精神病专科医院门诊不合理处方分析

Analysis of Outpatient Irrational Prescriptions in A Psychiatric Hospital

目的通过对本院2014年不合理处方的分析,了解本院门诊患者不合理处方的基本情况,为针对性地加强不合理处方的管理和制度制定提供参考。方法对2014年门诊药房收集到的各种不合理处方进行分析。结果共有处方841张,按类型分类居前2位的是超规定天数占46.8%,"18岁以下儿童禁用或慎用"占28.1%";"18岁以下儿童禁用或慎用"中,超FDA标准的只有20%。结论不合理处方有各种类型,其中"超规定天数"是可以通过分层管理进行避免;但"18岁以下儿童禁用或慎用"超说明书无法避免,为保障患者用药安全及医药护人员的权益,国家应尽快制定出相应的制度,以便在实际工作中能有法可依。

OBJECTIVE To investigate the basic situation of irrational prescriptions in the outpatients of the hospital,so as to provide reference for enforcement of regulation and revision of management system,the analysis of irrational prescriptions in 2014 was conducted. METHODS All irrational prescriptions collected by pharmacists of outpatient dispensary were analyzed. RESULTS A total of 841 prescriptions defined as irrational were collected,which could be classified by types： the primary type was the long course of usage violating the regulation,while another major type was off-label usage in children and adolescents（ younger than 18 years）,consisting 46.8% and 28. 1%,respectively. Among the latter conditions,all the usages were not approved by CFDA in children and adolescents,just 20% of the usages were not approved by FDA in pediatric patients. CONCLUSION Several types of irrational prescriptions were observed,hierarchical management could be conducted to prevent the long course of usage violating the regulation.However,off-label usages in pediatric patients are inevitable. To assure the safety of patients and rights of medical staffs,we suggest formulation of definite management system at national level.