某院重点监控药品全程管理的实践与成效分析

Practice and Effectiveness of Whole-Process Management of Key Monitored Drugs in a Hospital

目的 促进医院重点监控药品的管控及合理用药。方法 参考《第二批国家重点监控合理用药药品目录》制订医院第二批国家重点监控合理用药药品目录(化药及生物制品);通过健全药事管理体系,进行前置审方系统的信息化干预、强化处方/医嘱审核和点评,结合合理用药管理的绩效考核、预警控量、指标公示、宣教培训等行政干预手段,采取全程管理、分类管理,并应用多维工具实施监控。利用医院信息系统(HIS)对2022年8月至12月(干预前)和2023年2月至6月(干预后)统计重点监控药品的使用情况,分析干预前后的销售金额占比、处方合理率。结果 干预后,处方/医嘱合理率由干预前的93.80%升至96.07%(P=0.002)。药品消耗总金额占比整体呈下降趋势,干预后2023年6月最低,为6.65%。结论 药师参与重点监控药品用药管理,有助于降低药品费用,促进合理用药。

Objective To promote the control and rational use of key monitored drugs in the hospital.Methods Referring to the Second Batch of National Key Monitoring Rational Drug Catalogue,the Second Batch of National Key Monitoring Rational Drug Catalogue(chemical and biological products)for the hospital was formulated.By improving the pharmaceutical management system,implementing information intervention in the prescription pre-audit system,strengthening prescriptions/medical orders review and evaluation,and combining administrative intervention measures such as performance evaluation,early warning and control,indicator disclosure,and education and training in rational drug use management,the whole-process management,classified management,and apply multidimensional tools were adopted for monitoring.The hospital information system(HIS)was used to statistically analyze the usage of key monitoring drugs from August to December 2022(before the intervention)and from February to June 2023(after the intervention),and the ratio of consumption sum and rational rate of prescription before and after intervention were analyzed.Results The rational rate of prescriptions/medical orders increased from 93.80%before the intervention to 96.07%after the intervention(P=0.002).The ratio of total drug cost showed an overall downward trend,with the lowest in June 2023(6.65%)aftter the intervention.Conclusion Pharmacists'participation in key monitoring of drug use management can reduce drug costs and promote rational drug use.