心理疾病门诊处方500例点评

Review of Five Hundred Cases of Outpatient Prescriptions for Mental Illness

目的:对500例心理疾病门诊处方进行点评,以提高心理疾病用药安全。方法:选取2023年1—6月广州医科大学附属第二医院心理科门诊处方500张及其患者500例进行研究,根据患者性别、年龄等构成情况,依据心理疾病药品规范、说明书相关要点和使用等进行审核评价。结果:500例心理疾病门诊处方中,45~64岁患者占比较多(37.80%);女性患者占比最多(68.20%);疾病种类方面,焦虑症(焦虑障碍)占比最多(43.40%);≥3种药物处方占比最多(62.20%)。西药使用频率前三位分别为阿普唑仑、西酞普兰、奥沙西泮;中成药使用频率前三位分别为疏肝解郁胶囊、舒眠胶囊、乌灵胶囊。不合格处方类型及构成情况分析,不规范处方出现频率最高(33.63%),其次为超适应证处方(31.09%)。结论:针对心理疾病门诊开展处方点评发现,临床应对心理疾病制定针对性的临床用药质量管理改进措施,进一步对心理门诊医师进行培训,尽可能避免其不规范行为,降低处方不合格率,保障患者用药安全。

Objective:To review five hundred cases of outpatient prescriptions for mental illness in order to improve the safety of medication for psychological disorders.Methods:Five hundred outpatient prescriptions of the Department of Psychology of the Second Affiliated Hospital of Guangzhou Medical University and 500 cases of its patients from January to June 2023 were selected for the study.According to the composition of patients'gender and age,the review and evaluation were conducted based on the drug specification for mental illness,the relevant points of the instruction manual and the use.Results:Among the five hundred outpatient prescriptions for mental illness,patients aged forty-five to sixty-four years accounted for more(37.80%);female patients accounted for the most(68.20%);in terms of the type of disease,anxiety disorders(anxiety disorders)accounted for the most(43.40%);and≥3 drug prescriptions accounted for the most(62.20%).The top three frequencies of western medicines were alprazolam,citalopram and oxazepam;the top three frequencies of proprietary Chinese medicines were Shugan Jieyu capsule,Shumian capsule and Wuling capsule.The analysis of the type and composition of substandard prescriptions showed that the frequency of substandard prescriptions was the highest(33.63%),followed by super-indication prescriptions(31.09%).Conclusion:The prescription review for mental illness outpatient clinics found that clinical should develop targeted clinical medication quality management improvement measures for psychological disease,further training for psychological outpatient physicians,avoiding as much as possible their irregular behavior,reducing the prescription failure rate,and guaranteeing the safety of patients'medication.