2020年某市基层医疗机构门诊处方点评结果分析  

Analysis of the results of outpatient prescription review in a city′s primary medical institutions in 2020

作　　者：谢飞 周虹 徐建华 XIE Fei;ZHOU Hong;XU Jianhua(Haian People′s Hospital,Jiangsu Province,Haian 226600,China)

机构地区：[1]江苏省海安市人民医院,226600

出　　处：《临床合理用药杂志》2023年第32期25-28,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的 调查分析2020年某市基层医疗机构门诊不合理处方存在的问题,为临床合理用药提供参考。方法 随机抽取某市33家基层医疗机构2020年9月某天的门诊处方3 257张进行点评,采用帕累托法分析处方不合理的原因。结果 3 257张处方中,抗菌药物处方825张,抗菌药物使用率为25.33%;合理处方2 958张,合理率为90.82%,不合理处方299张,不合理率为9.18%。帕累托法分析显示:主要不合理处方类型为适应证不适宜(87张,29.10%)、用法、用量不适宜(64张,21.40%),以及临床诊断书写不全(52张,17.39%)。次要不合理处方类型为遴选的药品不适宜(43张,14.38%)和开具麻醉、精神药品未使用专用处方(18张,6.02%),其余为一般不合理处方类型。结论 基层医疗机构门诊处方依然存在不足之处,基层医师和药师应加强学习专业知识,医院应完善处方点评相关制度并落实到位,卫生主管部门应着力推进市级医院为主体的医联体建设,利用三级医院的优质资源对基层医疗机构进行帮扶,实现各级医院同质化管理。Objective To investigate and analyze the issues of inappropriate prescriptions in the outpatient clinics of primary healthcare institutions in a certain city in 2020,in order to provide references for rational drug use in clinical practice.Methods A total of 3257 outpatient prescriptions from 33 primary healthcare institutions in a certain city were randomly selected for review on a specific day in September 2020.The Pareto analysis method was used to analyze the reasons for the presence of inappropriate elements in these prescriptions.Results Among the 3257 prescriptions,there were 825 prescriptions for antimicrobial drugs,resulting in an antimicrobial utilization rate of 25.33%.Out of them,there were 2958 appropriate prescriptions(90.82%)and 299 inappropriate prescriptions(9.18%).Pareto analysis revealed that the main types of inappropriate prescriptions were inappropriate indications(87 prescriptions,29.10%),inappropriate dosage or administration(64 prescriptions,21.40%),and incomplete clinical diagnosis documentation(52 prescriptions,17.39%).The secondary types of inappropriate prescriptions included unsuitable drug selection(43 prescriptions,14.38%)and failure to use dedicated prescriptions for anesthesia and psychotropic drugs(18 prescriptions,6.02%).The remaining prescriptions fell into the category of general inappropriate prescriptions.Conclusion There are still deficiencies in the outpatient prescriptions of primary healthcare institutions.Primary physicians and pharmacists should enhance their professional knowledge,while hospitals should improve the relevant prescription review systems and implement them effectively.The health authorities should focus on promoting the establishment of medical consortia with municipal hospitals as the main body,utilizing the high-quality resources of tertiary hospitals to support primary healthcare institutions,in order to achieve standardized management across all levels of hospitals.

关 键 词：处方点评 基层医疗机构 门诊处方 帕累托法 

分 类 号：R95[医药卫生—药学]