MTP干预法对门诊患者抗菌药物合理应用的影响

Impact of MTP interventions on reasonable use of antibiotics in outpatient department

目的探讨监测-培训-计划(MTP)干预模式对门诊患者抗菌药物合理使用的干预效果。方法参照合理用药国际网络(WHO/INRUD)选择性用药指标调研方法(SDUIS),设置抗菌药物合理应用观察指标;采用MTP干预模式,每月对门诊患者抗菌药物合理应用进行干预,连续干预4次,比较干预前后观察指标值的变化。结果经过4次MTP干预后,门诊患者抗菌药物的使用率、平均用药时间、联合用药率、注射剂使用率及抗菌药物平均药费和抗菌药物金额百分比,分别由干预前的23.67%、4.52d、14.22%、49.29%、50.31元、51.98%下降至干预后的15.80%、2.19d、1.27%、11.39%、8.31元、10.37%,抗菌药物品种选择合理率由58.37%提高至92.73%,差异均有统计学意义(P<0.05)。结论 MTP合理用药干预模式能有效提高门诊患者抗菌药物的合理使用,具有较高的临床推广价值。

OBJECTIVE To investigate the effect of monitoring-training-planning（MTP） intervention on the rational application of antibiotics in outpatient department.METHODS By referring to the selected drug use indicators（SDUIS） of WHO/INRUD,the observational indicators for the rational use of antibiotics were established;by means of MTP intervention mode,the intervention in the reasonable use of antibiotics was performed monthly for the outpatients for consecutive four times,the change of the indicators was observed before and after the interventions.RESULTS After the MTP intervention for 4 times,the utilization rate,average medication duration,combination use rate,utilization rate of injections,average cost of antibacterials,and the proportion of antibacterials amount respectively decreased from 23.67%,4.52d,14.22%,49.29%,50.31yuan and 51.98% before the interventions to 15.80%,2.19d,1.27%,11.39%,8.31yuan and 10.37% after the interventions,and the percentage of reasonable selection of antibiotics increased from 58.37% to 92.73%,the differences were statistically significant（P〈0.05）.CONCLUSION The MTP intervention mode is feasible and effective in promoting the rational application of antibacterials in outpatient department,which is also worthy of the clinical promotion.