某院门/急诊前置审方系统中抗菌药物规则库精细化管理效果评价  

Effect Evaluation of the Refined Management of Antibacterial Drug Rule Base in Pre-Prescription Review System of Outpatient/Emergency Departments in Our Hospital

作　　者：陈勉维 杨宏图 常翠 李莹 吴富天 谢守霞 CHEN Mianwei;YANG Hongtu;CHANG Cui;LI Ying;WU Futian;XIE Shouxia(Shenzhen People′s Hospital·The Second Clinical Medical College,Jinan University·The First Affiliated Hospital,Southern University of Science and Technology,Shenzhen,Guangdong,China 518020)

机构地区：[1]广东省深圳市人民医院·暨南大学第二临床医学院·南方科技大学第一附属医院,广东深圳518020

出　　处：《中国药业》2023年第14期38-42,共5页China Pharmaceuticals

基　　金：广东省深圳市医学重点学科建设项目[SZXK059];广东省深圳市人民医院临床研究培育项目[SYLCYJ202108]。

摘　　要：目的促进门/急诊抗菌药物的合理使用。方法统计医院前置审方系统上线并稳定运行1年中门/急诊抗菌药物处方事后专项点评(简称专项点评)中存在的不合理用药问题,分析不合理类型及产生原因,据此寻找前置审方系统中抗菌药物管理规则存在的不足,以专项点评结果为规则修改依据,并以此对抗菌药物规则库进行精细化管理。比较管理前(2018年9月至2019年8月)及管理后(2020年9月至2021年8月)的专项点评结果。结果管理前,专项点评不合理处方3146张,不合理类型包括遴选药物不适宜(1720张,54.67%),用法用量不适宜(766张,24.35%),适应证不适宜(620张,19.71%)等。管理后,处方合理率在处方量增加近1倍的情况下仍有升高(由管理前的95.17%升至管理后的97.53%)。前述不合理类型不合理率分别由管理前的2.64%,1.18%,0.95%降至管理后的0.56%,1.03%,0.89%,降幅分别为78.79%,12.71%,6.32%。结论该院门/急诊前置审方系统中抗菌药物规则库的针对性改进和精细化管理,可促进相应药物在临床的合理使用。Objective To promote the rational use of antibacterial drugs in outpatient/emergency departments.Methods The irrational medication problems in the special review of prescriptions with antibacterial drugs in the outpatient/emergency departments during the one-year stable operation of the pre-prescription review system after launch in the hospital were recorded.The types and causes of irrationality were analyzed,on this basis,the deficiencies of the management rules for antibacterial drugs in the pre-prescription review system were identified,and the antibacterial drug rule base was managed refinedly with the results of special review as the basis of rule modification.The results of special review before the management(September 2018 to August 2019)and after the management(September 2020 to August 2021)were compared.Results Before the management,there were 3146 irrational prescriptions in the special review.The types of irrationality included inappropriate drug selection(1720 prescriptions,54.67%),inappropriate usage and dosage(766 prescriptions,24.35%),inappropriate indications(620 prescriptions,19.71%)and so on.After the management,the rational rate of prescriptions still increased despite the quantity of prescriptions nearly doubling(from 95.17%before the management to 97.53%after the management).The irrational rates of inappropriate drug selection,inappropriate usage and dosage,inappropriate indications decreased from 2.64%,1.18%,0.95%before the management to 0.56%,1.03%,0.89%after the management respectively,with a decrease rate of 78.79%,12.71%,6.32%respectively.Conclusion The targeted improvement and refined management of the antibacterial drug rule base in the pre-prescription review system of outpatient/emergency departments in the hospital can promote the rational use of corresponding drugs in clinical practice.

关 键 词：前置审方规则 抗菌药物 处方专项点评 精细化管理 合理用药 

分 类 号：R95[医药卫生—药学]