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·药师与药学服务·

我院多部门协作处方点评模式在重点监控药品管理中的实践 Δ

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沈爱宗 1，2＊ ，张圣雨 ，陈泳伍 ，闫方雪 ，邵 蓉 （1.中国药科大学国际医药商学院，南京 211198；2.中国科学
1 #
3
2
技术大学附属第一医院/安徽省立医院药剂科，合肥 230001；3.安徽省临泉县中医院西药房，安徽 临泉
236000）

中图分类号 R95 文献标志码 A 文章编号 1001-0408（2020）13-1646-04
DOI 10.6039/j.issn.1001-0408.2020.13.19

摘 要 目的：为医疗机构处方点评模式的构建及重点监控药品的监管提供参考。 方法：建立中国科学技术大学附属第一医院
（以下简称“我院”）多部门协作的处方点评模式，在药事管理与药物治疗委员会下设处方管理小组（由分管院长、药剂科主任、医务
处处长和药学、医学、护理学及行政管理部门负责人组成），并下设处方点评专家组（负责对处方点评工作提供专业技术咨询并负
责处方终评）和处方点评工作小组（负责处方初评），依据《药品管理法》《执业医师法》《反不正当竞争法》等制定我院《药品购销和
使用监督管理办法》并建立多部门协作的处方点评管理流程。采用此模式对我院重点监控药品处方进行干预，并考察干预前
（2019年6月）、干预后（2019年9月）我院重点监控药品使用率与医嘱合理性。结果：我院成功建立了多部门协作处方点评模式。
重点监控品种销售金额占药品总收入的比例由干预前的1.322％下降至干预后的0.735％（P＝0.010）；医嘱不合理率由干预前的
46.76％降低至干预后的 15.70％（P＝0.023），不合理医嘱主要类型由干预前的用法用量不适宜（18.52％）、适应证不适宜
（12.50％）、给药途径不适宜（9.26％）转变为干预后的用法用量不适宜（15.70％），其他医嘱不合理现象也得到明显改善。 结论：我
院构建的多部门协作处方点评模式在我院重点监控药品监管中的成效显著，显著减少了该类药品临床不合理使用情况。
关键词 多部门协作处方点评模式；重点监控药品；药品管理；实践

Practice of Multidisciplinary Collaborative Prescription Review Mode in Key Monitored Drugs Management
in Our Hospital
SHEN Aizong ，ZHANG Shengyu ，CHEN Yongwu ，YAN Fangxue ，SHAO Rong（1. School of International
2
1
2
3
1，2
Pharmaceutical Business，China Pharmaceutical University，Nanjing 211198，China；2. Dept. of Pharmacy，the
First Affiliated Hospital of University of Science and Technology of China/Anhui Provincial Hospital，Hefei
230001，China；3. Dispensary for Western Medicine，Anhui Province Linquan County Hospital of TCM，Anhui
Linquan 236000，China）
ABSTRACT OBJECTIVE：To provide reference for the construction of prescription review model in medical institution and key
monitored drugs management. METHODS：A multidisciplinary collaborative prescription review mode was established in the First
Affiliated Hospital of University of Science and Technology of China （called “our hospital” for short）. The prescription
management group（composed of the president in charge，the director of pharmacy department，the director of medical department
and the person in charge of pharmacy，medicine，nursing and administrative management）was set up under the Pharmaceutical
Affairs Management and Drug Treatment Committee；and then prescription review expert group （be responsible for providing
professional technical consultation and final evaluation of prescriptions）and prescription review working group（be responsible for
the initial evaluation of prescriptions）were set up. According to the Drug Administration Law，the Law of Licensed Doctors and
the Law of Anti-unfair Competition Act and so on，the Measures for the Supervision and Administration of Drug Purchase，Sale
and Use in our hospital was formulated. The multi-disciplinary collaborative prescription review procedure was established to
intervene key monitored drugs prescriptions. The utilization rate of key monitored varieties and prescription reasonability in our
hospital were investigated before（Jun. 2019）and after the intervention（Sept. 2019）by the mode. RESULTS：The multidisciplinary
collaborative prescription review mode was established sucessfully. The proportion of key monitored drugs in total drug sales
amount decreased from 1.322％ before intervention to 0.735％
Δ 基金项目：国家卫生健康委员会药政司课题（No.药政〔2018〕购
after intervention （P＝0.010）. The irrational rate of
2号）
prescriptions decreased from 46.76％ before intervention to
＊主任药师，博士研究生。研究方向：药事管理、药物经济学。电
15.70％ after intervention （P＝0.023）. The main types of
话：0551-62283379-800。E-mail：1649441800@qq.com
# 通信作者：教授，博士生导师，博士。研究方向：国家医药政策 irrational prescriptions were inappropriate usage and dosage
法规。E-mail：shaorong118@163.com （18.52％），inappropriate indications（12.50％），inappropriate

·1646 · China Pharmacy 2020 Vol. 31 No. 13 中国药房 2020年第31卷第13期