2013年北京医院门诊药房退药情况分析

Analysis of medicine Returning in Outpatient Pharmacy of Beijing Hospital in 2013

目的：总结退药原因，探讨减少退药的方法。方法收集2013年1月～12月门诊药房西药退药处方872例，中药退药处方198例，并分别对数据进行统计分析。结果门诊药房西药退药原因主要有医生操作失误272张（31.2％），不良反应177张（20.3％），患者病情变化、住院及死亡109张（12.5％），患者拒绝用药74张（8.5％），不合理用药33张（3.8％）等，其中前4项为主要原因，共计632例，占退药总例数的72.5％。中药退药原因主要为不良反应45张（22.7%），患者拒绝用药45张（22.7%），医保拒付、患者家中有药37张（18.7%），医生操作失误26张（13.2%），患者病情变化、住院及死亡22张（11.1%），不合理用药23张（11.6%），其中前4项为主要原因，共计153例，占退药总例数的77.3％。结论医院医生和药师应共同努力，采取建立退药制度、加强医患沟通、合理检查流程等措施，提高医疗服务质量，减少退药情况的发生。

Objective To sum up the reason for drug returning and to explore the ways to reduce drug returning for improving the quality of medical services and ensuring the medication safety.Methods872 outpatient prescriptions of western medicine returning and 198 outpatient prescriptions of traditional Chinese medicine returning from January to December in 2013 were collected to conduct meta-analysis.Results The main reasons for outpatient western medicine returning had doctors’operational errors,adverse drug reactions,diseases condition changes ,patients admitted to hospital and death, patients’poor compliance,irrational drug Use, etc.The former four were the main reasons,for total 632 cases,accounting for 72.5% of the total cases of medicine returning.The main reasons for outpatient traditional Chinese medicine returning had adverse drug reactions, patients’poor compliance,protest in medical insurance,doctors’operational errors,diseases condition changes ,patients admitted to hospital and death,,irrational drug Use,The former four were the main reasons,for total 153 cases,accounting for 77.3% of the total cases of medicine returning. Conclusion Doctors and pharmacists should take joint efforts to adopt the measure such as establishing the system of medicine returning,strengthening the physician-patient communication and retionalising the detection process to improve the quality of medical services and the phenomena of medicine returning.