6000张儿科门诊处方普通感冒用药合理性分析
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摘要
目的:了解川北医学院第二临床医学院·南充市中心医院(以下简称"我院")儿童普通感冒的合理用药情况,为合理用药管理提供依据。方法:利用PASS临床药学管理系统,抽取2016年我院儿科门诊处方,每月500张,共6 000张,对其中普通感冒用药处方进行合理用药评价与分析。以季度为阶段,针对每个季度的突出问题制订并实施药学干预措施,对4个季度合理用药情况进行统计学分析。结果:2016年我院儿科门诊6 000张处方中,临床诊断为感冒、上呼吸道感染以及感冒相关症状处方共2 628张,占43.8%。2016年我院儿科各季度抗菌药物使用率分别为93.3%(643/689)、76.8%(484/630)、60.7%(337/555)、53.2%(401/754),抗感冒复方制剂使用率分别为91.4%(631/689)、85.7%(540/630)、72.6%(403/555)、68.7%(518/754),相同或相似成分重复用药率分别为63.7%(439/689)、50.0%(315/630)、37.3%(207/555)、11.8%(89/754);通过药学干预,儿童普通感冒合理用药水平明显提高,第4季度各项指标明显优于第1季度,差异均有统计学意义(P<0.05)。结论:临床医师对抗感冒复方制剂的安全性存在认知缺陷,药学部通过参与药物治疗管理,对医师处方进行干预,并进行合理用药宣传教育,可显著提高儿童普通感冒合理用药水平。
OBJECTIVE: To investigate the application rationality of common cold drugs in children form Second Clinical Medical College of North Sichuan Medical Pharmacy·Nanchong Central Hospital( hereinafter referred to as"our hospital"),so as to provide reference for management of rational application of drugs. METHODS: By PASS clinical pharmacy system,outpatient pediatric prescriptions of 2016 were extracted,500 prescriptions per month,with a total of 6 000 prescriptions,evaluation and analysis were conducted on the application rationality of common cold drugs. To set one quarter as a stage,development and implementation of pharmacy intervention measures were taken for outstanding problems,statistical analysis and evaluation was conducted on application rationality of common cold drugs in 4 quarters. RESULTS: Of the 6 000 prescriptions,2 628 prescriptions were diagnosed as cold,upper respiratory infection and cold symptoms by clinic,accounting for 43. 8%. The application rate of antibiotics in4 quarters of 2016 were respectively 93. 3%( 643/689),76. 8%( 484/630),60. 7%( 337/555) and 53. 2%( 401/754),the application rate of anti-cold compound preparations were respectively 91. 4%( 631/689),85. 7%( 540/630),72. 6%( 403/555) and 68. 7%( 518/754),and repeated usage rate of same or similar components were respectively 63. 7%( 439/689), 50. 0%( 315/630), 37. 3%( 207/555) and 11. 8%( 89/754). Through pharmaceutical intervention,the level of application rationality of common cold drugs increased significantly,and the fourth quarter was better than the first quarter,with statistically significant difference( P < 0. 05). CONCLUSIONS:The clinicians have cognitive deficits in the safety of anti-cold compound preparations. Pharmacy department can significantly improve the level of rational drug application of common cold drugs by participating in the management of drug treatment,intervention of physician prescriptions,rational application of drug promotion and education.
OBJECTIVE: To investigate the application rationality of common cold drugs in children form Second Clinical Medical College of North Sichuan Medical Pharmacy·Nanchong Central Hospital( hereinafter referred to as"our hospital"),so as to provide reference for management of rational application of drugs. METHODS: By PASS clinical pharmacy system,outpatient pediatric prescriptions of 2016 were extracted,500 prescriptions per month,with a total of 6 000 prescriptions,evaluation and analysis were conducted on the application rationality of common cold drugs. To set one quarter as a stage,development and implementation of pharmacy intervention measures were taken for outstanding problems,statistical analysis and evaluation was conducted on application rationality of common cold drugs in 4 quarters. RESULTS: Of the 6 000 prescriptions,2 628 prescriptions were diagnosed as cold,upper respiratory infection and cold symptoms by clinic,accounting for 43. 8%. The application rate of antibiotics in4 quarters of 2016 were respectively 93. 3%( 643/689),76. 8%( 484/630),60. 7%( 337/555) and 53. 2%( 401/754),the application rate of anti-cold compound preparations were respectively 91. 4%( 631/689),85. 7%( 540/630),72. 6%( 403/555) and 68. 7%( 518/754),and repeated usage rate of same or similar components were respectively 63. 7%( 439/689), 50. 0%( 315/630), 37. 3%( 207/555) and 11. 8%( 89/754). Through pharmaceutical intervention,the level of application rationality of common cold drugs increased significantly,and the fourth quarter was better than the first quarter,with statistically significant difference( P < 0. 05). CONCLUSIONS:The clinicians have cognitive deficits in the safety of anti-cold compound preparations. Pharmacy department can significantly improve the level of rational drug application of common cold drugs by participating in the management of drug treatment,intervention of physician prescriptions,rational application of drug promotion and education.
引文
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[10]李根,郭文玫,梁华,等.我院儿童抗感冒复方制剂说明书及不合理用药处方分析[J].中国药房,2016,27(29):4053-4057.
[11]许巍,王丽杰,刘春峰.儿童容易忽略的药物中毒[J].中国小儿急救医学,2010,17(4):300-303.
[12]罗双红,温杨,朱渝,等.中国0至5岁儿童病因不明急性发热诊断和处理若干问题循证指南:病因、实验室检查和治疗部分解读[J].中国循证儿科杂志,2016,11(4):295-302.
[13]张伶俐,李幼平.基于风险与责任,促进中国儿童合理用药的思考[J].中国循证医学杂志,2011,11(9):983-984.
[14]张勤,姜云平,郑咏池,等.医疗机构药师干预促进合理用药的系统评价[J].中国医院药学杂志,2015,35(14):1327-1332.
[15]唐捷,龙云,龙凤,等.浅议医院药学服务的发展趋势[J].西部医学,2012,24(11):2240-2242.
[2]刘国梁,林江涛,刘关键,等.门诊普通感冒患者对普通感冒认知的调查[J].中华内科杂志,2012,51(4):262-265.
[3]陆权,安淑华,艾涛,等.中国儿童普通感冒规范诊治专家共识:2013年[J].中国实用儿科杂志,2013,28(9):680-686.
[4]中国医师协会呼吸医师分会,中国医师协会急诊医师分会.普通感冒规范诊治的专家共识[J].中华内科杂志,2012,51(4):330-333.
[5]特殊人群普通感冒规范用药专家组.特殊人群普通感冒规范用药的专家共识[J].国际呼吸杂志,2015,35(1):1-5.
[6]戴元荣,林江涛.普通感冒治疗中抗菌药物的滥用与原因分析[J].中华内科杂志,2012,51(4):260-261.
[7]Sharfstein JM,North M,Serwint JR.Over the counter but no longer under the radar—pediatric cough and cold medications[J].N Engl J med,2007,357(23):2321-2324.
[8]黄亮,陈力,韩璐,等.正确认识儿童感冒咳嗽药的安全性问题[J].中国药房,2010,21(1):3-6.
[9]苏楠,林江涛,刘关键,等.我国各级医院医师对普通感冒认知与诊治现状的调查[J].中华内科杂志,2012,51(4):266-269.
[10]李根,郭文玫,梁华,等.我院儿童抗感冒复方制剂说明书及不合理用药处方分析[J].中国药房,2016,27(29):4053-4057.
[11]许巍,王丽杰,刘春峰.儿童容易忽略的药物中毒[J].中国小儿急救医学,2010,17(4):300-303.
[12]罗双红,温杨,朱渝,等.中国0至5岁儿童病因不明急性发热诊断和处理若干问题循证指南:病因、实验室检查和治疗部分解读[J].中国循证儿科杂志,2016,11(4):295-302.
[13]张伶俐,李幼平.基于风险与责任,促进中国儿童合理用药的思考[J].中国循证医学杂志,2011,11(9):983-984.
[14]张勤,姜云平,郑咏池,等.医疗机构药师干预促进合理用药的系统评价[J].中国医院药学杂志,2015,35(14):1327-1332.
[15]唐捷,龙云,龙凤,等.浅议医院药学服务的发展趋势[J].西部医学,2012,24(11):2240-2242.