上海市51家医院处方点评工作现况调查分析

发布时间：2019-07-12 18:05

【摘要】：目的:为处方点评工作的持续改进提供科学依据。方法:设计网络调查问卷,以上海市医院药师为对象就医院处方点评工作开展的相关情况进行调查,并对数据进行统计和分析。结果:共回收问卷51份,均为有效问卷,问卷回收有效率为100%;共涉及51家医院。51家医院都采用了二级复核的处方点评模式,二级医院多采用"临床药师初评,专家组复评"模式,占23.53%,而三级医院和综合性医院多采用"门诊药房药师初评,临床药师复评"模式,分别占23.53%和21.57%;三级医院多采用"随机抽取某一阶段全部处方"的抽样方法(占23.53%);处方点评未使用信息化系统的占45.10%;处方点评频率为每月一次的占86.27%;门诊处方限量规定"不超过2周量"和"不超过1个月量"的占比较高(41.18%和45.10%);出现不合理使用的常见药物中比例最高的是抗菌药物(占43.14%),超常处方中最常见的问题是"无适应证用药"(占64.71%);不同类型医院的受访药师对同一问题处方的点评结果存在差异;处方点评工作对医院合理用药和药师能力的促进作用得到普遍认同,但对医师处方行为的影响并不令人满意(仅5.88%认为影响很大);"提高药师点评能力"、"增加医院领导重视程度"和"增加信息化管理力度"是受访药师对提高处方点评作用最主要的观点和建议。结论:在医院处方点评工作开展过程中,仍应注意提高处方点评权威性和抽样方法科学性,并优化处方点评频率和提升处方点评结果的一致性,还应注意与行政干预更好地结合。
[Abstract]:Objective: to provide scientific basis for continuous improvement of prescription evaluation. Methods: a network questionnaire was designed to investigate the related situation of hospital prescription evaluation among pharmacists in Shanghai, and the data were statistically analyzed. Results: a total of 51 questionnaires were collected, all of which were valid questionnaires, and the effective rate of questionnaire recovery was 100%. A total of 51 hospitals were involved. 51 hospitals adopted the prescription review mode of secondary review, the secondary hospitals mostly adopted the mode of "clinical pharmacist initial evaluation, expert group reevaluation" model, accounting for 23.53%, while tertiary hospitals and general hospitals mostly adopted "outpatient pharmacy pharmacist initial evaluation, clinical pharmacist reevaluation" model, accounting for 23.53% and 21.57%, respectively. Most of the tertiary hospitals adopted the sampling method of "random sampling of all prescriptions in a certain stage" (23.53%), 45.10% of them did not use the information system for prescription comments, 86.27% of them had the frequency of prescription comments once a month, and 41.18% and 45.10% of them had "no more than 2 weeks" and "no more than one month" (41.18% and 45.10%). The highest proportion of the common drugs with unreasonable use was antibiotics (43.14%), and the most common problem in the supernormal prescription was "no indication" (64.71%), and the results of the evaluation of the prescription of the same problem were different among the pharmacists interviewed in different types of hospitals, and the most common problem in the supernormal prescription was "non-indication drug use" (64.71%), and there were differences in the evaluation results of the prescription of the same problem among the pharmacists interviewed in different types of hospitals. The effect of prescription evaluation on rational drug use and pharmacist's ability in hospital was generally recognized, but the influence on doctor's prescription behavior was not satisfactory (only 5.88% thought it had a great influence). "improving pharmacist's evaluation ability", "increasing hospital leader's attention" and "increasing information management" were the most important viewpoints and suggestions of pharmacists interviewed to improve prescription comment. Conclusion: in the process of prescription evaluation in hospital, attention should still be paid to improving the authority of prescription evaluation and scientific sampling methods, optimizing the frequency of prescription evaluation and improving the consistency of prescription evaluation results, and should also pay attention to better combination with administrative intervention.
【作者单位】：上海市浦东新区人民医院药剂科;蚌埠医学院药学系;
【基金】：浦东新区卫生系统学科带头人培养项目(No.PWRd2014-11)
【分类号】：R95

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