2018年北京市16个区社区卫生服务中心63488张门诊处方点评与分析
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摘要
目的:了解2018年北京市社区卫生服务中心门诊处方点评的基本情况,促进基层医疗机构合理用药。方法:集中抽取2018年北京市16个区社区卫生服务中心门诊处方,共63 488张,按照处方点评标准进行点评,并对处方不合理情况进行汇总分析。结果:2018年北京市16个区社务卫生服务中心63 488张门诊处方中,不合理处方9 265张,处方不合理率为14.59%,各区域处方不合理率存在差异;其中,不规范处方2 417张(占3.81%),用药不适宜处方6 630张(占10.44%),超常处方218张(占0.34%),主要涉及用法与用量不合理问题。结论:2018年北京社区卫生服务中心处方点评结果提示,下一步应对全市医师及药师进行集中培训,以降低区域间处方点评不合理率的差异,并完善处方点评标准,尤其是西药的点评标准,促进临床合理用药,确保患者用药安全。
OBJECTIVE: To investigate the prescription review in community healthcare center of Beijing in 2018, so as to promote rational drug application in primary health care institution. METHODS: 63 488 outpatient prescriptions were concentrated extract from community healthcare center in 16 districts of Beijing in 2018 and reviewed according to the prescription review criteria, irrational prescriptions were summarized and analyzed. RESULTS: Among the 63 488 outpatient prescriptions in community healthcare center in 16 districts of Beijing in 2018, there were 9 265 irrational prescriptions, with the rate was 14.59%, and the irrational rates varied by regions; of which 2 417 were nonstandard prescription(3.81%), 6 630 prescriptions were inappropriate medication(10.44%), 218 were abnormal prescriptions(0.34%), mainly involved problems of irrational usage and dosage. CONCLUSIONS: Results of prescription review in community healthcare center of Beijing in 2018 indicates that centralized training should be conducted on clinicians and pharmacists in the whole city to reduce the difference in irrational rates of prescription reviews among regions, and to improve the prescription review criteria especially for western medicine, to promote clinical rational drug application and to ensure patient medication safety.
OBJECTIVE: To investigate the prescription review in community healthcare center of Beijing in 2018, so as to promote rational drug application in primary health care institution. METHODS: 63 488 outpatient prescriptions were concentrated extract from community healthcare center in 16 districts of Beijing in 2018 and reviewed according to the prescription review criteria, irrational prescriptions were summarized and analyzed. RESULTS: Among the 63 488 outpatient prescriptions in community healthcare center in 16 districts of Beijing in 2018, there were 9 265 irrational prescriptions, with the rate was 14.59%, and the irrational rates varied by regions; of which 2 417 were nonstandard prescription(3.81%), 6 630 prescriptions were inappropriate medication(10.44%), 218 were abnormal prescriptions(0.34%), mainly involved problems of irrational usage and dosage. CONCLUSIONS: Results of prescription review in community healthcare center of Beijing in 2018 indicates that centralized training should be conducted on clinicians and pharmacists in the whole city to reduce the difference in irrational rates of prescription reviews among regions, and to improve the prescription review criteria especially for western medicine, to promote clinical rational drug application and to ensure patient medication safety.
引文
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[2] 韩凤,杨明娜,林景怀,等.北京市医改后海淀区与朝阳区社区卫生服务中心处方点评结果对比分析[J].中国医院用药评价与分析,2019,19(2):222-225.
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[10] 毕伟彬.我院门诊处方点评干预成效分析[J].中国药业,2017,26(3):78-80.
[11] 金锐,赵奎君,郭桂明,等.中成药临床合理用药处方点评北京共识[J].中国中药杂志,2018,43(5):1049-1053.
[12] 金锐,王宇光,薛春苗,等.中成药处方点评的标准与尺度探索(九):寒热并用[J].中国医院药学杂志,2017,37(3):201-206.
[13] 金锐,孙路路,鄢丹.中成药重复用药的现状、问题和对策(一)[J].中南药学,2016,14(4):337-341.
[14] 关国娴.我院门诊处方点评与不合理处方分析[J].临床合理用药杂志,2017,10(14):92-93.
[15] 甄健存,边宝生,孔繁翠,等.区域性处方点评对临床合理用药的效果评估[J].中华医院管理杂志,2015,31(7):531-533.
[2] 韩凤,杨明娜,林景怀,等.北京市医改后海淀区与朝阳区社区卫生服务中心处方点评结果对比分析[J].中国医院用药评价与分析,2019,19(2):222-225.
[3] 卫生部.关于印发《医院处方点评管理规范(试行)》的通知[S].卫医管发[2010]28号.2010-02-10.
[4] 《中国国家处方集》编委会.中国国家处方集[M].北京:人民军医出版社,2010:56-59.
[5] 陈新谦,金有豫,汤光.新编药物学[M].17版.北京:人民卫生出版社,2011:10-12.
[6] 孔其芳,赵奇江.处方点评制度执行模式的探讨[J].中国社区医师,2017,33(22):12-13,15.
[7] 覃震常.药学干预对门诊抗生素应用合理性的作用观察[J].临床医药文献电子杂志,2017,4(27):5310-5311.
[8] 常晓红,张冰.医院中药注射剂专项处方点评及干预[J].中华中医药杂志,2017,32(1):88-91.
[9] 黄蕾,陈珊.处方点评的现状与思考[J].中医药管理杂志,2017,25(4):165-166.
[10] 毕伟彬.我院门诊处方点评干预成效分析[J].中国药业,2017,26(3):78-80.
[11] 金锐,赵奎君,郭桂明,等.中成药临床合理用药处方点评北京共识[J].中国中药杂志,2018,43(5):1049-1053.
[12] 金锐,王宇光,薛春苗,等.中成药处方点评的标准与尺度探索(九):寒热并用[J].中国医院药学杂志,2017,37(3):201-206.
[13] 金锐,孙路路,鄢丹.中成药重复用药的现状、问题和对策(一)[J].中南药学,2016,14(4):337-341.
[14] 关国娴.我院门诊处方点评与不合理处方分析[J].临床合理用药杂志,2017,10(14):92-93.
[15] 甄健存,边宝生,孔繁翠,等.区域性处方点评对临床合理用药的效果评估[J].中华医院管理杂志,2015,31(7):531-533.