门诊处方和住院医嘱点评及用药合理性的分析

目的:总结并分析我院门诊处方和住院医嘱的点评情况以及用药的合理性。方法:随机选取我院2022年1月-7月的中成药、中药门诊处方各700张,出院病历各210份,每个月各为100张,30份。统计处方不合理情况。结果:在抽取的910张中药处方中(包括门诊处方和住院医嘱),不合理处方21张,不合理率为2.31%,合理处方889张,占比为97.69%;中成药不合理处方12张,不合理率为1.32%;合理处方898张,合理率为98.68%。中成药不合理处方中,用法用量不适宜占比为50.00%均高于重复用药的41.67%和有配伍禁忌的8.33%,且重复用药率高于有配伍禁忌(P<0.05);中成药不合理处方中针灸二科、骨伤科、内科、外科各1张,占比为8.33%;疼痛科2张,占比为16.67%;针灸科、急诊科各3张,占比为25.00%,见表2。中药不合理处方中,内一科、内二科各8张,占比为38.1%;针灸科、急诊科各2张,占比为9.52%;骨伤科1张,占比为4.76%。结论:我院不合理处方主要集中在内科、急诊科、针灸科和疼痛科,不合理处方类型主要为用法用量不适宜和重复用药,实际中药师应进一步加强对处方的审核及点评力度,促进合理用药。

Objective:The review of outpatient prescriptions and inpatient orders in our hospital and the rationality of drug use were summarized and analyzed.Methods:700 outpatient prescriptions of proprietary Chinese medicine and traditional Chinese medicine and 210 discharge medical records were randomly selected in our hospital from January to July 2022,with 100 and 30 medical records each month.Statistics of unreasonable prescriptions.Results:Among 910 TCM prescriptions(including outpatient prescriptions and inpatient orders),21 were unreasonable prescriptions,the irrational rate was 2.31%,and 889 were reasonable prescriptions,accounting for 97.69%.There were 12 irrational prescriptions of proprietary Chinese medicine,and the irrational rate was 1.32%.There were 898 rational prescriptions,the rationality rate was 98.68%.Among the irrational prescriptions of proprietary Chinese medicine,the proportion of inappropriate usage and dosage(50.00%)was higher than that of repeated medication(41.67%)and that of incompatibility(8.33%),and the rate of repeated medication was higher than that of incompatibility(P<0.05).Among the unreasonable prescriptions of PCM,acupuncture and rehabilitation department,orthopedics and traumatology department,internal medicine and surgery department had one each,accounting for 8.33%;2 in the pain department,accounting for 16.67%;The two department of acupuncture and moxibustion and the Department of emergency were 3 pieces,accounting for 25.00%,as shown in Table 2.Among the irrational prescriptions of TCM,the first department of internal medicine and the second department of internal medicine were 8,accounting for 38.1%;The department of acupuncture and moxibustion and the department of emergency were 2,accounting for 9.52%;One was in the department of Bone and Traumatology,accounting for 4.76%.Conclusion:Irrational prescriptions were mainly concentrated in internal medicine,acupuncture and pain department in emergency department of our hospital,and the types of irrational prescriptions were mainly inappropriate usage and dosage and repeated drug use.In practice,Chinese pharmacists should further strengthen the review and comment of prescriptions to promote rational drug use.