PRECEDE理论联合多学科协作模式用于特殊使用级抗菌药物管理效果分析  

Application Effect of PRECEDE Theory Combined with Multi-Disciplinary Team in the Management of Specialized Antibacterial Drugs

作　　者：姜黎 吴倪 李波[1] 尚天琼 陈和平 徐智 刘天虎 JIANG Li;WU Ni;LI Bo;SHANG Tianqiong;CHEN Heping;XU Zhi;LIU Tianhu(The Third affiliated Hospital of Chengdu Medical College·Pidu District People's Hospital,Chengdu,Sichuan,China 611730)

机构地区：[1]成都医学院第三附属医院·四川省成都市郫都区人民医院,四川成都611730

出　　处：《中国药业》2023年第12期26-29,共4页China Pharmaceuticals

基　　金：四川省卫生和计划生育委员会科研课题[18PJ541];四川省高校人文社会科学重点研究基地科研项目[SCYG2018-18];四川省成都市医学科研课题[2018013]。

摘　　要：目的探讨PRECEDE理论联合多学科协作(MDT)模式用于特殊使用级抗菌药物(SAD)管理的效果。方法基于PRECEDE理论,调查影响医师SAD处方行为的倾向因素、促成因素和强化因素;据此构建MDT管理模式,并对SAD进行实时管理;比较干预前(2018年)和干预后(2019年)医院SAD的使用金额、用药频度(DDDs)、限定日费用(DDC)、使用强度(AUD)、药物利用指数(DUI)、使用前送检率、使用率、使用人次、细菌耐药率等指标的变化。结果与干预前比较,干预后SAD的使用金额构成比降低5.33%,DDDs降低8.89%,AUD降低45.16%,使用前送检率升高0.96%,使用人次减少65.65%;亚胺培南、氨曲南的铜绿假单胞菌耐药率分别由8.87%和19.80%降至3.28%和14.60%。结论PRECEDE理论联合MDT模式可进一步规范SAD的使用。Objective To investigate the application effect of PRECEDE theory combined with multi-disciplinary team(MDT)mode in the management of specialized antibacterial drugs(SADs).Methods According to the PRECEDE theory,the predisposing factors,enabling factors and reinforcing factors of physicians′prescribing behavior on SADs were investigated,on this basis,an MDT management mode was constructed,and the real-time management for SADs was carried out.The changes of SADs-related indicators such as the total cost,defined daily doses(DDDs),defined daily cost(DDC),antimicrobial use density(AUD),drug utilization index(DUI),specimen submission rate before use,use rate,cases of use and drug-resistance rate of bacteria in the hospital before the intervention(2018)and after the intervention(2019)were compared.Results Compared with those before the intervention,the ratio of total cost decreased by 5.33%,DDDs decreased by 8.89%,AUD decreased by 45.16%,specimen submission rate before use increased by 0.96%,and cases of use decreased by 65.65%after the intervention.Compared with those before the intervention,the resistance rate of Pseudomonas aeruginosa to imipenem decreased from 8.87%to 3.28%,and that to aztreonam decreased from 19.80%to 14.60%.Conclusion PRECEDE theory combined with MDT mode can further standardize the use of SADs.

关 键 词：PRECEDE理论 多学科协作 特殊使用级抗菌药物 用药管理 临床药师 

分 类 号：R95[医药卫生—药学]