北京积水潭医院1223张门诊不合理处方干预分析

Analysis of 1223 irrational prescriptions in Beijing Jishuitan Hospital's outpatient

目的:分析北京积水潭医院门诊处方中不合理用药的情况及原因,为改进处方质量提供数据参考。方法:以北京积水潭医院两院区门诊药房干预发现的1 223张不合理处方为对象,按照报销类别、问题类型进行统计分析,利用帕累托图分析门诊不合理处方的主要和次要因素。结果:该院门诊不合理处方主要为医保处方,以用药不适宜为主,"适应证不适宜"、"遴选药品不适宜"、"用法、用量不适宜"需皮试药品未注明皮试结果是造成门诊不合理药处方的主要因素,"需皮试药品未注明皮试结果"、"重复给药"、"处方用纸错误"构成了门诊不合理处方的次要因素。结论:该院门诊不合理处方主要以医保处方、用药不适宜处方为主,门诊调剂药师应根据不合理用药类型,制定相应的干预措施,有针对性地进行干预和药学服务,提高合理用药水平。

Objective： To analyze the situation and cause of irrational drug use found in prescription intervention in Beijing Jishuitan Hospital＇s outpatient, and provide data reference for improving prescription quality. Methods： According to the categories of reimbursement and the types of irrational problems, 1 223 irrational prescriptions found in prescription intervention in Beijing Jishuitan Hospital＇s two outpatients were analyzed, while Pareto Diagram analysis was used to find out the main and minor factors of irrational prescriptions in outpatient. Results： The 1 223 irrational prescriptions were mostly paid by medical insurance, and were mainly with the problem of drugs＇ misusing. ＂Indication mismatch＂, ＂drugs＇ selection unfit＂,＂usage or dosage disagree＂and＂the drugs needing skin test lack skin test results＂, were the main factors of irrational prescriptions in outpatient, ＂repeated dosing＂ and ＂prescription paper mismatch＂ were the minor factors. Conclusion： The irrational prescriptions in this hospital＇s outpatient were mostly paid by medical insurance, and with the problem of drugs＇ misusing. The outpatient pharmacists should set up corresponding intervention measures according to the types of irrational drug use, make targeted intervention and pharmaceutical service, and improve the level of rational drug use.