某结核病专科医院门诊处方基本指标评价及用药合理性分析
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摘要
目的通过对某结核病专科医院门诊处方进行点评,评价结核病专科医院门诊处方用药指标和合理用药情况,进一步促进临床合理用药。方法抽取医院2013年9月至2014年8月门诊处方2 400张进行点评,对相关指标进行回顾性汇总分析。结果 2 400张门诊处方中结核诊断处方1 913张,占79.71%,非结核诊断处方487张,占20.29%;在1 913张结核病处方中,含有护肝药物的处方占结核病处方的61.58%,含有其他辅助用药的处方占结核病处方的15.58%。2 400张门诊处方中,每张处方平均用药品种数为3.08种,每张处方平均金额为310.24元,基本药物使用率55.28%,处方通用名使用率为100%,抗菌药物使用率和注射剂使用率分别为6.92%和4.67%。2400张门诊处方中,合理处方1 969张(82.04%),不合理处方431张(17.96%);不合理处方中,不规范处方320张(74.25%),用药不适宜处方111张(25.75%),超常处方0张(0.00%)。结论结核病专科医院门诊处方,病种相对单一,单张处方药物品种多,药量大,金额高,特别是结核病辅助用药金额占比高;抗菌药物和注射剂使用率低;门诊处方不合理现象普遍,不规范处方比率较高,应加强监督,针对性干预,进一步规范医生处方行为,提高门诊的合理用药水平。
Objective The drugs use indicators and rationality of outpatient prescriptions in a specialized hospital were evaluated in order to further promote the rational use of clinical drug.Methods The relevant indicators were retrospectively analyzed by 2400 outpatient prescriptions comments from Sep.2013 to Aug.2014.Results The total number of outpatient prescriptions was 2 400,of which were divided into 1 913 prescriptions of tuberculosis diagnosis and 487 prescriptions of non-tuberculosis diagnosis,and the rate of outpatient prescriptions was 79.71% and 20.29%,respectively.The rate of hepatoprotective drugs and other adjuvant drugs in 1913 of tuberculosis prescriptions was 61.58% and 15.58%,respectively.The average number of drugs of each prescription was 3.08.The average drug cost was 310.24 Yuan per prescription.The percentages of prescribed antibiotics and injection were 6.92% and 4.67%.The rate of drugs prescribed from essential drugs was 55.28%.The percentages of drugs prescribed in generic names were 100%.The number of qualified and irrational prescriptions was 431(17.96%).In the irrational prescriptions,the non-standard prescriptions were 320(74.25%),the irrational drug use prescriptions were 111(25.75%) and the off-label use prescriptions were 0(0.00%).Conclusion The varieties of diseases are relatively single,however,the large amount of drugs and high costs were in tuberculosis specialized hospital outpatient prescription.The antibiotics and injection have low utilization rate.The outpatient prescriptions are irrational widely,non-standard prescriptions rate is higher.Therefore,it is important to strengthen supervision.The targeted intervention should be taken and doctors′ prescribing behavior should be regulated for improving the rational use of outpatient levels.
Objective The drugs use indicators and rationality of outpatient prescriptions in a specialized hospital were evaluated in order to further promote the rational use of clinical drug.Methods The relevant indicators were retrospectively analyzed by 2400 outpatient prescriptions comments from Sep.2013 to Aug.2014.Results The total number of outpatient prescriptions was 2 400,of which were divided into 1 913 prescriptions of tuberculosis diagnosis and 487 prescriptions of non-tuberculosis diagnosis,and the rate of outpatient prescriptions was 79.71% and 20.29%,respectively.The rate of hepatoprotective drugs and other adjuvant drugs in 1913 of tuberculosis prescriptions was 61.58% and 15.58%,respectively.The average number of drugs of each prescription was 3.08.The average drug cost was 310.24 Yuan per prescription.The percentages of prescribed antibiotics and injection were 6.92% and 4.67%.The rate of drugs prescribed from essential drugs was 55.28%.The percentages of drugs prescribed in generic names were 100%.The number of qualified and irrational prescriptions was 431(17.96%).In the irrational prescriptions,the non-standard prescriptions were 320(74.25%),the irrational drug use prescriptions were 111(25.75%) and the off-label use prescriptions were 0(0.00%).Conclusion The varieties of diseases are relatively single,however,the large amount of drugs and high costs were in tuberculosis specialized hospital outpatient prescription.The antibiotics and injection have low utilization rate.The outpatient prescriptions are irrational widely,non-standard prescriptions rate is higher.Therefore,it is important to strengthen supervision.The targeted intervention should be taken and doctors′ prescribing behavior should be regulated for improving the rational use of outpatient levels.
引文
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[6] 张云玲,阚晓红.40例复发性肺结核患者抗结核药物治疗不良反应的临床分析[J].结核病与肺部健康杂志,2015,12(4):242-246.
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[8] 中国防痨协会.耐药结核病化疗指南(2015)[J].中国防痨杂志,2015,37(5):421-469.
[9] 张云玲,贺思勋,洪健.某省级结核病专科医院2009-2012年抗结核药的临床应用分析[J].中国药房,2014,25(6):503-505.
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[2] 卫生部.医院处方点评管理规范(试行)[S].卫医管发[2010]28号.
[3] 卫生部,国家中医药管理局,总后卫生部.抗菌药物临床应用指导原则[J].药物不良反应杂志,2005,7(1):42.
[4] WHO.Medicines use in primary care in developing andtransitional countries [S].Fact book summarizing results from studies reported between 1990 and 2006,2009:91.
[5] 张强.结核患者门诊处方点评及用药分析[J].中国医院药学杂志,2010,30(13):1155-1157.
[6] 张云玲,阚晓红.40例复发性肺结核患者抗结核药物治疗不良反应的临床分析[J].结核病与肺部健康杂志,2015,12(4):242-246.
[7] 肖和平,唐神结.耐药结核病防治手册[M].北京:人民卫生出版社,2009:81-83.
[8] 中国防痨协会.耐药结核病化疗指南(2015)[J].中国防痨杂志,2015,37(5):421-469.
[9] 张云玲,贺思勋,洪健.某省级结核病专科医院2009-2012年抗结核药的临床应用分析[J].中国药房,2014,25(6):503-505.
[10] 肖和平.抗结核治疗时预防性护肝用药的是与非[J].中华结核和呼吸杂志,2013,36(10):722-723.