信息系统辅助抗肿瘤药物处方审核分析  

Analysis of Review of Anti-tumor Drug Prescriptions Assisted by Information System

作　　者：程凯[1] 王欢 杜春晓[1] 马雪[1] 商磊 胡志强 漆婷婷 CHENG Kai;WANG Huan;DU Chunxiao;MA Xue;SHANG Lei;HU Zhiqiang;QI Tingting(Department of Pharmacy,Sichuan Cancer Hospital&Institute,Sichuan Cancer Center,Affiliated Cancer Hospital of University of Electronic Science and Technology of China,Chengdu 610041,China;School of Pharmacy,Chengdu Medical College,Chengdu 610041,China)

机构地区：[1]四川省肿瘤医院·研究所、四川省癌症防治中心,电子科技大学附属肿瘤医院药学部,成都610041 [2]成都医学院药学院,成都610041

出　　处：《医药导报》2024年第1期47-53,共7页Herald of Medicine

基　　金：四川省干部保健科研课题(川干研2021-805);四川省肿瘤医院优秀青年基金(YB2021028)。

摘　　要：目的 分析信息系统辅助抗肿瘤药物处方及医嘱审核的问题,针对性完善审核规则,为提高抗肿瘤药物处方审核的质量提供参考。方法 收集四川省肿瘤医院2020—2022年信息系统辅助抗肿瘤药物处方及医嘱审核的问题,数据来源于医院美康合理用药监测系统(PASS),由临床药师对相关问题进行点评,对点评结果及相关问题进行分析。结果 共收集抗肿瘤药物处方审核问题9 325条,其中门诊处方6 279条(67.3%),住院医嘱3 046条(32.7%);适应证不适宜6 153条(66.0%),药物禁忌证1 933条(20.7%),给药途径不适宜449条(4.8%),药品配伍不适宜345条(3.7%),用药频次不适宜177条(1.9%),用药人群不适宜133条(1.4%),单次剂量不适宜74条(0.8%),药物相互作用不适宜39条(0.4%),药品总量不适宜22条(0.2%)。临床药师点评结果为合理的4 459条,假阳性率为47.8%,假阳性问题包括:适应证不适宜2 264条(50.8%),药物禁忌证1 933条(43.3%),给药途径不适宜231条(5.2%),用药人群不适宜31条(0.7%)。结论 信息系统辅助抗肿瘤药物处方审核可有效拦截不合理用药问题,提升处方和医嘱的审核质量,但抗肿瘤药物循证医学证据更新快,药师应结合最新的循证医学证据,不断维护和完善审方规则。Objective To analyze the problems of review of anti-tumor drug prescriptions and medical orders assisted by an information system to improve the review rules,and to provide a reference for improving review quality of anti-tumor drug prescription.Methods The problem with the pre-review of anti-tumor drug prescriptions and medical orders assisted by the information system in Sichuan Cancer Hospital during 2020-2022 were collected.The data came from the MEDICOM PASS system in Sichuan Cancer hospital.Clinical pharmacists made comments on relevant problems and analyzed the results.Results A total of 9325 antitumor drug pre-approval problems,including 6279 outpatient prescriptions(67.3%)and 3046 inpatient orders(32.7%),among which 6153(66.0%)were unsuitable indications,1933(20.7%)were drug contraindications,449(4.8%)were problematic routes of administration,345(3.7%)were unsuitable drug compatibility,177(1.9%)were inappropriate drug frequency,133(1.4%)were problematic drug populations,74(0.8%)were unsuitable single doses,39(0.4%)were unacceptable drug interactions,22(0.2%)were unsuitable drug total.The results of clinical pharmacists'comments were 4459 reasonable cases,with a false positive rate of 47.8%.The false positive problems included 2264(50.8%)cases of unsuitable indications,1933(43.3%)cases of drug contraindications,231(5.2%)cases of problematic routes of administration,and 31(0.7%)cases of unsuitable populations.Conclusion The review of anti-tumor drug prescriptions assisted by an information system can effectively intercept irrational drug use and improve the review quality of prescriptions and medical orders.However,the evidence-based medicine date of antitumor drugs is updated quickly.Pharmacists should constantly improve the prescription review rules based on the latest evidence-based medicine data.

关 键 词：抗肿瘤药物 信息系统 前置审核 

分 类 号：R979.1[医药卫生—药品] R969.3[医药卫生—药学]