药事管理干预对基层医疗机构中药注射剂临床使用的影响
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篇名: | 药事管理干预对基层医疗机构中药注射剂临床使用的影响 |
TITLE: | Effects of Pharmaceutical Management Intervention on Clinical Use of TCM Injection in Primary Medical Insti- tutions |
摘要: | 目的:探讨药事管理干预对基层医疗机构中药注射剂使用的影响。方法:随机选取江西省宜春市20个基层卫生院,依托宜春市卫生健康委药政科和宜春市药事质控中心,由宜春市人民医院牵头,对各基层卫生院进行中药注射剂处方评价标准建立、药学服务技能培训、处方及医嘱专项点评、完善管控措施等药事管理干预,并以发放中药注射剂使用情况调查表和随机抽取处方/医嘱进行点评的方式获得各基层卫生院药品使用的相关数据。将2018年1-6月未进行药事管理(干预前)的相关数据作为未干预组,2019年1-6月进行药事管理(干预后)的相关数据作为干预组,比较干预前后中药注射剂的使用情况、用药频度(DDDs)、限定日费用(DDC)、排序比。同时,随机抽取干预前(1222份)和干预后(1005份)中药注射剂的处方/医嘱进行点评,比较干预前后其合理情况。结果:干预后,使用量排名前10位中药注射剂的使用总量、销售金额、DDDs均明显下降。干预前的处方/医嘱合理率为48.04%,干预后升至70.65%;且干预前后的不合理情况均集中在适应证不适宜。干预后,注射用血塞通(冻干)、血栓通注射液、醒脑静注射液(两种规格)、生脉注射液、注射用血栓通(冻干)、清开灵注射液的不合理率均较干预前显著下降。结论:药事管理干预能降低基层医疗机构中药注射剂的使用总量和销售金额,促进其临床合理用药。 |
ABSTRACT: | OBJECTIVE:To investigate the effects of pharmaceutical management intervention on the use of TCM injection in primary medical institutions. METHODS :Twenty grass-roots health centers in Yichun city ,Jiangxi province were randomly selected. Relying on Department of Pharmacy and Health Services of the Municipal Health Committee and the Quality Control Center for Pharmacy Affairs of the City ,Yichun People ’s Hospital took the lead in establishing the prescription evaluation criteria for TCM injection ,training pharmaceutical service skills ,conducting special reviews on prescriptions/medical orders ,improving control measures ,obtaining relevant data of drug use in primary health centers by issuing questionnaires on the use of TCM injection and randomly selecting prescriptions/medical orders for comments. The relevant data without drug administration (before intervention)from Jan. to Jun. 2018 were taken as the non-intervention group ,and the relevant data with drug administration (after intervention)from Jan. to Jun. 2019 were taken as the intervention group. The use of TCM medicine injection ,DDDs,DDC and sequencing ratio were compared before and after intervention. At the same time ,the prescriptions/medical orders of TCM injections before(1 222 copies)and after (1005 copies)intervention were randomly selected for comment and the reasonable situations of the prescriptions/medical orders were compared before and after the intervention. RESULTS :After intervention ,total amount , consumption sum and DDDs of top 10 TCM injections in the list of amount were significantly decreased. The reasonable rate of prescriptions and medical orders was 48.04% before intervention , but increased to 70.65% after intervention. Besides , unreasonable situations before and after intervention all manifested as inappropriate indications. After the intervention ,the unreasonable rates of Xuesaitong powder for injection (lyophilized),Xueshuantong injection ,Xingnaojing injection (two specifications),Shengmai injection ,Xueshuantong for injection (lyophilized)and Qingkailing injection were significantly lower than before intevention (P<0.05). CONCLUSIONS :Pharmaceutical administration intervention can reduce the total amount and the consumption sun of TCM injection in primary medical institutions ,and promote rational drug use in the clinic. |
期刊: | 2021年第32卷第12期 |
作者: | 王群,金钊,黄颖,胡文,刘波,伍婷 |
AUTHORS: | WANG Q un,JIN Zhao,HUANG Ying,HU Wen,LIU Bo,WU Ting |
关键字: | 药事管理;基层医疗机构;中药注射剂;合理性评价;处方点评 |
KEYWORDS: | Pharmaceutical administration ;Primary medical institutions ;TCM injection ;Rationality evaluation ;Prescription |
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