我院“医改”后2013年1-5月门诊药房处方点评情况与不合理处方分析

Analysis of Outpatient Pharmacy Prescription Review and Unreasonable Prescriptions in Our Hospital after Medical Reform from Jan. to May in 2013

目的:对某院"医改"后2013年1-5月门诊药房处方点评结果进行分析,以提高医院合理用药水平。方法:根据《处方管理办法》《医院处方点评管理规范(试行)》等,抽取该院2013年1-5月中每月第1个连续5个工作日的门诊处方,采取处方四级点评、四级反馈的模式,对不合理用药处方进行分析,并提出建议。结果:共抽取处方186 944张,不合理处方总数为648张,平均处方合理率为99.65%,与"医改"前(2012年7-11月)平均处方合理率93.18%比较,处方合理率显著提高,差异有统计学意义(P<0.05);主要不合理用药类型为适应证不适宜(25.37%)、用法用量不适宜(48.70%)。结论:"医改"后该院处方合理率明显提高,但仍应继续通过多种措施加强对不合理处方的干预,进一步提高该院合理用药水平。

OBJECTIVE ： To improve the level of rational drug use in a hospital by analyzing the results of the outpatient pharmacy prescriptions review after medical reform from Jan. to May in 2013. METHODS： According to Prescription Management Methods, Management Criteria of Hospital Prescription Comment（trial）and others, the outpatient prescriptions of the first continuous five workdays in every month from Jan. to May in 2013, were evaluated by 4-levels review and the results were communicated by 4 levels feedback; irrational prescriptions were analyzed to put forward some suggestions. RESULTS： Of the total 186 944 prescriptions reviewed, 648 prescriptions were irrational with rational rate of 99.65% in average. Compared with average rational rate of prescription （93.18%） before medical reform （Jul-Nov. 2012）, rational rate of prescription increased significantly; there was statistical significance （P〈0.05）. The main irrational type were improper indication（25.37% ）, and improper usage and dosage （48.70%）. CONCLUSIONS： The rational rate of prescription is increased significantly, but we still should strengthen the intervention of inappropriate prescriptions by much more method, to promote the clinical use of drugs.