国内外医疗机构药物遴选和评价现状的概况性综述

Drug Selection and Evaluation in Medical Institutions:A Scoping Review

目的:通过对国内外医疗机构药物遴选和评价现状进行分析,了解目前国内外相关遴选方法和工具的发展情况,为中医医疗机构开展药物遴选提供参考依据,促进中医医疗机构药物目录的优化。方法:采用概况性综述的方法,系统全面地检索国内外8大数据库,随后进行文献筛选、数据提取和分析,将研究结果进行图表展示。结果:该研究纳入了23篇文献(中文13篇,英文10篇),共涉及23个药物遴选相关的方法或工具。14个国内的方法或工具中,最早的发布于2012年,有5个发表于2022年。发布的方法或工具中,涉及不同级别的医院、不同药物品种、不同评估角度等,如1个县级医院、1个乡镇医院的药物遴选方法;针对抗菌药、儿童退热药布洛芬制剂、儿科重症监护病房使用的质子泵抑制剂、降糖药等不同类型药物的方法工具;中成药遴选工具;专门针对药物经济学角度评估的工具,此外还包括具有普适性的国内医疗机构遴选工具。9个国外医疗机构药物遴选工具分别来自欧洲、美洲、亚洲、非洲的国家。最早发表于1955年,工具内容包括医疗机构药物处方集应该遵循的制定标准、医院处方集的管理制定和更新、药物评估工具。结论:总体来看,国外医疗机构的药物遴选方法及制度较国内发展更早,国内近几年关注度较高,发布了各种类别的药物遴选工具,然而缺乏规范性,未来还需要进一步完善。

Objective:By analyzing the current situation of drug selection and evaluation in medical institutions in the world,we aim to understand the development of relevant selection methods and tools,provide reference basis for drug selection in traditional Chinese medicine(TCM) medical institutions,and promote the optimization of drug catalogs in TCM medical institutions.Method:Based on the method of scoping review,the eight databases were systematically searched,the included documents were screened,extracted and analyzed,and the research results were graphically displayed.Result:A total of 23 articles were included in this study,including 13 in Chinese and 10 in English,involving 23 methods or tools related to drug selection.Of the 14 methods or tools from Chinese medical institutions,the earliest one was published in 2012,and five were published in 2022.The published methods or tools involved different levels of hospitals,different drug varieties,different evaluation angles,etc.,such as the drug selection methods of one county hospital and one township hospital,methods and tools for different types of drugs such as antibacterial drugs,ibuprofen preparations,proton pump inhibitors and hypoglycemic drugs used in pediatric intensive care units,Chinese patent medicine selection tools,tools for evaluation from the perspective of pharmacoeconomics,and universal tools for selecting domestic medical institutions.The nine drug selection tools of foreign medical institutions were from the European,American,Asian and African countries.It was first published in 1955.The contents included the formulation standards that medical institutions should follow for drug prescription sets,the management formulation and update of hospital prescription sets,and drug evaluation tools.Conclusion:On the whole,the drug selection methods and institutional methods of foreign medical institutions developed earlier than those in China.In recent years,Chinese medical institutions have paid high attention to drug selection and released various types of drug selection tools.However,the standardization should be further improved in the future.