处方点评联合前置审核对门诊抗肿瘤用药处方质量的影响

Effect of pre-prescription audit combined with post-prescription review on the quality of anti-tumor drug prescriptions in outpatient

目的分析实施处方前置审核工作后对我院门诊抗肿瘤用药处方质量的影响。方法选取我院2017年11月~2018年8月门诊处方中每个月所有抗肿瘤用药处方,共计14 598张,进行处方点评。其中2017年11月~2018年3月5个月为未开展处方前置审核工作的阶段,2018年4月~2018年8月5个月则开始处方前置审核工作,对比实施处方前置审核工作前后5个月我院门诊抗肿瘤药处方质量的变化。结果 14 598张处方中不合理处方1 060张占处方总数的7.26%,其中用法用量不适宜(83.87%)为不合理主要因素。开展处方前置审核后5个月,门诊抗肿瘤药处方合格率从89.65%上升至95.47%(P=0.011),其中用法用量不适宜处方从9.04%降至3.48%(P=0.012),开展处方前置审核后2018年4月~2018年8月每月门诊抗肿瘤处方合格率逐渐升高,分别为91.80%、93.37%、96.62%、97.42%、97.56%,用法用量不适宜不合理处方数呈逐渐下降趋势。结论处方前置审核干预工作可明显提高门诊抗肿瘤用药处方质量,控制用药不合理应用现象。

Objective To analyze the effect of pre-prescription audit on the quality of anti-tumor drug prescriptions in outpatient. Methods A total of 14 598 prescriptions for anti-tumor drugs from November 2017 to August 2018 in the outpatient prescriptions from our hospital were used for a post-prescription review. Then, the qualities of prescriptions from November 2017 to March 2018 which didn’t experienced pre-prescription audit were compared with that of prescriptions from April 2018 to August 2018 which were received pre-prescription audit since the Pre-Prescription Audit System was conducted in our hospital. Results Among the 14 598 prescriptions, 1 060 prescriptions were unqualified prescriptions, accounting for 7.26% of the total prescriptions. The main factor of unqualified prescriptions was the unsuitable dosage of usage accounting for 83.87% of the unqualified prescriptions. After carrying out pre-prescription audit in the late five months, compared with the previous five months which didn’t conduct the pre-prescription audit, the qualified prescription rate of outpatient antineoplastic drugs increased from 89.65% to 95.47%(P=0.011), and the unsuitable prescription rate for usage and dosage decreased from 9.04% to 3.48%(P=0.012). Meanwhile in the late five months carrying out pre-prescription audit, rational prescription rate was gradually increased monthly, shown as 91.80%, 93.37%, 96.62%, 97.42%, 97.56%. The unsuitable prescription rate for usage and dosage was decreased gradually monthly. Conclusion Pre-prescription audit intervention can significantly improve the quality of anti-tumor drug prescriptions in outpatient department and control the phenomena of irrational using about drug.