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药师借助合理用药App开展门急诊处方前置审核的实践及效果
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篇名: 药师借助合理用药App开展门急诊处方前置审核的实践及效果
TITLE: Practice and Effect of Outpatient and Emergency Prescription Pre-audit by Pharmacists with the Help of Rational Drug Use Software
摘要: 目的:探讨药师借助合理用药App开展门急诊处方前置审核在合理用药中的作用。方法:借助合理用药App收集2020年1-4月开展处方前置审核的门急诊处方,分析对不合理处方的干预效果;收集2019年9-12月的处方作为对照组(仅进行事后点评)、2020年1-4月的处方作为干预组(开展处方前置审核,并进行事后点评),比较干预前后不合理处方情况;进一步选取2019年11-12月被App系统拦截的处方作为拦截对照组、2020年1-2月被拦截的处方为拦截干预组,比较干预前后处方拦截情况,评价前置审核对医师开方行为的影响。此外,以2020年4月获取的108992张处方为对象,分别采用传统模式(即全人工审核)与信息化模式(即App辅助人工审核)进行事后点评,比较两种模式下的处方事后点评效果。结果:2020年1-4月,药师开展前置审核处方共2393张,其中合理处方1387张(占57.96%),不合理并进行干预的处方1006张(占42.04%);药师干预后医师返回修改处方数983张,干预成功率为97.71%。与对照组比较,干预组的门急诊处方总体不合理率、各类型处方不合理率均显著降低(P<0.001);与拦截对照组的拦截处方数(1402张)比较,拦截干预组的拦截处方数(721张)显著降低(P<0.001)。与传统模式比较,信息化模式下需要人工事后点评的处方数及“假阳性”处方数显著减少,且发现的不合理处方数显著增加(P<0.001)。结论:药师借助合理用药App开展处方前置审核,可显著提高门急诊处方的合理率;在信息化模式下进行处方事后点评,可在降低药师工作强度的同时提高点评的准确度。
ABSTRACT: OBJECTIVE:To explore the role of pharmacists i n developi ng the outpatient and emergency prescription pre-audit with the help of rational drug use software. METHODS :With the help of rational drug use software ,outpatient and emergency prescription pre-aduit was conducted during Jan.-Apr. 2020;the intervention effects of irrational prescriptions were analyzed. The prescriptions from Sept. to Dec. in 2019 were included in the control group (only for post review ),and the prescriptions from Jan. to Apr. in 2020 were included in the intervention group (pre-audit and post review );the unreasonable prescriptions were compared before and after the intervention. The prescriptions intercepted by the software system from Nov. to Dec. in 2019 were further selected as the interception control group ,and the prescriptions intercepted from Jan. to Feb. in 2020 were selected as the interception intervention group ;the interception situation of prescriptions before and after the intervention was compared ,and the influence of pre-audit on physicians ’prescription behavior was evaluated. In addition ,108 992 prescriptions in Apr. 2020 were selected for post review using the traditional model (i.e. complete manual audit )and the information model (i.e. software-assisted manual audit )respectively;the effects of two models were compared. RESULTS :From Jan. to Apr. in 2020,a total of 2 393 prescriptions were pre-audited by pharmacists ,among which 1 387 prescriptions were reasonable (57.96%)and 1 006 prescriptions were unreasonable and intervened (42.04%). After pharmacist intervention ,983 prescriptions were modified by doctors ,and the success rate of intervention was 97.71% . Compared with control group ,unreasonable rate of outpatient and emergency prescriptions,that of each type of prescriptions were all decreased significantly (P<0.001). Compared with interception control group(1 402 pieces),the number of intercepted prescriptions (721 pieces)was significantly reduced in interception intervention group (P<0.001). Compared with traditional model , the number of prescriptions requiring manual post review and E-mail:xss306@126.com “false positive ” prescriptions were decreased significantly # under information model , and the number of discovered unreasonable prescriptions were increased significantly (P< 0.001). CONCLUSIONS :With the help of rational drug use software ,prescription pre-audit by pharmacists can significantly improve reasonable rate of outpatient and emergency prescriptions. The work intensity of pharmacists in post review of prescriptions can be reduced and the accuracy of prescription review can be improved in the information mode.
期刊: 2021年第32卷第07期
编辑: 谢珊珊,刘松,万瑾瑾,梅蕾蕾,刘烨,张卫芳
AUTHORS: XIE Shanshan ,LIU Song,WAN Jinjin,MEI Leilei,LIU Ye,ZHANG Weifang
关键字: 合理用药App;前置审核;处方点评;合理用药
KEYWORDS: Rational drug use software ;Pre-audit;Prescription review ;Rational drug use
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