作　　者： (林平）; (陈宁）; (杨学文）; (吴雪）; (崔蔚）; (甄健存）;

机构地区： 北京积水潭医院药剂科,北京100035

出　　处： 《实用药物与临床》 2017年第8期952-955,共4页

摘　　要： 目的了解门诊不合理处方状况,为医院处方管理和不合理用药监测提供数据参考。方法以某院2014-2015年门诊药房窗口药师干预的577张不合理处方为研究对象,按问题类型、药品类别进行帕累托图分析,比较不同科室间的差异。结果 577张不合理处方共存在14种问题类型,涉及药品19类。构成主要问题类型的为"适应证不适宜"(57.2%)和"用法、用量不适宜"(15.1%)。构成主要因素的药品共7类,构成比排名前两位的分别为"循环系统药物"(17.3%)和"解热镇痛、抗炎抗风湿、抗痛风药"(13.6%),这两类药品分别为内科、骨科处方排名首位的问题药品。"遴选药品不适宜"、"用法用量不适宜"分别为骨科、内科处方排名第2位的问题类型(首位均为"适应证不适宜")。结论不同科室常见不合理处方问题类型及药品存在差异,整体以"适应证不适宜"、"用法用量不适宜"为主,以骨科和内科使用较多的药品居多。提示在审核处方过程中,应加强对医院常用药品使用合理性的审核,尤其应关注其适应证及用法用量的正确与否。 Objective To understand the situation about unreasonable outpatient prescriptions,and to provide reference for the management of hospital prescription and the monitoring of irrational drug use.Methods According to the types of unreasonable problems and the classifications of drugs misused,Pareto Diagram analysis was performed on 577 unreasonable prescriptions intervened by pharmacists in one hospital＇s outpatient from 2014 to 2015,and the differences among different departments were found out.Results Totally 14 types of unreasonable problems were found in the 577 prescriptions which involved 19 classifications of drugs.The main types of problems were indication mismatch（57.2%） and improper usage or dosage（15.1%）.The main drugs＇ classifications could be divided into 7 categories,the top 2 of which were circulatory system drugs（17.3%） and antipyretic,analgesic,anti-inflammatory,anti-rheumatic and anti-gout drugs（13.6%）,and they were respectively the first drugs misused in internal prescriptions and orthopedic prescriptions.Drugs selection and improper usage or dosage were respectively the second problem in orthopedic prescriptions and internal prescriptions,while indication mismatch was the first problem in both.Conclusion The common types of unreasonable problems and classifications of drugs misused differ in different departments.In a word,indication mismatch and improper usage or dosage are the main unreasonable problems,the common drugs used in orthopedic and internal prescriptions are more misused.It is necessary to strengthen the prescriptions＇ checking on the commonly used drugs in a hospital,especially on the correctness of indication,usage and dosage.

关 键 词： 门诊 不合理处方 帕累托图