基于药品动态监测的合理用药项目化管理实践  

Practice of project management of rational drug use based on dynamic drug monitoring

作　　者：杨秀丽[1] 石佳娜 郑小春[1] 严洁萍[1] 胡颖[1] 叶晓兰[1] 毛小红[1] 张夙[1] 罗丹[1] 祁金文[1] 黄萍 Yang Xiuli;Shi Jiana;Zheng Xiaochun;Yan Jieping;Hu Ying;Ye Xiaolan;Mao Xiaohong;Zhang Su;Luo Dan;Qi Jinwen;Huang Ping(Center for Clinical Pharmacy&Department of Pharmacy,Zhejiang Provincial People′s Hospital(Affiliated People′s Hospital,Hangzhou Medical College),Hangzhou 310014,China)

机构地区：[1]浙江省人民医院(杭州医学院附属人民医院)临床药学中心、药学部,杭州310014

出　　处：《中华医院管理杂志》2024年第3期224-229,共6页Chinese Journal of Hospital Administration

基　　金：国家自然科学基金(72204073);浙江长三角健康科研基金项目(2022CSJ-A001)。

摘　　要：药品动态监测是临床合理用药管理的重要抓手。2020年3月,某三级医院建立了药品使用动态监测系统,将药品动态监测结果与药品合理性评价相结合,由医院药事管理与药物治疗委员会下设的工作小组对不合理用药问题突出的异动药品采取合理用药项目化管理,逐项推进落实,形成合理用药闭环管理。2020年3月至2022年12月,某医院先后开展了辅助用药、围手术期预防用药和抗菌药物3类药物的合理用药项目化管理实践。实践后,2022年辅助用药收入占比为1.17%,较2019年下降26.88%;骨科质子泵抑制剂预防应激性溃疡的合理率从2019年的53.53%升至2022年的75.12%,围手术期雾化吸入制剂预防用合理率从55.80%升至89.80%;抗菌药物使用强度从2019年的51.30降至2022年的39.28。基于医院药品使用动态监测的合理用药项目化管理能促进临床合理用药,提高工作效率,形成全院"提质、控费、增效"的合理用药局面,可为其他医院加强精细化合理用药管理提供参考。Dynamic drug monitoring is an important tool for rational clinical drug management.In March 2020,a tertiary hospital established a dynamic monitoring system for the use of medicines.The working group under the Hospital Pharmacy Management and Drug Therapy Committee combined the results of dynamic monitoring of medicines with the evaluation of rationality of medicines,adopted the project management of rational use of medicines for dissimilar medicines with outstanding irrationality problems,and promoted the implementation of the projects one by one,so as to form the closed-loop management of rational use of medicines.From March 2020 to December 2022,the hospital carried out rational drug use project management for 3 categories of drugs:adjuvants,perioperative prophylaxis and antimicrobials.After practice,the revenue share of adjunctive medications was 1.17%in 2022,with a decrease of 26.88%from 2019;Orthopedic proton pump inhibitor prophylaxis for stress ulcers was justified from 53.53%in 2019 to 75.12%in 2022,and prophylactic use of perioperative nebulized inhalation agents was justified from 55.80%to 89.80%;The intensity of antimicrobial drug use wais justified from 51.30 in 2019 to 39.28 in 2022.Based on the dynamic monitoring of drug use in hospitals,the rational drug use project management promoted the rational use of drugs in clinical practice,improved work efficiency,and formed a rational drug use situation of"improving quality,controlling costs,and increasing efficiency"in the whole hospital,which could provide references for other hospitals to strengthen the fine rational drug management.

关 键 词：药品动态监测 项目化管理 闭环管理 合理用药 药学服务 

分 类 号：R954[医药卫生—药学]