深圳市某院门诊合理用药现状及相关影响因素研究

Study on outpatient rational drug use and related factors in a hospital in Shenzhen

目的:对医院门诊合理用药国际指标等进行调研,分析合理用药相关影响因素,为进一步制定门诊合理用药干预措施提供科学依据。方法:采用系统抽样的方法对深圳市某医院部分门诊患者进行问卷调查及处方资料收集,利用多因素Logistic回归分析筛选影响门诊患者合理用药的影响因素。结果:对867份处方进行合理性评价,其中76份处方被判定为不合理处方,处方不合理率7.73%。867张处方中,门诊患者平均用药(2.20±1.21)种,处方中抗菌药物应用率为26.30%、注射剂应用率达14.07%,基本药物应用率达16.96%,患者对正确用药方式知晓率为84.54%,药品通用名使用率、药品标示完整率、实际药品调配率为100%,医生平均诊治时间3.78min,药品平均调配时间2.39min。以处方合理性判定结果作为因变量(合理处方:Y=1,不合理处方:Y=0),进行Logistic回归分析,结果显示:开方医生的职称越高所开处方为合理处方的可能性越高(OR=2.213),开方医生工作年限越长处方合理性概率越高(OR=2.130),用药种类数越多不合理处方的风险越高(OR=0.969)。结论:不合理处方占比较低,抗菌药物和注射剂的使用得到有效控制,基本药物使用比例偏低,医师职称、工作年限是影响处方合理性的重要因素。

Objective：To investigate the present condition of the international indicators of outpatient of rational drug use in our hospital,to provide scientific basis for the rational use of drugs in the clinic. Methods：A systematic sampling method was used to collect the prescription data of outpatients in our hospital and the related factors affecting the rational use of drugs were analyzed by using Logistic regression analysis. Results：To evaluate the rationality of the 867 prescriptions,76 prescriptions were judged to be unreasonable,and the unreasonable pres criptions were 7.73%. 867 prescriptions,the average number of drugs for outpatients,26.30%,the use of antibacterial drugs,14.07%,16.96%,the rate of drug use is 84.54%,the rate of drug use,the rate of drug labeling,the actual rate of3.78 minutes,2.39 minutes,2.20 minutes. In order to prescribe the rationality judgment results as the dependent variable（reasonable prescription： Y=1,unreasonable prescriptions： Y=0） and logistic regression analysis. The results showed that the higher title of doctor＇s prescription prescription for rational prescribing the possibility of higher（OR=2.213）,prescribing doctors work in limiting the rationality of prescription probability is higher（OR=2.130）,the number of types of medication unreasonable prescription of risk is more high（OR=0.969）. Conclusion：Unreasonable prescriptions accounted for relatively low,the use of antibacterial drugs and injections were effectively controlled,the proportion of basic drugs is low,doctors title,working age is an important factor affecting the rationality of prescription.