持续改善处方前置审核系统规则库对提高老年患者门诊处方质量的作用

Influence of Continuous Revision of Database of Rules in the Prescription Review System on Quality of Prescriptions for Elderly Outpatients

目的探讨持续改善处方审核系统规则库对老年患者门诊处方质量的作用。方法调取某医院2020年5月1日至12月31日和2021年1月1日至8月31日,患者年龄在60岁以上的门诊处方,回顾性分析比较两组不合理处方问题类型、假阳性处方数、假阴性处方数、窗口药师拦截数和处方合格率变化。结果改善前不合理处方的主要类型是适应证不适宜、无特殊理由超疗程用药和用药频次不适宜;改善后为适应证不适宜和无特殊理由超疗程用药。与改善前相比,假阳性和假阴性的处方数量、窗口药师拦截的不合格处方数均明显下降,处方合格率由91.43%增长至93.01%,差异有统计学意义。结论持续改善处方前置审核系统规则库可以显著提升门诊老年患者的处方质量,缓解窗口药师审方压力,促进临床合理用药。

Objective To study the influence of continuous improvement of the rule database in the prescription review system on the quality of prescriptions for elderly outpatients.Methods The prescriptions for outpatients over 60 years old given between May 1,2020 and December 31,2020 and between January 1,2021 and August 31,2021 were retrieved from the electronic record system of the hospital.The types of irrational prescriptions and numbers of false positive prescriptions,false negative prescriptions and the number of times prescriptions were blocked by dispensers were compared between the two groups.Results The main types of irrational prescriptions before improvements were made were inappropriate indications,too long medications and too frequent medications.After improvement,the main types of irrational prescriptions were inappropriate indications and too long medications.After measures of improvement were taken,the number of false positive and false negative prescriptions,the number of times irrational prescriptions were blocked by dispensers decreased significantly,and the qualified rate of prescriptions increased from 91.43%to 93.01%.The difference was statistically significant.Conclusion Continuous amendment of the rule database in the prescription review system can significantly improve the quality of prescriptions for elderly outpatients,alleviate the pressure on dispensers to review prescriptions,and promote clinical rational drug use.