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基于PCNE分类系统的儿科前置审核医嘱分析
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| 篇名： | 基于PCNE分类系统的儿科前置审核医嘱分析 |
| TITLE： | Analysis of pediatric pre-prescription review orders based on PCNE classification system |
| 摘要： | 目的 采用欧洲药学监护联盟（PCNE）分类系统分析儿科医院门诊前置审核医嘱中的药物相关问题（DRPs），为改进前置审核系统、减少用药错误的发生提供参考依据。方法回顾性收集2022年7月至2023年6月上海交通大学医学院附属上海儿童医学中心的门诊前置审核医嘱数据，通过PCNE分类系统（V9.1版）对医嘱中存在的DRPs进行分类汇总，分析DRPs医嘱产生的问题类型、问题的产生原因、介入被接受情况。结果本研究共纳入门诊前置审核DRPs医嘱66017条，涉及患者41165例。其中≤5岁患儿的DRPs医嘱占比最高（58.25%），其次为6～12岁患儿（33.52%）；DRPs医嘱占比最高的科室为儿内科（71.41%）；DRPs医嘱发生率最高的科室为胸外科（9.73%）；发生DRPs医嘱的药品种类前3名为全身用抗感染药（25.26%）、中成药（24.74%）和呼吸系统药物（22.38%）。参照PCNE分类系统，DRPs医嘱中问题类型占比最高为治疗安全性问题（64.86%）；DRPs医嘱产生的原因主要为剂量选择（82.09%），其中药物剂量过高占41.26%；92.13%的介入都能被临床医生接受并完全执行。结论使用PCNE分类系统，能够有效分析前置审核系统识别的DRPs医嘱。药师应重点关注≤5岁儿童的用药情况，及时更新和制定个性化的审核规则，满足儿童临床用药的合理性需求。 |
| ABSTRACT： | OBJECTIVE To provide reference for improving the pre-prescription review system and reducing the occurrence of medication error by analyzing the drug-related problems （DRPs） in the pre-prescription review orders of pediatric outpatient clinics using the Pharmaceutical Care Network Europe （PCNE） classification system. METHODS The data of pre-prescription review orders were retrospectively collected from outpatient department of Shanghai Children’s Medical Center， Shanghai Jiao Tong University School of Medicine from July 2022 to June 2023； DRPs in the pre-prescription review orders were classified and summarized by using the PCNE classification system （version 9.1）， and then analyzed in terms of types and causes of issues， and the acceptance of interventions. RESULTS A total of 66 017 DRPs orders were included， involving 41 165 patients. The proportion of DRPs orders in children aged ≤5 years old was the highest （58.25%）， followed by children aged 6-12 years old （33.52%）； the department with the highest proportion of DRPs was internal medicine of pediatrics department （71.41%）； the department with the highest incidence of DRPs was thoracic surgery department （9.73%）； top three drug categories of DRPs orders were systemic anti- infective drugs （25.26%）， Chinese patent medicines （24.74%） and respiratory drugs （22.38%）. Referring to PCNE classification system， the types of DRPs mainly focused on treatment safety （64.86%）； the reasons of DRPs orders mainly focused on dose selection （82.09%）， of which 41.26% were due to excessive drug dosage； 92.13% of interventions could be accepted and fully executed by doctors. CONCLUSIONS DRPs orders identified by the pre-prescription review system can be effectively analyzed by using PCNE classification system. Pharmacists should focus on medication use in children aged ≤5 years old， update and develop personalized prescription review rules timely， and meet the rational needs of clinical medication for children. |
| 期刊： | 2025年第36卷第03期 |
| 作者： | 沈安乐；王佩齐；徐涛；骆佳；王学贤；张顺国；李志玲 |
| AUTHORS： | SHEN Anle，WANG Peiqi，XU Tao，LUO Jia，WANG Xuexian，ZHANG Shunguo，LI Zhiling |
| 关键字： | PCNE分类系统；药物相关问题；医嘱；儿科；前置审核 |
| KEYWORDS： | PCNE classification system； drug-related |
| 阅读数： | 8 次 |
| 本月下载数： | 8 次 |
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