医药联动模式在抗肿瘤药物处方点评中的实践  

Practice of Pharmaceutical Linkage Model in the Prescription Review of Anti-Tumor Drugs

作　　者：徐立伟 刘敏 XU Liwei;LIU Min(Dept.of Medical Affairs,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China;Dept.of Pharmacy,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院医务处,北京100021 [2]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院药剂科,北京100021

出　　处：《中国医院用药评价与分析》2024年第10期1277-1280,共4页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:探讨医药联动模式在抗肿瘤药物处方点评中的作用,为抗肿瘤药物处方点评提供新的思路。方法:以该院2022年、2023年全年的抗肿瘤药物处方为研究对象(分别为35864、39845张),采用帕累托图分类和鱼骨图分析不合理处方产生的主要原因。医务处联合药剂科梳理管理流程,依据国家法规、诊疗指南和专家共识,针对处方点评难点持续改进。结果:诊断不全或诊断不规范是2022年不合理处方的主要类型,占70.93%(410/578)。信息系统中规则制定不全面、临床药师与医师沟通不及时、合理用药培训覆盖不全面是产生不合理处方的主要原因。通过医药联动使用PDCA循环改进和效果评价,形成了处方点评的闭环管理。2023年,该院处方不合理率降至1.33%(528/39845),与2022年的1.61%(578/35864)比较,差异有统计学意义(P<0.05)。结论:医药联动点评模式强调团队合作、跨部门协作和持续改进,可以提高抗肿瘤药物处方质量和合理用药水平。OBJECTIVE:To explore the role of the pharmaceutical linkage model in the review of anti-tumor drug prescriptions,so as to provide new ideas for the review of anti-tumor drug prescriptions.METHODS:Taking the anti-tumor drug prescriptions of the hospital in 2022 and 2023 as the research objects(with 35864 and 39845 prescriptions,respectively),Pareto chart classification and fishbone chart were used to analyze the main causes of irrational prescriptions.Management process was sorted out by the Department of Medical Affairs and Pharmacy.According to national regulations,diagnosis and treatment guidelines and expert consensus,the difficulties in prescription review were continuously improved.RESULTS:Incomplete or non-standard diagnosis was the main type of irrational prescriptions in 2022,totally 70.93%(410/578).The main reasons for irrational prescription were the incomplete formulation of rules in the information system,the lack of timely communication between clinical pharmacists and clinicians,and the incomplete coverage of rational drug use training.Through the use of PDCA cycle improvement and effect evaluation through pharmaceutical linkage,a closed-loop management of prescription reviews had been established.In 2023,the irrational rate of prescriptions in the hospital decreased to 1.33%(528/39845),which was statistically significant compared with 1.61%(578/35864)in 2022(P<0.05).CONCLUSIONS:The pharmaceutical linkage model emphasizes teamwork,cross-departmental collaboration and continuous improvement,which can improve the quality of prescription and level of rational medication.

关 键 词：抗肿瘤药物 处方点评 帕累托图 鱼骨图 PDCA循环 医药联动 

分 类 号：R979.1[医药卫生—药品]