福建省某三甲医院合理用药规则设置及对处方前置审核效果分析  

Analysis on the setting of rational medication rules and the effect of pre-audit of prescriptions in a Class A tertiary hospital in Fujian Province

作　　者：游文兵 吉小丽 阮一方 YOU Wenbing;JI Xiaoli;RUAN Yifang(Department of Pharmacy,Fuzhou Second General Hospital,Fujian,Fuzhou 350007,China)

机构地区：[1]福州市第二总医院药学部,福建福州350007

出　　处：《中国医药科学》2025年第4期164-168,共5页China Medicine And Pharmacy

摘　　要：目的探讨福州市第二总医院(本院)合理用药管理系统自定义规则的设置,处方干预流程及分析系统上线前后处方干预效果。方法以药品说明书为主,权威诊疗规范、临床指南等循证证据为辅,设置适应证、用法用量、相互作用、重复用药、用药禁忌、特殊人群用药等多维度合理用药规则及不同警示等级。对不合格处方按风险程度给予不同的处理流程,并在实践中不断完善规则。回顾上线前后处方干预率、处方干预成功率、处方点评合理率,分析处方干预效果。结果2020年7月系统上线后至2022年6月本院设置自定义规则共计3580条,2020、2021、2022年1—6月不合格处方干预率分别为1.29%、1.96%、1.89%,2021、2022年干预率均高于2020年,2022年干预率低于2021年,差异有统计学意义(P<0.05);2021、2022年不合格处方干预成功率分别为93.54%,93.99%,较2020年的87.93%高,差异有统计学意义(P<0.05)。系统上线后对用药与诊断不符、用法用量错误、重复用药、不良相互作用及其他类型不合格处方的干预率较上线前均提高,差异有统计学意义(P<0.05);2021年与2022年用法用量不适宜、用药与诊断不符、存在不良相互作用等类型不合格处方的干预率比较,差异有统计学意义(P<0.05)。2020、2021、2022年1—6月处方点评合理率分别为94.72%、99.18%、99.85%,处方合理率逐年提高,差异有统计学意义(P<0.05)。结论通过设置并持续完善合理用药规则,可以有效提高不合格处方干预率,提高医院合理用药水平。Objective To introduce the setting of self-defined rules of rational medication management system in Fuzhou Second General Hospital(our hospital),the process of prescription intervention and the effect of prescription intervention before and after the system goes online.Methods Based on drug instructions,supplemented by evidence-based information such as authoritative diagnosis and treatment norms and clinical guidelines,multi-dimensional rational medication rules and different warning levels such as indications,usage and dosage,interaction,repeated medication,contraindications,and medication for special groups were set up.Different treatment processes were given to unqualified prescriptions according to the degree of risk,and the rules were constantly improved in practice.Before and after going online,the rate of prescription intervention,the success rate of prescription intervention and the reasonable rate of prescription review were reviewed,and the effect of prescription intervention were analyzed.Results From July 2020 to June 2022,there were 3,580 self-defined rules in our hospital.The rates of unqualified prescription intervention from January to June of 2020,2021 and 2022 were 1.29%,1.96%and 1.89%,respectively.The intervention rates in 2021 and 2022 were all higher than that in 2020,and the intervention rate in 2022 was lower than that in 2021,with statistically significant differences(P<0.05).The success rate of unqualified prescription intervention was 93.54%in 2021 and 93.99%in 2022,which were higher than 87.93%in 2020,with statistically significant difference(P<0.05).The intervention rate of medication inconsistent with diagnosis,incorrect usage and dosage,repeated medication,adverse interaction and other types of unqualified prescriptions increased after the system went online,with statistically significant differences(P<0.05).Compared of intervention rate of unqualified prescriptions with inappropriate usage and dosage,medication inconsistent with diagnosis,and adverse interactions between 2021 and

关 键 词：合理用药 药品规则 处方干预 处方点评 

分 类 号：R95[医药卫生—药学]