我院多部门协作处方点评模式在重点监控药品管理中的实践
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篇名: 我院多部门协作处方点评模式在重点监控药品管理中的实践
TITLE: Practice of Multidisciplinary Collaborative Prescription Review Mode in Key Monitored Drugs Management in Our Hospital
摘要: 目的:为医疗机构处方点评模式的构建及重点监控药品的监管提供参考。方法:建立中国科学技术大学附属第一医院(以下简称“我院”)多部门协作的处方点评模式,在药事管理与药物治疗委员会下设处方管理小组(由分管院长、药剂科主任、医务处处长和药学、医学、护理学及行政管理部门负责人组成),并下设处方点评专家组(负责对处方点评工作提供专业技术咨询并负责处方终评)和处方点评工作小组(负责处方初评),依据《药品管理法》《执业医师法》《反不正当竞争法》等制定我院《药品购销和使用监督管理办法》并建立多部门协作的处方点评管理流程。采用此模式对我院重点监控药品处方进行干预,并考察干预前(2019年6月)、干预后(2019年9月)我院重点监控药品使用率与医嘱合理性。结果:我院成功建立了多部门协作处方点评模式。重点监控品种销售金额占药品总收入的比例由干预前的1.322%下降至干预后的0.735%(P=0.010);医嘱不合理率由干预前的46.76%降低至干预后的15.70%(P=0.023),不合理医嘱主要类型由干预前的用法用量不适宜(18.52%)、适应证不适宜(12.50%)、给药途径不适宜(9.26%)转变为干预后的用法用量不适宜(15.70%),其他医嘱不合理现象也得到明显改善。结论:我院构建的多部门协作处方点评模式在我院重点监控药品监管中的成效显著,显著减少了该类药品临床不合理使用情况。
ABSTRACT: OBJECTIVE:To provide referenc e for the construction of prescription review model in medical institution and key monitored drugs management. METHODS :A multidisciplinary collaborative prescription review mode was established in the First Affiliated Hospital of University of Science and Technology of China (called“our hospital ”for short ). The prescription management group (composed of the president in charge ,the director of pharmacy department ,the director of medical department and the person in charge of pharmacy ,medicine,nursing and administrative management )was set up under the Pharmaceutical Affairs Management and Drug Treatment Committee ;and then prescription review expert group (be responsible for providing professional technical consultation and final evaluation of prescriptions )and prescription review working group (be responsible for the initial evaluation of prescriptions )were set up. According to the Drug Administration Law ,the Law of Licensed Doctors and the Law of Anti-unfair Competition Act and so on ,the Measures for the Supervision and Administration of Drug Purchase ,Sale and Use in our hospital was formulated. The multi-disciplinary collaborative prescription review procedure was established to intervene key monitored drugs prescriptions. The utilization rate of key monitored varieties and prescription reasonability in our hospital were investigated before (Jun. 2019)and after the intervention (Sept. 2019)by the mode. RESULTS :The multidisciplinary collaborative prescription review mode was established sucessfully. The proportion of key monitored drugs in total drug sales amount decreased from 1.322% before intervention to 0.735% after intervention (P=0.010). The irrational rate of prescriptions decreased from 46.76% before intervention to 15.70% after intervention (P=0.023). The main types of irrational prescriptions were inappropriate usage and dosage (18.52%),inappropriate indications(12.50%),inappropriateroute of administration (9.26%)before intervention changed into inappropriate usage and dosage (15.70%)after intervention ; other irrational prescription types had been significantly improved. CONCLUSIONS : The multidisciplinary collaborative prescription review model shows significant effect on key monitored drugs and reduce irrational use of this variety in the clinic significantly.
期刊: 2020年第31卷第13期
作者: 沈爱宗,张圣雨,陈泳伍,闫方雪,邵蓉
AUTHORS: SHEN Aizong ,ZHANG Shengyu ,CHEN Yongwu ,YAN Fangxue ,SHAO Rong
关键字: 多部门协作处方点评模式;重点监控药品;药品管理;实践
KEYWORDS: Multidisciplinary collaboration prescription review mode ;Key monitored drugs ;Drug management ;Practice
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