广东省25家基层医疗卫生机构实施国家基本药物制度及药品不良反应监测情况的调查分析

Investigation and Analysis of ADR Monitoring and the Implementation of National Essential Medicine System in 25 Primary Health Care Institutions from Guangdong Province

目的:促进国家基本药物制度在广东省基层医疗卫生机构的推行,完善基层医疗卫生机构基本药物不良反应(ADR)监测网络。方法:采用横断面研究方法,通过问卷调查、定性访谈及ADR数据库检索等方式获取资料。结果:受访机构2010-2012年平均用药总品种数逐年减少,基本药物采购金额占药品采购总金额的比例逐年上升,药品收入占医院总收入的比例逐年下降,基本药物全部实现"零差率"销售的机构占比逐年上升,基本药物平均配送到货率分别为94.0%、92.0%、90.3%,有相当数量的基本药物品种存在缺货现象。此外,受访机构中建立了ADR监测制度的有80%,建立了专门监测部门的有56%,仅20%的受访机构配备了专职的ADR上报人员。结论:广东省基层医疗卫生机构实施国家基本药物制度情况基本达到国家要求,但基本药物采购配备及销售方面仍需改善,ADR监测现状不容乐观,全省基本药物ADR监测能力有待提高。

OBJECTIVE： To promote the implementation of National Essential Medicine System, and to provide a basis for ADR monitoring network in primary health care institutions. METHODS： By cross-sectional study, the data was collected through questionnaire, qualitative interviews and database retrieval, etc. RESULTS： In 2010-2012, the average number of drug varieties reduced year by year, the basic drug proportion of the total amount of the purchase amount of drug purchase rise year by year, hos pital drugs accounted for the proportion of total revenue decline year by year, basic drugs all realize ＂zero rate＂ sales agency of rising year by year, average distribution of essential medicines arrival rate are 94.0%, 92.0% and 90.3% respectively, there are a number of essential medicines varieties exist shortage phenomenon. Responding to the survey institutions established in 80% of adverse drug reaction monitoring system, the establishment of a dedicated monitoring departments have 56%, only 20% of those surveyed institutions equipped with full-time ADR reporting staff. CONCLUSIONS： The implementation of essential medicines approximately meets the national requirements, but essential medicines purchase and dispensing still need to be improved and the ability of ADRs monitoring has to be improved.