Page 11 - 2019年11月第30卷第21期

2017－2018年上海市金山区延伸处方开具现状调查及患者执行

依从性分析 Δ

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冒长青 ，沈卫华 ，郭 澄（1.上海市第六人民医院金山分院药剂科，上海 201599；2.上海市第六人民医院药
剂科，上海 200233）
中图分类号 R197.1 文献标志码 A 文章编号 1001-0408（2019）21-2886-04
DOI 10.6039/j.issn.1001-0408.2019.21.02

摘 要 目的：为社区延伸处方的管理和药学服务开展提供理论依据和数据支持。方法：从上海市金山区整体及其管辖的11个
街镇的卫生信息系统数据库中导出2017－2018年所有使用延伸处方患者的数据，采用回顾性调查方法，分析延伸处方患者的基
本医疗信息、延伸处方执行依从性（2 年内坚持通过延伸处方进行就诊配药）信息等数据，并分析影响依从性的因素。结果：
2017－2018年金山区开具延伸处方的患者4 835例，开具率（延伸处方开具人数/开具处方人数）为2.08％，以60岁以上（4 038例，
83.51％）、常见慢病患者[4 793 例次，83.18％（4 793/5 763）]为主，不同街镇延伸处方开具率之间比较，差异有统计学意义（P＜
0.05）；金山区延伸处方患者执行依从率总体为81.62％（62.02％～88.84％），不同性别患者的延伸处方执行依从率差异无统计学
意义（P＞0.05），年龄、疾病种类、延伸处方药品种类数等因素对延伸处方患者执行依从率有影响，以年龄在40岁以下、高血压、慢
性气道疾病患者、开具1种药品的患者的延伸处方执行依从率低于同组其他患者（P＜0.05）。结论：未来可探索利用大数据对延伸
处方的执行依从性进行监测，同时在家庭医生团队中加入药师的工作，针对依从性低的群体制订相应的指导和宣教，提高延伸处
方患者用药的合理性、有效性。
关键词 上海市；金山区；延伸处方；依从性；药学服务；大数据
Investigation on the Situation of Prescribing Extended Prescription and Analysis of Patient’s Compliance
in Execution in Jinshan District of Shanghai from 2017 to 2018
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MAO Changqing ，SHEN Weihua ，GUO Cheng（1.Dept. of Pharmacy，Jinshan Branch of the Shanghai Sixth
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People’s Hospital，Shanghai 201599，China；2.Dept. of Pharmacy，Sixth People’s Hospital of Shanghai，
Shanghai 200233，China）
ABSTRACT OBJECTIVE：To provide theoretical basis and data support for community extended prescription management and
pharmaceutical care. METHODS：Data of all patients using extended prescription from 2017 to 2018 were derived from the health
information system database of Jinshan district of Shanghai and 11 streets towns under its jurisdiction. Retrospective survey was
used to analyze the basic medical information of extended prescription patients and the compliance with extended prescription
execution（insisting on dispensing drugs through extended prescription within 2 years），and the factors affecting compliance were
analyzed. RESULTS：From 2017 to 2018，there were 4 835 patients with Jinshan district extended prescription，with prescribing
rate （number of extended prescriptions/number of prescriptions） of 2.08％ ，mainly patients over 60 years old （4 038 cases，
83.51％）and patients with common chronic diseases [4 793 casetimes，83.18％（4 793/5 763）]；there was statistical significance
in the prescribing rate of extended prescription among different streets and towns （P＜0.05）. The overall compliance rate of
extended prescription patients in Jinshan district was 81.62％（62.02％-88.84％）. There was no significant difference in compliance
rate of extended prescription execution between male and female patients（P＞0.05）. Age，type of disease and types of extended
prescription drugs had influence on compliance rate of extended prescription patients. Compliance rate of extended prescription in
patients under 40 years of age or hypertension and chronic airway disease or those who were given one kind of drug was lower than
other patients in same group （P＜0.05）. CONCLUSIONS：Big data can be used for monitoring the compliance of extended
prescription in the future. At the same time，pharmacists participating in family doctor team formulate relevant guidance and
education for poor compliance group so as to improve the rationality and effectiveness of extended prescription for patients.
KEYWORDS Shanghai；Jinshan district；Extended prescription；Compliance；Pharmaceutical care；Big data
Δ 基金项目：国家自然科学基金资助项目（No.81873042）；金山区
卫生和计划生育委员会青年项目（No.JSKJ-KTQN-2018-06）；上海市
药学会科研基金（No.2018-YY-23） 随着信息化技术的成熟和发展，信息化系统的应用
＊ 主 管 药 师 。 研 究 方 向 ：临 床 药 学 、社 区 药 学 。 E-mail：
越来越广泛，在大数据环境下，数据成为原材料，成为了
mao_changqin@126.com
一种新型的能源，为世界经济创造了巨大的价值，为推
# 通信作者：副主任中药师。研究方向：医院药学、社区药学。
[1]
E-mail：swh1294@126.com 动创新、提高生产力以及效率做出了重大贡献 。三级

·2886 · China Pharmacy 2019 Vol. 30 No. 21 中国药房 2019年第30卷第21期