Sichuan,China 621000;Sichuan Cancer Hospital&Insti-tute·Sichuan Cancer Center,Chengdu,Sichuan,China 610041;School of Medicine,University of Electronic Science and Technology of China,Chengdu,Sichuan,China 610054)

机构地区：[1]四川省阿坝藏族羌族自治州人民医院,四川阿坝621000 [2]四川省肿瘤医院研究所·四川省癌症防治中心,四川成都610041 [3]电子科技大学医学院,四川成都610054

出　　处：《中国药业》2023年第11期108-111,共4页China Pharmaceuticals

基　　金：四川省卫生健康委员会医学科技项目[21PJ115]。

摘　　要：目的评价某院系统审核+药师复核模式下处方前置审核的应用效果。方法以《临床用药须知》《医院处方点评管理规范(试行)》《陈新谦新编药物学(第18版)》及药品说明书、相关临床指南等构建个性化的审核规则库,对门诊用药医嘱进行精准审核和有效拦截不合理医嘱。分别收集某院经合理用药监测系统(PASS)审核(实施前,2021年10月至2022年1月)与系统审核+药师复核(实施后,2022年2月至5月)的门(急)诊处方47787张和45277张,进行处方点评,并对典型病例进行分析。结果实施后,医师修改后处方合理率从96.34%升至99.00%(P<0.05),系统审核后医师修改率从0.74%升至62.74%(P<0.05)。不合理用药类型主要为超适应证、给药途径不适宜、联合用药不恰当、特殊人群用药禁忌、给药剂量不合理、重复用药。结论系统审核+药师复核模式下处方前置审核能促进审方药师与医师的沟通,提高临床合理用药水平,保证患者用药安全。Objective To evaluate the application effect of prescription pre-review under the mode of"system review+pharmacist review".Methods According to the Clinical Medication Guidelines,Hospital Prescription Review Management Standards(Trial),Chen Xinqian New Pharmacology(18th Edition),package insert of drugs,and relevant clinical guidelines,a personalized review rule library of a hospital was constructed to accurately review and effectively intercept outpatient medication orders.A total of 47787 prescriptions reviewed by the Prescription Automatic Screening System(PASS)from October 2021 to January 2022(before the implementation)and 45277 prescriptions reviewed by the mode of"system review+pharmacist review"from February to May 2022(after the implementation)in a hospital were collected to conduct the prescription review and the typical case analysis.Results After the implementation,the reasonable rate of revised prescriptions by physicians increased from 96.34%to 99.00%(P<0.05),and the physician's modification rate after system review increased from 0.74%to 62.74%(P<0.05).The main types of unreasonable drug use included medication without indication,inappropriate administration route,inappropriate drug combination therapy,drug contraindications of special populations,unreasonable drug dosage,and repeated drug use.Conclusion The prescription pre-review under the mode of"system review+pharmacist review"can promote the communication between the prescription pharmacists and physicians,improve the level of clinical rational medication,and ensure the medication safety of patients.

关 键 词：系统审核 药师复核 处方前置审核 处方合理率 合理用药 

分 类 号：R95[医药卫生—药学]