西药房不合理处方的成因及应对方法研究

Study on the Causes and Countermeasures of Irrational Prescriptions in Western Pharmacies

目的研究西药房不合理处方的成因,并提出相应的处理方法。方法纳入2017年2月至2018年2月期间本院门诊西药房开出的500张处方作为此次研究的对照组,通过回顾性分析的方法,统计此500张处方单不合理的数量及概率,分析其不合理的原因,并提出相应的解决及改进方法。同时,纳入2018年3月至2019年3月期间本院门诊西药房经解决改进措施过后开出的500张处方作为此次研究的观察组,回顾性分析其不合理的数量及概率,并将其与2017年2月至2018年2月期间本院西药房不合理处方进行对比。结果 2017年2月至2018年2月期间的500张处方单中,不合理的处方单有84张,不合理占比为16.8%,不合理的原因包括:用药间隔时间不合理20张(23.81%),给药方式不合理16张(19.05%),用药次数不合理14张(16.67%),药物剂量不合理13张(15.48%),药物搭配不合理11张(13.10%),药物选择不合理10张(11.90%),改进后,2018年3月至2019年3月期间500张处方单中出现不良事件的有22张(4.4%),组间对比差异显著(P <0.05)。结论在西药房开出的不合理处方中,用药时间间隔不合理是最主要的原因,其次按占比依次为给药方式不合理、用药次数不合理、药物剂量不合理、药物搭配不合理以及药物选择不合理,经过针对性的改进之后,不合理处方出现的概率有了明显的降低,因此,值得在临床上进行推广及应用。

Objective This paper studies the causes of irrational prescriptions in western pharmacies and puts forward corresponding treatment methods. Methods 500 prescriptions issued by the outpatient western medicine pharmacy of our hospital from February 2017 to February 2018 were included as the control group of this study. By retrospective analysis, the unreasonable number and probability of these 500 prescriptions were counted, the unreasonable reasons were analyzed, and corresponding solutions and improvement methods were proposed.At the same time, 500 prescriptions of the outpatient western medicine pharmacy of our hospital from March 2018 to March 2019 were included as the observation group of this study, and their unreasonable quantity and probability were retrospectively analyzed, and they were compared with the unreasonable prescriptions of the western medicine pharmacy of our hospital from February 2017 to February 2018. Results Among the 500 prescriptions from February 2017 to February 2018, 84 are unreasonable, accounting for 16.8%. Unreasonable reasons include: Unreasonable drug use time interval 20(23.81%), drug delivery way is not reasonable 16(19.05%), unreasonable drug use frequency of 14(16.67%), unreasonable drug dose 13(15.48%), 11 pieces of words is a mismatched drugs(13.10%), drug selection unreasonable 10(11.90%), and after the improvement, in March 2018 to March 2019, 500 copies in the prescriptions of adverse events during the period of 22(4.4%), compare the significant difference between groups(P<0.05). Conclusion In pharmacy, prescribing the unreasonable drug use unreasonable time interval is the main reason, secondly according to the proportion of drug delivery way is not reasonable and unreasonable drug use frequency and unreasonable drug dosage, drugs, drug selection is not reasonable and unreasonable collocation, after a targeted improvement, unreasonable prescription of probability had significantly lower, therefore, is worth in clinical promotion and application.