中成药超量应用的分析与管理

Analysis and Management on the Excess Application of Chinese Patent Medicine

目的通过对中药师记录医师超量用药情况分析,加强对中药超量用药管理,减少中药的不良反应,规范医院质量管理工作。方法回顾性对某院2007年-2013年中药师记录中成药处方用药剂量、频次和疗程超量情况进行分析。结果我院2007年-2013年中成药处方中医师处方用药失误30052例,占处方总数的0.57%,呈上升趋势。在医师处方用药失误中用药超量12147例,占医师处方用药失误40.42%,排在第一位;用药超量由2007年最少时235例,到2010年最多时3032例,增长了1190%;2010年-2013医师用药超量10221例,药师干预请医师签字确认或更改的为7412例,占超量处方的72.51%;在用量超量处方中,医师大多签字确认,只有严重超量或超极量的方更改处方用量。结论医师处方用药超量现象逐年增长,造成中药不良反应逐年增加。应完善医院质量管理工作,加强含西药成分中药、毒性药物及其复方制剂的管理和合理用药的宣传与指导,保证患者用药安全。

Objective To strengthen the management of excess application of Chinese patent medicine, decrease the adverse drug reaction and standardize the quality management of the hospital through an analysis on the excess application situation of Chinese patent medicine from pharmacist and record doctors. Method A retrospective analysis on the excess pharmacy dosage, frequency and treatment course of Chinese patent medicine in the prescription records of pharmacist from 2007 to 2013 in a hospital. Results There were mistakes existing in 30052 cases of Chinese patent medicine prescription by doctors in our hospital from 2007 to 2013, which accounted for 0.57% of all the prescriptions and had an increasing tendency. 12147 cases of drug use mistakes in the prescriptions of doctors were excess medication, which accounted for 40.42% and ranked the first place. The number of excess medication cases was 235 in 2007, which was the least compared with the most in 2010 which was 3032, the increased percent was 1190%. There were 10221 cases of excess medication from 2010 to 2013, 7412 cases were affirmed or modified by the doctors with the intervention of pharmacist, which accounted for 72.51% of all the excess medication prescriptions. Most of the prescriptions were affirmed by doctors with signatures on the excess medication, only prescriptions of seriously or super excess medication were modified in dosage. Conclusions The phenomenon of excess medication has become more and more common year by year, which caused the increasing of adverse drug effect of Chinese patent medicine. We should improve the quality management work of hospital, strengthen the management of traditional Chinese medicine which contain ingredient of western medicine, as well as poisonous drugs and compound preparation, and also put emphasis ~n the publicity and guidance of rational drug use, so as to guarantee the safety of patients.