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·医药热点·
医疗机构药品遴选指南 Δ
李正翔 ,张 玉 ,张伶俐 ,段 蓉(1.天津医科大学总医院,天津 300052;2.华中科技大学同济医学院附属
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3
1*
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协和医院,武汉 430022;3.四川大学华西第二医院,成都 610041)
中图分类号 R95 文献标志码 A 文章编号 1001-0408(2022)07-0769-08
DOI 10.6039/j.issn.1001-0408.2022.07.01
摘 要 为促进医疗机构药品遴选工作规范开展,提升医疗机构药事管理水平,促进患者在疾病的药物治疗中安全、有效、经济、
适宜地使用药品,制定《医疗机构药品遴选指南》。该指南的构建严格遵循了美国国家科学院医学研究所(IOM)关于指南的最新
定义,并以世界卫生组织(WHO)标准指南制定的方法学为基本依据。在指南构建的过程中,基于德尔菲法构建《医疗机构药品遴
选指南》研究问题,并设计了以10个一级指标、30个二级指标为核心的药品遴选评价体系,评估指标按其属性及主要证据来源可
划分为研究型指标和政策型指标。其中研究型指标采用GRADE方法评价问题证据体系的质量,政策型指标按照《立法法》进行
证据分级。在此基础上,应用循证医学方法建立各项指标的评价方法和内容,并通过专家共识法形成推荐意见,最终形成医疗机
构药品遴选的标准指南。
关键词 药品遴选;医疗机构;遴选指标;评价体系;指南
Drug selection guideline for medical institutions
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LI Zhengxiang ,ZHANG Yu ,ZHANG Lingli ,DUAN Rong(1. Tianjin Medical University General Hospital,
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Tianjin 300052,China;2. Union Hospital, Tongji Medical College, Huazhong University of Science and
Technology,Wuhan 430022,China;3. West China Second Hospital,Sichuan University,Chengdu 610041,
China)
ABSTRACT In order to promote the standardization of drug selection in medical institutions,enhance the level of pharmaceutical
affairs management of medical institutions and promote the safe,effective,economical and appropriate use of drugs in the
treatment of diseases,the Drug Selection Guideline for Medical Institutions(hereinafter refer to as the Guideline)is formulated.
The development of the Guideline for medical institutions is following the latest definition of Institution of Medicine (IOM),
National Academy of Sciences and based on the methodology of WHO handbook for guideline development. During the
construction of the Guideline,the research points of the Guideline are constructed on the basis of Delphi method;a drug selection
and evaluation system with 10 primary indicators and 30 secondary indicators as the core is also designed. The evaluation indexes
can be divided into research indexes and policy indexes according to their attributes and main sources of evidence. The GRADE
method is used to evaluate the quality of the evidence system for research indexes,while the policy indexes are graded according to
the Legislation Law of the People’s Republic of China. On this basis,the evaluation methods of those indexes are constructed by
using evidence-based medicine method,the recommendation is formed through expert consensus method,and finally a standard
guideline for drug selection in medical institutions is formed.
KEYWORDS drug selection;medical institutions;selection index;evaluation system;guideline
近年来,随着医药卫生事业的持续发展,大量药品 关键的技术手段。构建客观、科学、标准的药品遴选方
不断迭代上市,在为临床诊疗工作提供了更多选择的同 法和指标体系更是医疗机构药品目录遴选过程标准化、
时,也对医疗机构药事管理工作提出了更高的要求和巨 透明化、规范化的重要步骤和保障 [1-3] 。为此,《医疗机
大的挑战。医疗机构在优化院内药品结构、合理调整药 构药品遴选指南》的项目组开展了本指南的制定工作,
品目录的工作过程中,利用科学完善的评价指标体系及 现将指南公布,供医疗机构参考。
评价方法,对待遴选药品进行多维度综合评价是重要且 1 指南制定目的
本指南的制定旨在将医疗机构药事管理工作中一
Δ 基金项目:天津市赵以成医学科学基金资助项目
直以来以主观评价为主要方法的药品遴选工作,转化为
*主任药师。研究方向:药理学、药事管理。电话:022-60363702。
E-mail:13820893896@163.com 客观的评价方法和标准的规范化流程,以期科学、规范、
中国药房 2022年第33卷第7期 China Pharmacy 2022 Vol. 33 No. 7 ·769 ·