某医院合理用药国际指标调研及处方合理性的分析

摘要

目的对某院门诊处方合理性进行调研,为制定促进合理用药干预措施提供依据.方法根据世界卫生组织/基本药物行动计划/合理用药国际网络联合制定的国际指标及我国的《医院处方点评管理规范(试行)》,对2011年5月至6月的1440张门诊处方和同期380例门诊患者进行调研,分别统计处方指标、关怀指标及不合理处方.结果处方指标中,平均用药品种数为2.04种,通用名使用率为99.56%,抗菌药物使用率为28.96%,注射剂使用率为25.07%,基本药物使用率为56.92%,处方平均金额为86.79元；关怀指标中,患者平均就诊时间为6.90min,平均发药交代时间为32s,调配药物率为100%,药品标签标示完整率为100%,患者了解正确用药方法率为90.43%；处方合格率为97.99%.结论该医院门诊处方在处方平均用药品种数、药品通用名使用率、基本药物使用率、处方平均金额、平均就诊时间、实际调配药物率、药品标签完整率、患者了解药品用法率等方面均符合合理用药标准.但在抗菌药物使用率、注射剂使用率、平均发药交待时间等方面不符合合理用药标准；不合理处方主要是药物选择、用法用量、联合用药不适宜,需采取有效干预措施.%　　Objective To investigate the rationality of prescription among outpatients in a hospital, in order to provide a reasonable basis for making intervention measures of promoting rational drug use. Methods We investigated 1440 outpatients' prescriptions and 60 outpatients during May–June in 2010 and analyzed the prescription indicators, the care indicators and the rationality of prescription , according to the international indicators developed by WHO/DAP/INRUD and the Management Specification of Prescription Evaluation in Hospital(on trial) in China. Results The prescription indicators were as follows:the average number of drug types was 2.04, the use rate of drug's generic name was 99.56%, the use rate of antibacterial was 28.96%, the use rate of injections was 25.07%, and the use rate of basic drugs was 56.92%, and the average cost was 86.79 Yuan. The patient care indicators were as follows:the average visiting time was 6.90 min;the average explanatory time was 32 sec;the percentage of drug dispensing was 100%;100%drugs were labeled;the percentage of patients,who understood the drugs usage,accounted for 90.43%;the percentage of rational prescription was 97.99%. Conclusion The outpatient-prescriptions from the hospital have met medication standard in the following aspects:the average number of drug types;the use rate of drug's generic name;the use rate of basic drugs;the average cost;the average visiting time;the percentage of drug dispensing;the percentage of complete drug label;the percentage of patients who understood the drugs usage. However,it still needs improvement in following aspects:the use rate of antibacterial and injections , the average explanatory time. The main aspects of irrational prescription were:unreasonable drug selection,dosage, administration and combination , which need further pragmatic intervention measures.