不合理用药处方分析及改进措施探究

Analysis of unreasonable medication prescription and its improvement measures

目的分析不合理用药处方情况,并制定改进措施。方法选择2019年用药处方88492份与2020年用药处方72364份进行分析,按照《医院处方点评管理规范(试行)》、《中华人民共和国药典临床用药须知》等为评价标准,总结不合理用药类型并评价其构成比,分析原因,并制定改进措施。结果2019年不合理处方计58份,发生率为0.07%(58/88492),2020年不合理处方计103份,发生率为0.14%(103/72364),2020年不合理处方发生率高于2019年(χ^(2)=23.479,P=0.000)。不合理用药处方常见类型及其构成比包括:诊断与用药不符56.52%(91/161)、用药指征偏宽13.04%(21/161)、用药指征不明确11.18%(18/161)、用法用量不适宜9.94%(16/161)、遴选药品不适宜3.73%(6/161)、重复用药3.11%(5/161)、其他2.48%(4/161)。结论目前临床用药不合理处方问题依旧严重,强化处方点评工作有利于及时发现不合理处方,故应当加强处方以及合理用药管理,以促进临床合理用药。

Objective To analyze the situation of unreasonable drug prescription and make improvement measures.Methods 72364 prescriptions in our hospital in 2019 and 72364 prescriptions in 2020 were selected for analysis.According to the Management Standards for Hospital Prescription Comments(trial)and The Clinical Medication Instructions of the Pharmacopoeia of the People's Republic of China,the types of irrational medication were summarized and the composition ratio was evaluated,the causes were analyzed,and the improvement measures were made.Results In 2019,there were 58 unreasonable prescriptions,with an incidence of 0.07%(58/88492);in 2020,there were 103 unreasonable prescriptions,with an incidence of 0.14%(103/72364).In 2020,the incidence of unreasonable prescriptions was higher than that in 2019(χ^(2)=23.479,P=0.000).The common types and composition of unreasonable drug prescription include:diagnosis is inconsistent with drug use 56.52%(91/161),indication is wide 13.04%(21/161),indication is unclear 11.18%(18/161),inappropriate usage and dosage 9.94%(16/161),inappropriate selection of drugs 3.73%(6/161),repeated drug use 3.11%(5/161),and other 2.48%(4/161).Conclusion At present,the problem of unreasonable prescription of clinical medication is still serious,and strengthening the prescription comment work is conducive to the timely discovery of unreasonable prescription,so we should strengthen the management of prescription and rational drug use,in order to promote rational clinical drug use.