某三甲西医院门诊中成药退药的帕累托图分析

Pareto diagram analysis of Chinese patent medicine return reasons in out-patient pharmacy of hospital

目的分析该院门诊药房中成药退药的主要原因，促进临床合理用药。方法利用Excel软件对该院2010年1月～2012年12月的中成药退药数据进行处理，并应用帕累托图分析退药原因。结果帕累托图分析显示，药物不良反应（30％）、患者依从性（24％）和不合理用药（23％）是造成退药的主要因素；患者病情变化（10％）、患者自身因素（8％）为次要因素；医生录入错误（5％）为一般因素。结论针对造成西医医院中成药退药现象的主要因素，应提升医师辨证辨病使用中成药的水平，提高药师中药药学服务主动性，加强处方事前干预，提高患者用药依从性，有效减少西医院中成药退药现象的发生。

Objective To investigate the main reasons for Chinese patent medicine withdrawal and promote rational clinical medication. Methods The drug withdrawal data during Jan.2010 to Dem.2012 was processed with Excel software and the reasons for drug withdrawal were analyzed with the pareto diagram. Results The main reasons for drug withdrawal were adverse drug reactions（30%）, patient＇s compliance（24%） and irrational drug use（23%）. The secondary reason were changes in the patient＇s condition（10%） and factors in the patient＇s own（8%）.Conclusion According to the main reasons for drug withdrawal, physician＇s ability of dialectical identifying diseases for using Chinese patent medicine, pharmaceutical service, prescription intervention beforehand and patient＇s medication compliance should be strengthened for an acceptable drug withdrawal rate.