北京市密云区19家基层医院集中处方点评结果分析

Analysis of Centralized Prescription Review Results in 19 Primary-Level Hospitals in Miyun District of Beijing

目的通过集中处方点评,了解北京市密云区基层医院用药现状,发现其不合理用药问题,通过反馈,规范临床医师处方行为,促进全区合理用药水平整体提高。方法对比密云区19家基层医院2016年、2019年和2022年3次集中处方点评结果,从处方合格率、存在问题类型等进行分析。结果3次集中点评处方数分别是2284张、1938张和1900张,合格处方数分别是2058张、1702张和1801张,占比为90.11%、87.82%和94.79%。2022年集中点评处方合格率与2016年、2019年比较,差异有统计学意义(P<0.001)。处方中不合理问题类型主要是临床诊断书写不全、无中医证型诊断、适应证不适宜、用法、用量不适宜、联合用药不适宜及重复用药等。结论密云区基层医院处方合格率近几年稳步提升,但医师处方还存在一定程度的不合理用药现象。应进一步加强对临床医师、药师合理用药的培训,加强处方管理,促进临床安全、合理用药。

Objective To understand the current situation of drug use in primary-level hospitals in Miyun District of Beijing through centralized prescription comments,find out the problem of irrational drug use,so as to standardize the prescribing behavior of clinicians through feedback,and promote the overall improvement of rational drug use in the district.Methods Three centralized prescription review results of 19 primary-level hospitals in Miyun District in 2016,2019 and 2022 were analyzed in terms of the prescription qualification rate and types of problems.Results The number of prescriptions for the three centralized reviews was 2284,1938 and 1900,with 2058,1702 and 1801 rational prescriptions,accounting for 90.11%,87.82%and 94.79%,respectively.The qualified rate of centralized review prescriptions in 2022 was compared with 2016 and 2019,and the difference was statistically significant(P<0.001).The main types of problems in prescription are incomplete clinical diagnosis writing,diagnosis without traditional Chinese medicine syndrome,inappropriate indications,inappropriate usage and dosage,inappropriate combination therapy and repeated drug use.Conclusion The prescription qualification rate of primary-level hospitals in Miyun District has increased steadily in recent years,but there is still a certain degree of irrational drug use.We should further strengthen the training of clinicians and pharmacists on rational drug use,strengthen prescription management,to promote clinical safety and rational drug application.