构建多学科协作的临床合理用药评价体系对重点监控药品合理使用的影响

The Impact of Constructing a Multidisciplinary Clinical Rational Drug Use Evaluation System on the Rational Use of Key Monitored Drugs

目的分析临床药师参与的多学科临床用药评价体系联合信息技术在我院重点监控药物管理中的应用效果。方法抽取我院2019年1~7月重点监控药品600份病历中不合理使用情况及统计全院重点监控药品的金额占比作为监管前数据,统计我院2019年8月~2020年2月重点监控药品专项点评的1647份病历的不合理使用情况以及统计金额占比作为监管后数据。利用间断时间序列模型对比分析监管前后两组的重点监控药品的合理使用率以及使用金额占比变化情况。结果自2019年8月实施重点监控药品监管模式后,平均使用金额占比由17.9%下降为12.51%。降幅为43.25%;使用合理率由96.36%上升为97.52%。升幅为1.21%。监管后较监管前重点监控药品的使用金额占比的下降有统计学差异(β_(3)=-2.468214,P<0.01),使用合理率上升有统计学差异(β_(3)=1.629892,P<0.01)。结论临床药师参与的多学科临床用药评价体系联合信息技术在我院重点监控药物管理中的应用效果明显,值得相关医院借鉴。

OBJECTIVE To evaluate the application effect of multidisciplinary clinical drug use evaluation system participated by clinical pharmacists and information technology in key monitoring drug management in our hospital.METHODS The irrational use of 600 medical records of key monitored drugs in our hospital from January to July 2019 and the amount proportion of key monitored drugs in the whole hospital were taken as the pre supervision data,and the irrational use of 1647 medical records and the amount proportion of special comments on key monitored drugs in our hospital from August 2019 to February 2020 were taken as the post supervision data.The intermittent time series model was used to compare and analyze the changes of the rational use rate and the proportion of the use amount of the key monitored drugs in the two groups before and after supervision.RESULTS Since the implementation of the key monitored drug management mode in August 2019,the average use amount decreased from 17.9%to 12.51%.The decrease was 43.25%;The reasonable utilization rate increased from 96.36%to 97.52%.The increase was 1.21%.There was a significant difference in the proportion of the use amount of key monitored drugs after supervision compared with that before supervision(β_(3)=-2.468214,P<0.01),and there was significant difference in the increase of reasonable utilization rate(β_(3)=1.629892,P<0.01)。CONCLUSION The multidisciplinary clinical drug use evaluation system participated by clinical pharmacists combined with information technology has an obvious effect in the key monitored drug management in our hospital,which is worthy of reference for relevant hospitals.