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目的探讨处方点评对促进临床合理用药的影响。方法随机选取中山市坦洲医院2013年1月至2014年12月的512张处方作为对照组(实施传统处方管理模式),选取2015年1月至2016年12月的563张处方为研究组(实施处方点评管理模式)。对两组处方的不合理处方比例以及各项基本指标进行比较分析。结果 2013—2016年度,急诊患者抗菌药物处方比例、门诊患者抗菌药物处方比例、住院患者抗菌药物使用率、住院患者抗菌药物使用强度及Ⅰ类清洁手术预防使用抗菌药物比例呈降低趋势,住院患者使用抗菌药物治疗前微生物检验样本送检率及Ⅰ类清洁手术预防使用抗菌药物时机合理率呈上升趋势;研究组处方抗菌药物使用比例、注射剂使用比例均明显低于对照组,基本药物使用率明显高于对照组,差异均有统计学意义(均P<0.05);研究组内容不全、诊断书写不规范、药品规格不规范、单张处方药品种类≥5种、药物种类不适宜、基本药物未选择、联合用药不适宜、开具多种相同药理作用药物及开具高价药物处方比例均明显低于对照组,差异均有统计学意义(均P<0.05)。结论采用处方点评制度可提高临床用药合理性,降低用药不良反应发生率,减少医疗纠纷。
Objective To explore the impact of prescription reviews on promoting clinical rational use of drugs. Methods A total of 512 prescriptions from January 2013 to December 2014 in Zhongshan Hospital of Tanzhou were randomly selected as the control group (traditional prescription management mode). 563 prescriptions from January 2015 to December 2016 were selected as the research group The implementation of prescription reviews management mode). The two groups of prescriptions irrational prescription ratio as well as the basic indicators for comparative analysis. Results In 2013-2016, the proportion of antimicrobial prescriptions in emergency patients, prescriptions of antimicrobial drugs in outpatients, the use of antimicrobials in hospitalized patients, the intensity of antimicrobial use in hospitalized patients and the preventive use of antimicrobials in class I patients showed a decreasing trend. Inpatients The rate of rational use of antibacterials for antimicrobial agents in pre-treatment of antimicrobial agents increased at a reasonable rate. The proportion of prescription antibacterials used in the study group and the proportion of injections used in the study group were significantly lower than those in the control group, and the rate of using essential drugs was significantly higher In the control group, the differences were statistically significant (all P <0.05); the study group was incomplete, the diagnosis and writing is not standardized, the specifications of medicines are not standardized, the prescriptions of single prescriptions are more than 5 kinds, the types of medicines are not suitable, the essential medicines are not selected , The combination of drugs is not appropriate, issued a variety of the same pharmacological effects of drugs and issued a prescription drug prices were significantly lower than the control group, the difference was statistically significant (P <0.05). Conclusion The prescription review system can improve the rationality of clinical medication, reduce the incidence of adverse drug reactions and reduce medical disputes.