深圳市某院门诊合理用药国际指标调查及相关影响因素分析

Investigation on international index of rational drug use in outpatients of a hospital in Shenzhen and analysis of its related factors

目的对深圳市某医院门诊合理用药国际指标进行调查,并探讨合理用药国际指标的相关影响因素,为制定进一步促进门诊合理用药的相关干预措施提参考依据。方法采用随机抽样的方法选择1000例门诊就诊患者,收集分析患者的一般资料、处方指标、患者关怀指标等,采用多因素Logistic回归模型分析影响门诊患者合理用药国际指标的相关影响因素。结果本研究共选择1000例门诊就诊患者,发放调查问卷1000份,收回合格有效问卷980份,有效率98.00%。男性患者略多于女性,男性性别比为1.25∶1;患者年龄3个月~87岁,平均年龄(31.52±17.11)岁。980张处方中,门诊患者平均用药品种数为(2.32±1.22)种,就诊患者抗菌药物应用百分比为24.59%,就诊患者注射剂应用百分比为18.27%,药品通用名使用率为100.00%,基本药物占处方药物百分比为91.73%。以处方合理性作为因变量(合理处方:Y=1,不合理处方:Y=0),以患者、开方医师、配药药师的一般资料,处方指标、患者关怀指标作为自变量,进行多因素Logistic回归分析,筛选影响门诊患者处方合理性的相关影响因素。结果显示:开方医生职称、医生诊治时间、处方用药品种数是影响门诊患者处方合理性的主要因素,具体表现为:开方医生的职称越高,所开出处方为合理处方的可能性也越高[OR=2.223,95%CI=(1.321,3.711),P=0.001<0.05];开方医生的诊治时间越长,所开出处方为合理处方的可能性也越高[OR=2.115,95%CI=(1.350,3.355),P=0.004<0.05];处方药品种类数越多,所开出处方为合理处方的可能性也越低[OR=0.968,95%CI=(0.951,0.992),P=0.005<0.05]。结论抗菌药物和注射剂的使用得到有效控制,基本药物使用比例不高,医师职称、开方医生职称、医生诊治时间、处方用药品种数是影响门诊患者处方合理性的主要因素。

Objective To investigate the international indicators of rational drug use in outpatient of a hospital in Shenzhen,and to discuss the related factors influencing international indicators of rational drug use,so as to provide references for formulating further interventions for rational drug use in outpatient.Methods A total of 1000 outpatients were selected by random sampling.The general data,prescription index and patient care index were collected and analyzed.Multivariate Logistic regression model was used to analyze the related factors influencing the international indicators of rational drug use in outpatients.Results In this study,a total of 1000 outpatient patients were selected and 1000 questionnaires were issued,and 980 valid questionnaires were recovered,with effective rate as 98.00%.The male patients were slightly more than women,and the sex ratio of men and women was 1.25∶1;the age of the patients was 3 months^87 years old and the average age was(31.52±17.11)years old.In 980 prescriptions,outpatient patients had average number of drug as(2.32±1.22)species,antibacterial application percentage as 24.59%,injection application percentage as 18.27%,generic drugs utilization rate as 100.00%,and percentage of essential drugs in prescription drugs as 91.73%.The rationality of prescription as the dependent variable(reasonable prescription:Y=1,unreasonable prescription:Y=0),and the general data of patients,prescribers,pharmacists dispensing,prescription indicators and patient care indicators as independent variables.Logistic regression analysis was used to screen factors influencing the prescription rationality of outpatients.The results showed that the title of doctor of prescribing,time of diagnosis and treatment of doctors,number of prescriptions for medication were the main factors influencing the prescription rationality of outpatients.The specific manifestations were as follows:the higher the professional title of doctor,the higher the possibility of prescribing a reasonable prescription[OR=2.223,95%CI=(1.321,3.711),P=0.001<0.05].The longer time of diagnosis and treatment of doctors,the higher the possibility of prescribing a reasonable prescription[OR=2.115,95%CI=(1.350,3.355),P=0.004<0.05].The more number of prescriptions for medication,the lower the possibility of prescribing a reasonable prescription[OR=0.968,95%CI=(0.951,0.992),P=0.005<0.05].Conclusion Effectively controlled antibiotics and injections,low proportion of basic drug use,doctor title,title of doctor of prescribing,time of diagnosis and treatment of doctors,and number of prescriptions for medication are the main factors influencing outpatient prescription rationality.