前置处方审核中西药联用药物相互作用规则的建立及优化  

Establishment and optimization of drug interaction rules for the combination of western and Chinese medicine in pre-prescription review

作　　者：张晓茹 李大奇[2] 石树青 何静 王然 刘伟 张元庆 ZHANG Xiaoru;LI Daqi;SHI Shuqing;HE Jing;WANG Ran;LIU Wei;ZHANG Yuanqing(Institute Office,Guangwai Hospital,Xicheng District,Beijing100055,China;Medical Insurance Office,Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Beijing100053,China;Department of Cardiovascular,Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Beijing100053,China;Department of Medical,Guangwai Hospital,Xicheng District,Beijing100055,China;Department of Information,Guangwai Hospital,Xicheng District,Beijing100055,China;West Pharmacy,Guangwai Hospital,Xicheng District,Beijing100055,China;Chinese Pharmacy,Guangwai Hospital,Xicheng District,Beijing100055,China)

机构地区：[1]北京市西城区广外医院院办,北京100055 [2]中国中医科学院广安门医院医保办,北京100053 [3]中国中医科学院广安门医院心血管科,北京100053 [4]北京市西城区广外医院医务科,北京100055 [5]北京市西城区广外医院信息科,北京100055 [6]北京市西城区广外医院西药房,北京100055 [7]北京市西城区广外医院中药房,北京100055

出　　处：《中国医药导报》2024年第14期121-124,共4页China Medical Herald

基　　金：国家自然科学基金青年科学基金资助项目(82205096)。

摘　　要：目的 以建立医院前置处方审核中西药联用相互作用规则和管理制度为手段,提高中西药联合应用水平。方法 通过访谈法查找前置处方审核中西药联用存在的问题,通过文献及其他资料查阅建立中西药不合理联用数据库,以数据库为依据设置前置处方审核中西药联用规则。调取北京市西城区广外医院2022年1月至12月门急诊处方,采用PDCA循环法进行药物相互作用规则及管理制度优化,比较优化前后中西药联用的合理性水平。结果 建立了57类147种中药、61类148种西药不合理联用数据库。经过四轮PDCA循环管理建立前置审核中西药联用相互作用规则和管理制度后,中西药联用不合理处方占比由9.11%降至2.44%,干预处方医师修改率由82.93%升至95.45%、医师考核平均分数由79.30分升至94.25分。结论 通过前置处方审核中西药不合理联用处方规则的建立,能提高中西药不合理联用水平,降低因不合理联用带来的风险。Objective To improve the level of the combined application of Chinese and western medicine by establishing the interaction rules and management system of pre-prescription review in hospital.Methods The problems existed in the pre-prescription review of the combination application of Chinese and western medicine were found through interviews,and the unreasonable combined use database of Chinese and western medicine was established through literatures and other materials,and the rules of the pre-prescription review were set up according to the database.The outpatient and emergency prescriptions of Guangwai Hospital,Xicheng District of Beijing,from January to December 2022 were obtained,and the drug interaction rules and management system were optimized by PDCA cycle method,and the rationality level of combined application of Chinese and western medicine before and after optimization was compared.Results A database of 57 kinds of 147 kinds of Chinese medicine and 61 kinds of 148 kinds of western medicine was established.After four rounds of PDCA cycle management and the establishment of pre-review interaction rules and management system for the combination of western and Chinese medicine was established,the proportion of unreasonable prescriptions for the combination of traditional Chinese and western medicine decreased from 9.11%to 2.44%,the modification rate of intervention prescription by physicians increased from 82.93%to 95.45%,and the average assessment score of physicians increased from 79.30 scores to 94.25 scores.Conclusion Through the establishment of the prescription rules for the irrational combination application of Chinese and western medicine in the pre-prescription review,the level of irrational combination of Chinese and western medicine can be improved and the risk caused by irrational combination can be reduced.

关 键 词：前置处方审核 中西药联用 药物相互作用 数据库 

分 类 号：R95[医药卫生—药学]