医院门诊含扎冲十三味丸处方点评结果分析与对策

目的了解某基层医院门诊扎冲十三味丸使用情况及存在问题并提出相应对策,为提高临床合理用药提供参考.方法应用医院合理用药系统导出2018年7月门诊含扎冲十三味丸所有处方共868张,采用回顾性处方点评方法,依据药品说明书、文献报道、相关法律法规及指导原则等对处方进行点评.结果2018年7月使用扎冲十三味丸的门诊处方共868张,不合理处方189张,不合理率为21.77%.门诊外科使用率最高,占84.91%,其不合理率为22.66%.不合理处方中"重复用药"占91.01%,其次为"适应证不适宜"占16.40%,"用药超天数"占2.12%.通过合理用药系统设置药品规则(扎冲十三味与其他有重复用药的药品不能同时开具),可将"重复用药"问题解决.结论该院扎冲十三味丸的应用主要问题为"重复用药",通过设置药品规则可有效对此进行监管,同时临床需重视对中成药的合理使用,提高合理用药水平,使中成药的应用更加规范.

Objective To understand the usage and existing problems of Zhachong Shisanwei Pills in a primary hospital by reviewing the outpatient prescriptions,and propose corresponding countermeasures to provide reference for improving clinical rational drug use.Methods A total of 868 prescriptions containing the Zhachong Shisanwei Pills in the outpatient clinic in July 2018 were exported using the hospital's rational drug use system.The prescriptions were reviewed according to the drug manual,literature reports,relevant laws,regulations and guidelines.Results In July 2018,a total of 868 outpatient prescriptions were used for Zhachong Shisanwei Pills,and 189 unreasonable prescriptions were used,with an unreasonable rate of 21.77%.Outpatient surgery had the highest rate of use,accounted for 84.91%,and its unreasonable rate was 22.66%.Among the unreasonable prescriptions,“repeated medication”accounted for 91.01%,followed by“inappropriate indications”accounted for 16.40%,and“medication super days”accounted for 2.12%.The"repeated medication"problem was solved by setting the drug rules through a rational drug use system(the drug was dispensed at the same time as other drugs with repeated drugs).Conclusion The main problem of the application of Zhachong Shisanwei Pills in this hospital is“repeated drug use”.It can be effectively supervised by setting drug rules.At the same time,clinicians should pay more attention to the rational use of proprietary Chinese medicines and improve the level of rational drug use.