安徽歙县28家乡镇卫生院合理用药调查分析

Investigation and Analysis of Rational Drug Use in 28 Township Hospitals in the She County of Anhui Province

目的 实地考察安徽省黄山市歙县28家乡镇卫生院的合理用药现状,分析药学专业技术人员的作用。方法 以该县28家乡镇卫生院为研究对象,按是否配备药学专业技术人员分为对照组(15家,配备药学专业技术人员)和试验组(13家,未配备药学专业技术人员)。随机抽取28家医院2020年1月至10月每月的门诊处方100份、住院病历10份,点评用药合理性,并统计抗菌药物使用率和门诊处方不合理率。结果 门诊处方点评结果显示,对照组处方不合理率为10.73%(161/1 500),试验组不合格率为16.77%(218/1 300),组间差异显著(P <0.001);门诊处方的用药不合理类型主要为适应证不适宜、用法用量不适宜、超常处方;住院病历的不合理类型主要为用法用量不适宜、遴选药物不适宜、联合用药不适宜、存在配伍禁忌;对照组门诊、住院抗菌药物使用率均显著低于试验组(P=0.018,0.038),但各院中仅少数卫生院的门诊与住院抗菌药物使用率符合要求。结论 该县各乡镇卫生院在药学专业技术人员配备方面存在不足,应配备合适的药学专业技术人员,以提升乡镇卫生院的用药合理性,并控制抗菌药物使用率,同时进一步提高乡镇卫生院药学专业技术人员的服务与药学管理水平。

Objective To investigate the current situation of rational drug use in 28 township hospitals in the She County,Huangshan City,Anhui Province,and to analyze the role of pharmaceutical professionals.Methods A total of 28 township hospitalsin the county were selected and divided into the control group(15 township hospitals,with pharmaceutical professionals) and the test group(13 township hospitals,without pharmaceutical professionals) according to whether there were pharmaceuticalprofessionals. A total of 100 out-patient prescriptions and 10 in-patient medical records in the 28 hospitals from January toOctober 2020 were randomly selected to comment on the rationality of drug use,make statistics on the utilization rate of antibioticsand unreasonable rate of out-patient prescriptions.Results The results of out-patient prescription comment showed that theunreasonable rate of prescription in the control group was 10. 73%(161/1 500),while that in the test group was 16. 77%(218/13 00),with significant difference between the two groups(P < 0. 001). The unreasonable types of drug use in the out-patientprescriptions mainly included inappropriate indications,inappropriate usage and dosage,extraordinary prescriptions. The unreasonabletypes of drug use in the in-patient medical records mainly included inappropriate usage and dosage,inappropriate selection ofdrugs,inappropriate combination of drugs and incompatibility. The utilization rates of antibiotics in the outpatient and inpatientdepartments in the control group were significantly lower than those in the test group(P = 0. 018,0. 038),but only a few outpatientand inpatient departments had the required utilization rates of antibiotics.Conclusion The township hospitals in the county haveinsufficient pharmaceutical professionals. We should organize an appropriate number of pharmaceutical professionals to improve therationality of drug use in the township hospitals,and control the utilization rate of antibiotics. We also should further improve thepharmaceutical care and management level of pharmaceutical professionals in the township hospitals.