摘要
目的:介绍广州市天河区区域性审方中心的建设运营经验,评价审方中心的初期实施效果。方法:建立前置审方信息系统,制定审方规则,规范审方行为与流程,对处方存在的问题进行分级警示,分别采取对应的措施。统计对比先行上线审方系统的3家社区卫生服务机构上线前后处方情况、审方干预情况。2018年7-12月前置审方系统上线前的处方数据为对照组,2019年7-12月审方系统上线后的处方数据为观察组,比较2组数据不合理用药处方数量和比例,统计分析不合理处方情况及审方干预结果,进行初期评价。结果:经过审方系统前置审核后,处方合格率有较大幅度提升;重复用药或者联合用药不适宜、选药不合理或适应症不适宜占据所有不合理类型前2位;一级/二级/三级警示处方的总趋势逐步减少,四级处方在逐步增加;医生对药师的审方意见接受率总体呈上升趋势。结论:审方中心确实提高了区域基层医疗机构的处方合格率和合理用药水平,是前置审方集约化模式的尝试,是值得推广的医联体统一药学服务模式。
OBJECTIVE To introduce the construction and operation experience of regional reviewer center in Tianhe District,Guangzhou City,and evaluate the initial implementation effect of reviewer center.METHODS The pre-reviewer information system was established;the reviewer rules were formulated;the reviewer behavior and process were standardized,the existing problems of prescriptions were graded and warned,and the corresponding measures were given.The prescription and reviewer intervention of the three community health service institutions that went online in advance of the reviewer system were statistically compared before and after going online.The prescription data before the pre-reviewer system went online from July to December 2018 was the control group,and the prescription data after the reviewer system went online from July to December 2019 was the observation group.The number and proportion of irrational drug use prescriptions were compared between the two groups,and the irrational drug use and reviewer intervention results were statistically analyzed for initial evaluation.RESULTS After the pre-review of the review system,the qualified rate of prescriptions was greatly increased;the top 2 of all unreasonable types included inappropriate repeated medication or combined medication,unreasonable drug selection and inappropriate indication;the general trend of primary/secondary/tertiary warning prescriptions was gradually reduced,and the fourth-level prescriptions were gradually increased;the acceptance rate of doctors’review comments to pharmacists was generally on the rise.CONCLUSION The review center does improve the qualified rate of prescription and the level of rational drug use in regional grassroots medical institutions,which is an attempt of intensive model of pre-review,and is a unified pharmaceutical care model for medical alliances worth popularizing.
作者
冯焕村
陈文瑛
郑晓霞
何炳洪
何楚欣
朱江尉
韦美丹
段萍萍
徐康州
李秀娟
何葳
唐美珍
夏冬
曾振坤
吴杨
胡波
FENG Huan-cun;CHEN Wen-ying;ZHENG Xiao-xia;HE Bing-hong;HE Chu-xin;ZHU Jiang-wei;WEI Mei-dan;DUAN Ping-ping;XU Kang-zhou;LI Xiu-juan;HE Wei;TANG Mei-zhen;XIA Dong;ZENG Zhen-kun;WU Yang;HU Bo(Department of Pharmacy,The Third Affiliated Hospital,Southern Medical University,Guangdong Guangzhou 510630,China;Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases,Guangdong Guangzhou 510630,China;Hunan Sanya Information Technology Co.LTD,Hunan Changsha 410000,China)
出处
《中国医院药学杂志》
CAS
北大核心
2020年第18期1992-1997,共6页
Chinese Journal of Hospital Pharmacy
基金
2018年广东省卫生计生适宜技术推广项目(项目名称:依托药学专科联盟提高社区卫生服务中心慢性疾病合理用药水平的推广及应用)
2018年广州市天河区科技计划(编号:2018YT033)(项目名称:依托药学专科联盟提高基层医院慢性疾病合理用药水平)。
关键词
区域性审方中心
处方前置审核
医联体药学服务
regional prescription examination center
prescription pre-review
pharmaceutical care of medical alliances
