6000张儿科门诊处方普通感冒用药合理性分析

摘要

目的:了解川北医学院第二临床医学院·南充市中心医院(以下简称"我院")儿童普通感冒的合理用药情况,为合理用药管理提供依据.方法:利用PASS临床药学管理系统,抽取2016年我院儿科门诊处方,每月500张,共6 000张,对其中普通感冒用药处方进行合理用药评价与分析.以季度为阶段,针对每个季度的突出问题制订并实施药学干预措施,对4个季度合理用药情况进行统计学分析.结果:2016年我院儿科门诊6 000张处方中,临床诊断为感冒、上呼吸道感染以及感冒相关症状处方共2 628张,占43.8％.2016年我院儿科各季度抗菌药物使用率分别为93.3％(643/689)、76.8％(484/630)、60.7％(337/555)、53.2％(401/754),抗感冒复方制剂使用率分别为91.4％(631/689)、85.7％(540/630)、72.6％(403/555)、68.7％(518/754),相同或相似成分重复用药率分别为63.7％(439/689)、50.0％(315/630)、37.3％(207/555)、11.8％(89/754);通过药学干预,儿童普通感冒合理用药水平明显提高,第4季度各项指标明显优于第1季度,差异均有统计学意义(P<0.05).结论:临床医师对抗感冒复方制剂的安全性存在认知缺陷,药学部通过参与药物治疗管理,对医师处方进行干预,并进行合理用药宣传教育,可显著提高儿童普通感冒合理用药水平.%OBJECTIVE:To investigate the application rationality of common cold drugs in children form Second Clinicalmedical College of North Sichuan Medical Pharmacy·Nanchong Central Hospital(hereinafter referred to as "our hospital"),so as to provide reference for management of rational application of drugs.METHODS:By PASS clinical pharmacy system,outpatient pediatric prescriptions of 2016 were extracted,500 prescriptions per month,with a total of 6 000 prescriptions,evaluation and analysis were conducted on the application rationality of common cold drugs.To set one quarter as a stage,development and implementation of pharmacy intervention measures were taken for outstanding problems,statistical analysis and evaluation was conducted on application rationality of common cold drugs in 4 quarters.RESULTS:Of the 6 000 prescriptions,2 628 prescriptions were diagnosed as cold,upper respiratory infection and cold symptoms by clinic,accounting for 43.8％.The application rate of antibiotics in 4 quarters of 2016 were respectively 93.3％(643/689),76.8％(484/630),60.7％(337/555)and 53.2％(401/754),the application rate of anti-cold compound preparations were respectively 91.4％(631/689),85.7％(540/630),72.6％(403/555)and 68.7％(518/754),and repeated usage rate of same or similar components were respectively 63.7％(439/689),50.0％(315/630),37.3％(207/555)and 11.8％(89/754).Through pharmaceutical intervention,the level of application rationality of common cold drugs increased significantly,and the fourth quarter was better than the first quarter,with statistically significant difference(P<0.05).CONCLUSIONS:The clinicians have cognitive deficits in the safety of anti-cold compound preparations.Pharmacy department can significantly improve the level of rational drug application of common cold drugs by participating in the management of drug treatment,intervention of physician prescriptions,rational application of drug promotion and education.