门诊处方不合理用药原因、影响因素分析及解决对策研究

Analysis of reasons,influencing factors and countermeasures study of irrational use of drugs in outpatient prescriptions

目的探讨门诊处方不合理用药的原因、影响因素以及相应的解决对策。方法从江西省高安市人民医院各门诊科室医师于2016年12月~2019年3月所开具的众多处方中随机选择240份纳为本研究对象。由参与本研究的相关工作人员采用回顾性分析法以《处方管理办法》等为依据客观统计240份门诊处方中不合理用药处方所占比率以及全面分析不合理用药处方的类型与原因并完成单因素及多因素Logistic分析。结果240份门诊处方中共有不合理处方用药30份,不合理用药占8.00%。单因素结果显示,不同溶媒选择情况下的门诊处方不合理发生率比较,差异无统计学意义(P>0.05);不同给药方式、药物选择、用药时间间隔、联合用药、用药次数情况下的门诊处方不合理发生率比较,差异有统计学意义(P<0.05)。多因素Logistic分析结果显示,给药方式、药物选择、用药时间间隔、联合用药、用药次数是门诊处方不合理用药发生的危险因素(P<0.05)。结论医院门诊处方中存在以给药方式不合理、药物选择不合理等为主的不合理用药情况,受到的影响因素较多,不同因素相互作用、相互影响,医院相关部门应进一步推动用药制度的落实,同时注重不断提升医务人员的综合技术水平和职业道德水平,促使其能够在工作岗位中严于律己、认真负责,从而不断提高门诊处方的合理性。

Objective To explore the reasons,influencing reasons and countermeasures of irrational use of drugs in outpatient prescriptions.Methods A total of 240 prescriptions from the numerous prescriptions issued by physicians in the outpatient departments of Gao'an People's Hospital in Jiangxi Province from December 2016 to March 2019 were randomly selected for this experimental study.The relevant staff involved in this study used a retrospective analysis method to objectively count the proportion of irrational drug prescriptions in 240 outpatient prescriptions based on the Prescription Management Method,comprehensively analyze the types and reasons of irrational drug prescriptions,and completed univariate and multivariate Logistic analysis.Results Among the 240 outpatient prescriptions,there were 30 unreasonable prescription drugs,and the unreasonable drug use rate accounted for 8.00%.The univariate results showed that there was no statistically significant difference in the incidence of irrational outpatient prescriptions under different solvent choices(P>0.05).There was statistically significant difference in the incidence of unreasonable outpatient prescriptions under administration methods,drug selection,medication interval,combination medication,and medication frequency(P<0.05).The results of multivariate Logistic analysis showed that the method of administration,drug selection,medication interval,combination medication,and medication frequency were the risk factors for irrational medication use in outpatient prescriptions(P<0.05).Conclusion There are many factors affecting the unreasonable use of drugs in hospital outpatient prescriptions,such as unreasonable drug administration and unreasonable drug selection.Different factors can interact and affect each other.Relevant hospital departments should further promote the drug system implementation,while focusing on continuously improving the comprehensive technical level and professional ethics of medical personnel,prompting them to be strict in their work positions,conscientious and responsible,so as to continuously improve the rationality of outpatient prescriptions.