医师处方行为规律与不合理处方规律分析
目的：分析门急诊医师用药规律,以期找出出现不合理处方的可能环节,提高处方审核的成效。方法：对医院信息系统中门急诊处方记录按科室分组,随机抽取处方记录,采用ABC分类法对医师的处方数及药品品规、数量进行汇总分析。对照门急诊处方审核发现的不合理处方,分析出现不合理处方的药品临床应用频度。结果：收集到门急诊用药处方记录19万多条,涉及药品490种。纳入分析的门急诊医师有297位,个人使用药品数量为30~253种,中位数为156种,Q1、Q3四分位数分别为111、182种。在样本医师的不合理处方记录中,无＂适应证不适宜的＂、有＂配伍禁忌或者不良相互作用的＂记录。药师判断为＂用法用量不适宜的＂并获得医师...
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| Published in | 药学服务与研究 Vol. 18; no. 1; pp. 55 - 57 |
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| Main Author | |
| Format | Journal Article |
| Language | Chinese |
| Published |
上海市儿童医院,上海交通大学附属儿童医院药学部,上海200063%上海市儿童医院,上海交通大学附属儿童医院信息科,上海200063%上海市儿童医院,上海交通大学附属儿童医院医务科,上海200063
2018
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1671-2838 |
| DOI | 10.5428/pcar20180114 |
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| Abstract | 目的：分析门急诊医师用药规律,以期找出出现不合理处方的可能环节,提高处方审核的成效。方法：对医院信息系统中门急诊处方记录按科室分组,随机抽取处方记录,采用ABC分类法对医师的处方数及药品品规、数量进行汇总分析。对照门急诊处方审核发现的不合理处方,分析出现不合理处方的药品临床应用频度。结果：收集到门急诊用药处方记录19万多条,涉及药品490种。纳入分析的门急诊医师有297位,个人使用药品数量为30~253种,中位数为156种,Q1、Q3四分位数分别为111、182种。在样本医师的不合理处方记录中,无＂适应证不适宜的＂、有＂配伍禁忌或者不良相互作用的＂记录。药师判断为＂用法用量不适宜的＂并获得医师修正的处方涉及8位医师、10条记录,有5条记录的药品属于医师最常用的A类药品,另5条记录的药品属于医师常用的B类药品。结论：门急诊医师的处方用药数量与专业科室有关,普通内科医师个人使用药品种类范围和平均数均高于普通外科医师。有不合理处方记录的医师情况符合工作量大、压力大容易出错的一般规律。不合理处方的出现属于随机小概率事件,难以发现其中规律,提示药师审核处方要持之以恒,全方位审核才能保证临床用药安全。 |
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| AbstractList | 目的：分析门急诊医师用药规律,以期找出出现不合理处方的可能环节,提高处方审核的成效。方法：对医院信息系统中门急诊处方记录按科室分组,随机抽取处方记录,采用ABC分类法对医师的处方数及药品品规、数量进行汇总分析。对照门急诊处方审核发现的不合理处方,分析出现不合理处方的药品临床应用频度。结果：收集到门急诊用药处方记录19万多条,涉及药品490种。纳入分析的门急诊医师有297位,个人使用药品数量为30~253种,中位数为156种,Q1、Q3四分位数分别为111、182种。在样本医师的不合理处方记录中,无＂适应证不适宜的＂、有＂配伍禁忌或者不良相互作用的＂记录。药师判断为＂用法用量不适宜的＂并获得医师修正的处方涉及8位医师、10条记录,有5条记录的药品属于医师最常用的A类药品,另5条记录的药品属于医师常用的B类药品。结论：门急诊医师的处方用药数量与专业科室有关,普通内科医师个人使用药品种类范围和平均数均高于普通外科医师。有不合理处方记录的医师情况符合工作量大、压力大容易出错的一般规律。不合理处方的出现属于随机小概率事件,难以发现其中规律,提示药师审核处方要持之以恒,全方位审核才能保证临床用药安全。 R969.3%R95; 目的:分析门急诊医师用药规律,以期找出出现不合理处方的可能环节,提高处方审核的成效.方法:对医院信息系统中门急诊处方记录按科室分组,随机抽取处方记录,采用ABC分类法对医师的处方数及药品品规、数量进行汇总分析.对照门急诊处方审核发现的不合理处方,分析出现不合理处方的药品临床应用频度.结果:收集到门急诊用药处方记录19万多条,涉及药品490种.纳入分析的门急诊医师有297位,个人使用药品数量为30~253种,中位数为156种,Q1、Q3四分位数分别为111、182种.在样本医师的不合理处方记录中,无"适应证不适宜的"、有"配伍禁忌或者不良相互作用的"记录.药师判断为"用法用量不适宜的"并获得医师修正的处方涉及8位医师、10条记录,有5条记录的药品属于医师最常用的A类药品,另5条记录的药品属于医师常用的 B类药品.结论:门急诊医师的处方用药数量与专业科室有关,普通内科医师个人使用药品种类范围和平均数均高于普通外科医师.有不合理处方记录的医师情况符合工作量大、压力大容易出错的一般规律.不合理处方的出现属于随机小概率事件,难以发现其中规律,提示药师审核处方要持之以恒,全方位审核才能保证临床用药安全. |
| Abstract_FL | Objective:To analyze the medication pattern of doctorin the outpatientand emergency departments,so ato find outhe potential linkof unreasonable prescriptionand improve the effectivenesof prescription review.Methods:Pre-scription recordof the outpatientand emergency departmentfrom the database of the hospital information system(HIS) were divided by differendepartmentand were randomly chosen fothe study.The numbeof prescriptions,the typeand numbeof drugwere summarized and analyzed by the Abclassification system.Then,irrational medication frequency shown in unreasonable prescriptionwaanalyzed againsprescriptionby physicianfrom the outpatientand emergency departments. Results:Totally,ove190 000 medication recordwere collected,including 490 drugs.Included in the analysiwere 297 physi-cianfrom the emergency department.The numbeof drugprescribed by individual doctorwa30-253,with the medium being 156 and the uppeand lowequartilebeing 111 and 182.In the recordof all irrational prescriptions,there were no pre-scriptionwith impropeindications,buthere were prescriptionwith incompatibility oadverse drug interactions.Eighphy-sicianand 10 recordwere involved in irrational prescriptions,which were viewed abeing impropemedication and dosage by pharmacistand were then revised by doctoraproposed.With the drug typeof 10 records,the drugin the 5 recordwere of the moscommonly used A-type drugs,and those in the othe5 recordwere of the frequently used B-type drugs. Conclusion:The numbeof prescribed drugby doctorwadirectly associated with occupational specialty and medical depart-ments.The typeand average numbeof drugprescribed by physicianwere all highethan those by surgeons.The doctorwith unreasonable prescription recordwere consistenwith the general pattern of easy to make mistakedue to heavy work load and pressure.Presence of irrational prescriptionwaof random low-rate incidence,withouregulapattern.All thiindicated thaclinical pharmacistshould persisin making prescription review to ensure medication safety clinically. |
| Author | 朱彦;曾娜;陈敏;刘永斌;孙华君 |
| AuthorAffiliation | 上海市儿童医院上海交通大学附属儿童医院药学部,上海200063;上海市儿童医院上海交通大学附属儿童医院信息科,上海200063;上海市儿童医院上海交通大学附属儿童医院医务科,上海200063 |
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| Author_FL | CHEN Min ZENG Na SUN HuaJun ZHU Yan LIU YongBin |
| Author_FL_xml | – sequence: 1 fullname: ZHU Yan – sequence: 2 fullname: ZENG Na – sequence: 3 fullname: CHEN Min – sequence: 4 fullname: LIU YongBin – sequence: 5 fullname: SUN HuaJun |
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| Copyright | Copyright © Wanfang Data Co. Ltd. All Rights Reserved. |
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| DOI | 10.5428/pcar20180114 |
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| DocumentTitleAlternate | Analysis of the pattern of prescription behavior and unreasonable prescriptions |
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| Keywords | 合理用药 不合理处方 rational use of drugs prescription review 处方审核 unreasonable prescription |
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| Notes | prescription review;rational use of drugs;unreasonable prescription 31-1877/R ZHU Yan1 ,ZENG Na1 ,CHEN Min2 ,LIU YongBin3,SUN HuaJun1（1 .Department of Pharmacy ,Children＇s Hospital of Shang-hai ,Children＇s Hospital Affiliated to Shanghai Jiaotong University ,Shanghai 200063 ,China？2 .Department of Information , Children＇s Hospital of Shanghai ,Children＇s Hospital Affiliated to Shanghai Jiaotong University ,Shanghai 200063 ,China？3 .Department of Medical Affairs ,Children＇s Hospital of Shanghai ,Children＇s Hospital Affiliated to Shanghai Jiaotong University ,Shanghai 200063 ,China） Objective：To analyze the medication pattern of doctors in the outpatients and emergency departments,so as to find out the potential links of unreasonable prescriptions and improve the effectiveness of prescription review.Methods：Prescription records of the outpatients and emergency departments from the database of the hospital information system（HIS）were divided by different departments and were randomly chosen for the study.The number |
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| Publisher | 上海市儿童医院,上海交通大学附属儿童医院药学部,上海200063%上海市儿童医院,上海交通大学附属儿童医院信息科,上海200063%上海市儿童医院,上海交通大学附属儿童医院医务科,上海200063 |
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| SubjectTerms | 不合理处方 合理用药 处方审核 |
| Title | 医师处方行为规律与不合理处方规律分析 |
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