眼科处方适应证不适宜情况调查研究

Investigation of indication inadequacy of prescriptions in ophthalmology department

目的调查和分析眼科处方适用证不适宜情况,为眼科合理用药提供依据。方法对我院2014年3月17-20日门急诊处方进行全样本点评,了解眼科处方适应证不适宜情况。结果共抽取处方26 189张,共51 052条药品信息,适应证不适宜药品信息共3 787条,占7.42%,其中眼科适应证不适宜药品信息1 731条,占总抽取药品信息条目数的3.39%,占总适应证不适宜药品信息条目数的45.7%,涉及的药物主要包括诊断或检查用药、门诊手术/处置局麻用药、针对不良反应的用药、抗菌药物、针对并发症的用药、术后抗炎用药、营养角膜药、维生素类药物、抗病毒药等。结论为确保医疗质量安全和防范医疗纠纷的发生,针对门急诊处方的适应证不适宜情况应加强管理,眼科处方点评结果及时反馈临床,并提示医师补充、修改诊断或提交超说明书用药申请,提高眼科合理用药水平。

Objective To investigate and analyze the indication inadequacy and provide the base for rational use of drugs in ophthalmology department. Methods The full sample of prescriptions from 17 to 20 of M ar 2014 in our hospital was commented. The indication inadequacy in ophthalmology outpatient and emergency department was analyzed. Results Totally 26 189 prescriptions were analyzed,including 51 052 records. Totally 3 787 records（ 7. 42%）were inappropriate in indication,of which,1 731 records（ 45. 7%） were prescriptions in ophthalmology outpatient and emergency department. The drugs involved included diagnosis or examination drugs,local anesthetics for outpatient operation,drugs to prevent adverse reactions,antibacterial drugs,drugs to treat complications,postoperative anti-inflammatory drugs,corneal nutrition drugs,vitamins and antiviral drugs. Conclusion The management of the indication inadequacy of prescriptions in ophthalmologic outpatient and emergency department should be strengthened to ensure the medical quality and safety and prevent medical disputes. The pharmacist should feed back the comment results of prescriptions timely to the doctors,and remind the doctor to add,amend or submit the application of off-label usage,so as to improve the level of rational use of drugs in ophthalmology department.