某院前置审核系统中成药处方审核规则拓展优化

Construction and optimization of prescription auditing rules for Chinese patent medicine in prescription pre-audit system of a hospital

目的:优化航天中心医院前置审核系统中成药处方审核规则,通过信息化手段规范中成药合理用药。方法:基于该院中成药使用现状及前置审核系统应用情况,在国家颁布的中成药合理用药政策制度要求下,结合该院近5年中成药处方点评结果,提炼出对应审核规则。结果:审核规则优化后,实时审核不合理处方检出率提高,事后处方点评不合理率由13%下降到3%~4%。不合理处方类型也发生变化,优化前多集中在"重复用药"和"联合用药"两方面,优化后这两类不合理处方明显减少,现多集中在"适应证不适宜"方面。结论:根据该院个性化用药情况优化中成药处方审核规则,能有效弥补现有审核系统中成药审核方面的不足,进一步提高中成药处方审核能力,保障患者用药安全,但有些审核规则的优化上仍存在一些不足之处需进一步研究。

OBJECTIVE To optimize the prescription auditing rules for Chinese patent medicines in pre-audit system and standardize the rational use of Chinese patent medicines by means of information technology at our hospital.METHODS Based upon the current usage status of Chinese patent medicine and the application of pre-audit system at our hospital,the requirements of national policy system for rational use were analyzed along with the results of prescription reviews over the last five years.The corresponding prescription review rules were formulated.RESULTS After expanding and optimizing audit rules,the detection rate of irrational prescriptions increased during real-time audit and irrational rate of prescription comment declined from 13%to 3%-4%.Unreasonable prescription types also changed.Prior to optimization,‘repeated drug use’and‘combined drug use’dominated;after optimization,these two types of unreasonable prescription dropped markedly and concentrated in‘non-suitable indications’aspect.CONCLUSION According to the current pre-audit status of our hospital,expanding and optimizing the prescription audit rules can effectively compensate for the shortcomings of existing audit system during a prescription review,enhance the auditing capability,improve the rational use of Chinese patent medicine in clinical practices and ensure the safety of patient medication.However,some shortcomings in audit rules should be further studied.