某医共体内区域智能审方系统应用效果评价  

Application Effect of Regional Intelligent Prescription-Review System in a Medical Community

作　　者：胡晓蕾 周均 刘佳[1] 杨昕伟 刘梦英 毛文琴 唐玲[1] HU Xiaolei;ZHOU Jun;LIU Jia;YANG Xinwei;LIU Mengying;MAO Wenqin;TANG Ling(Chongqing University Shapingba Hospital,Chongqing,China 400030)

机构地区：[1]重庆大学附属沙坪坝医院,重庆400030

出　　处：《中国药业》2023年第24期44-46,共3页China Pharmaceuticals

基　　金：重庆市科卫联合医学科研项目[2022MSXM057];重庆市沙坪坝区决策咨询与管理创新项目[沙科局发[2022]27号]。

摘　　要：目的提高基层医疗机构药学服务能力。方法纳入某院牵头医疗服务共同体(简称医共体)内15家基层医疗机构,分别随机抽取每家医疗机构2022年9月、12月及2023年1月门诊处方各40张,共1800张,按审方方式的不同分为智能审方组(区域智能审方系统审方)和人工审方组(5名低年资药师独立审方),各900张。两组初审后,均由2位高年资药师独立交叉复审。分析处方审核准确性、用药教育情况及区域智能审方系统的应用效果。结果智能审方组,初审不合理处方38张(4.22%),复审不合理处方367张(40.78%),开展用药教育6962条;人工审方组分别为64张(7.11%),392张(43.56%),223条;两组初审、复审不合理处方率均相当(P>0.05),但2种审核方式均存在漏审、错审,且准确率均较低。结论区域智能审方系统具有一定可行性,但仍需进一步完善。同时还应持续加强审方药师的专业技能培训,推进上下级医疗机构处方流转审核模式,保证区域内各级医疗机构药学服务连续化、同质化,提高药学服务能力,从而保障患者用药安全有效。Objective To improve the pharmaceutical care level of grassroot medical institutions.Methods A total of 15 grassroot medical institutions in a medical community led by a hospital were included.A total of 1800 outpatient prescriptions of the medical institutions in September 2022,December 2022 and January 2023 were randomly selected,with 40 per hospital in each time period,and the prescriptions were divided into the intelligent prescription-review group(by regional intelligent prescription-review system)and the manual prescription-review group(reviewed independently by five junior pharmacists)based on different review methods,with 900 in each group.After the preliminary review,the two groups were given crossed re-review by two senior pharmacists independently.The accuracy of prescription review,medication education and application effect of the regional intelligent prescription-review system was analyzed.Results There were 38,64 irrational prescriptions in preliminary review(4.22%,7.11%),367,392 irrational prescriptions in re-review(40.78%,43.56%),and 6962,223 items of medication education were carried out in the intelligent prescription-review group and manual prescription-review group respectively.The proportions of irrational prescriptions in preliminary review and re-review in the two groups were similar(P>0.05),but both review methods had the missed-review and wrong-review problems,and their accuracy was both low.Conclusion The regional intelligent prescription-review system is feasible,but it still needs further improvement.At the same time,we should continue to strengthen the professional skills training of prescription review pharmacists,promote the prescription circulation review mode of upper-and lower-level medical institutions,ensure the continuity and homogeneity of pharmaceutical care at all levels of medical institutions in the region,improve pharmaceutical care level to ensure the medication safety and effectiveness of patients.

关 键 词：区域智能审方系统 医共体 基层医疗机构 药学服务 处方流转 用药安全 

分 类 号：R95[医药卫生—药学]