某三甲综合医院2023年门急诊处方的合理用药点评分析  

Analysis of Comments on Rational Drug Use for Outpatient and Emergency Prescriptions in a Grade A Tertiary General Hospital in 2023

作　　者：秦楠 张美 郑爽[1] 沈海娟[1] 李轶[1] QIN Nan;ZHANG Mei;ZHENG Shuang;SHEN Hai-juan;LI Yi(Department of Pharmacy,The First Affiliated Hospital of Soochow University,Suzhou Jiangsu 215006,China)

机构地区：[1]苏州大学附属第一医院药学部,江苏苏州215006

出　　处：《抗感染药学》2024年第7期703-707,共5页Anti-infection Pharmacy

摘　　要：目的:分析医院2023年门急诊处方的合理用药点评情况,为促进临床合理用药提供参考。方法:抽取2023年1—12月苏州大学附属第一医院的15060张门急诊处方作为研究资料,采集处方中患者的年龄、性别、诊断,以及药物的种类、剂型、用法、用量等信息,依据相关指南、共识、药品说明书等资料对处方进行合理用药点评,分析不合理用药的主要原因和科室分布。结果:处方点评结果显示,15060张处方中,不合理处方有146张,不合理发生率为0.97%;此外,全年门诊的抗菌药物使用率为7.00%,而国家基本药物使用率为65.73%;146张不合理处方中,不合理用药的主要原因为“用法用量不适宜”(62张,占42.47%)和“适应证不适宜”(37张,占25.34%),次要原因为“医师签名盖章不规范”(20张,占13.70%);146张不合理处方基本涉及医院所有门急诊科室,而不合理率最高的前3个科室依次为普外科、消化内科和放疗科,其不合理发生率依次为1.75%、1.60%和1.60%。结论:医院2023年门急诊的用药情况整体较为合理,但仍存在一些问题,应加大检查和培训的力度,从而促进临床合理用药,确保用药的安全性。Objective:To analyze the comments on rational drug use for outpatient and emergency prescriptions in the hospital in 2023,and provide a reference for promoting rational drug use in clinical practice.Methods:A total of 15060 outpatient and emergency prescriptions from the First Affiliated Hospital of Soochow University from January to December 2023 were selected as research data.The information such as patients'ages,sex and diagnosis,and type,dosage form,usage and dosage of drugs in the prescriptions was collected,and comments on rational drug use for the prescriptions were made based on relevant guidelines,consensus,package inserts of drugs and other relevant data,and the main reasons for irrational drug use and department distribution were analyzed.Results:The results of comments on prescriptions showed that among 15060 prescriptions,there were 146 irrational prescriptions,with an irrational incidence of 0.97%.In addition,the use rate of antibacterial drugs in the outpatient clinics throughout the year was 7.00%,while the use rate of national essential drugs was 65.73%.Among the 146 irrational prescriptions,the main reasons for irrational drug use were"inappropriate usage and dosage"(62 prescriptions,42.47%)and"inappropriate indications"(37 prescriptions,25.34%),and the secondary reason was"irregular signature and seal of physicians"(20 prescriptions,13.70%).The 146 irrational prescriptions basically involved all outpatient and emergency departments of the hospital,and the top three departments with the highest irrational rates were general surgery,gastroenterology and radiotherapy departments,with irrational incidences of 1.75%,1.60%and 1.60%,respectively.Conclusion:The overall drug use in the outpatient and emergency departments of the hospital in 2023 is relatively rational,but there are still some problems.The inspection and training should be strengthened to promote clinical rational drug use and ensure the medication safety.

关 键 词：门诊处方 处方点评 合理用药 综合医院 

分 类 号：R969.3[医药卫生—药理学]