用药绩效管理与移动医疗技术对药品使用评价与合理用药的促进研究  

Evaluation of Drug Use and Promotion of Rational Drug Use Through Multidisciplinary Collaboration in Drug Management

作　　者：胡燕君 周燕萍 HU Yanjun;ZHOU Yanping(Outpatient Department of Jingnan Medical Area,Department of Pharmacy,Medical Security Center,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院京南医疗区门诊部,医疗保障中心药剂科,北京100853

出　　处：《中国药学杂志》2023年第24期2294-2298,共5页Chinese Pharmaceutical Journal

摘　　要：目的本研究旨在探讨在重点监控药品管理中加入合理用药绩效管理+移动医疗技术对药品使用评价与合理用药的促进研究。方法针对中国8家医院,对于2020年1月至2023年1月期间患者使用的重点药品监控目录内药品进行了回顾性分析。旨在评估重点药品合理使用绩效管理的实施情况,并探究移动医疗技术措施对药品使用量和金额的影响趋势。抽取8家医院2020年1月—2021年6月维持原有药品管理措施的重点监控药品5000份病历作为监管前数据,抽取8家医院2021年7月—2023年1月实施合理用药绩效管理+移动医疗技术的重点监控药品的5000份病历作为监管后数据。利用间断时间序列模型对比分析两组在药物合理使用率及不合理用药发生率方面的差异。结果采用合理用药绩效管理+移动医疗技术监管重点监控药品后,8家医院5000份病历中16种重点监控药品使用量相对监管前明显下降,且具有统计学意义(P<0.05),咪唑类药物、盐酸地芬诺酯、替硝唑与头孢拉定这4种药物使用量无明显变化;重点监控药品不合理类型没有变化,但无适应证用药及溶媒选择不适宜、医嘱不合理情况比重均较监管前明显下降(P<0.05);使用监管模式前,重点监控药品平均使用合理率为94.57%,采用监管措施后,重点监控药品平均使用合理率为97.18%。升幅为2.61%。监管后重点监控药品使用合格率明显高于监管前,差异具有统计学意义(P<0.05);采用移动医疗技术监管重点监控药品使用前,重点监控药品平均使用金额占比为17.24%,采用监管措施后,重点监控药品平均使用金额占比为13.16%。降幅为4.08%。监管后重点监控药品使用金额占比明显低于监管前,具有统计学差异(P<0.05)。结论在重点监控药品管理中加入合理用药绩效管理+移动医疗技术可以有效提高药物合理使用率,降低不合理用药发生率及使用金额占比,值得临�OBJECTIVE To investigate the promotion of drug utilization evaluation and rational drug use through the addition of performance management for rational drug use and mobile medical technology in key drug monitoring management.METHODS A retrospective analysis was conducted on the trend of drug usage and expenditure before and after the implementation of performance management for rational drug use and mobile medical technology for key drugs listed in the monitoring catalog in 8 Chinese hospitals from January 2020 to January 2023.The data collected included 5000 medical records for key drugs managed with the original drug management measures from January 2020 to June 2021,and 5000 medical records for key drugs managed with performance management for rational drug use and mobile medical technology from July 2021 to January 2023.An interrupted time-series model was used to compare and analyze the differences in the rational drug use rate and the incidence of irrational drug use between the two groups.RESULTS After implementing rational drug use performance management and mobile medical technology supervision to monitor drug usage,the usage of 16 key monitored drugs significantly decreased relative to before the supervision in 5000 medical records from 8 hospitals,and it was statistically significant(P<0.05).The usage of metronidazole,drotaverine hydrochloride,tinidazole,and ceftriaxone did not change significantly.After supervision,there was no change in the types of irrational drug use,but the proportion of inappropriate use of drugs without indications and solvents,and unreasonable medical orders decreased significantly compared with before(P<0.05).The average rational drug use rate for key drugs was 94.57% before the implementation of management measures,and it increased to 97.18% after the implementation,with an increase of 2.61%.The post-management qualified rate for key drugs was significantly higher than that before management,with statistical significance(P<0.05).Before the implementation of mobile medical tec

关 键 词：临床药师 药品管理 药物合理使用 不合理用药 

分 类 号：R95[医药卫生—药学]