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全国医疗机构药物重整服务规范化开展情况的调查研究
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          田 欣 ,闫雪莲 ,梅 丹 ,甄健存              2, 3 # ,沈群红 ,陆 进(1.中国医学科学院北京协和医学院北京协和医院药
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          剂科,北京 100730;2.中国医院协会药事专业委员会,北京 100035;3.首都医科大学附属北京积水潭医院药
          学部,北京 100035;4.清华大学公共管理学院卫生与发展研究中心,北京 100084;5.中日友好医院药学部,
          北京 100029)

          中图分类号  R95      文献标志码  A      文章编号  1001-0408(2024)10-1163-05
          DOI  10.6039/j.issn.1001-0408.2024.10.02

          摘  要  目的  为医院药物重整服务工作的顺利开展和高质量发展提供参考。方法  设计半结构式调查问卷,分别于《医疗机构药
          物重整服务规范》等5项规范(下称“规范”)发布前后(2021年和2022年)对全国各医疗机构的药物重整服务开展情况进行调查,
          并对调查结果进行描述性分析。结果  规范发布后,各级医疗机构药物重整服务开展率由 2021 年的 15.10%(434/2 874)增长到
          2022年的27.84%(363/1 304)。2022年,363家开展了药物重整服务的医疗机构中,参与药物重整服务的药师中位人数为6人,药
          师参加药物重整服务规范化培训的参培率为75.00%,其中三级甲等医院的参培率较高,达到了85.71%。药物重整服务覆盖的主
          要环节包括患者新入院、转科和出院。药师在药物重整服务中发现的主要问题包括重复用药(252家,69.42%)、用法用量不合理
         (228家,62.81%)和药物相互作用及不良反应(218家,60.06%)。仅69家(19.01%)医疗机构有单独的电子化信息记录系统,48家
         (13.22%)构建了完善的质量管理和评价改进系统。在药师价值体现方面,有141家(38.84%)医疗机构没有给予相关药师任何形
          式的补偿。“与提高患者满意度、改进服务等工作紧密联系”是影响药物重整服务工作的最主要经验(192家,52.89%),而“符合要
          求的人才严重不足”是各级医疗机构开展药物重整服务面临的最主要困难(238家,65.56%)。结论  规范的发布有效提升了全国
          医疗机构药物重整服务的开展率,但各级医疗机构在药物重整服务人员的配备、服务内容、药物重整服务信息管理以及质量控制
          与评价系统的构建方面均还有一定的完善空间。
          关键词  药物重整;医疗机构;规范化培训;问卷

          Investigation on the standardization of medication reconciliation service in national medical institutions
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          TIAN Xin ,YAN Xuelian ,MEI Dan ,ZHEN Jiancun ,SHEN Qunhong ,LU Jin(1. Dept. of Pharmacy, Peking
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          Union  Medical  College  Hospital,Chinese  Academy  of  Medical  Sciences  and  Peking  Union  Medical  College,
          Beijing  100730,  China;2.  Pharmaceutical  Specialized  Committee,  Chinese  Hospital  Association,  Beijing
          100035, China;3. Dept. of Pharmacy, Beijing Jishuitan Hospital, Capital Medical University, Beijing 100035,
          China;4.  Health  and  Development  Institute,  School  of  Public  Policy  &  Management,  Tsinghua  University,
          Beijing 100084, China;5. Dept. of Pharmacy, China-Japan Friendship Hospital, Beijing 100029, China)
          ABSTRACT   OBJECTIVE  To  provide  a  reference  for  the  implementation  and  high-quality  development  of  hospital  medication
          reconciliation.  METHODS  A  semi-structured  questionnaire  was  designed  to  investigate  the  implementation  of  drug  reconciliation
          services in medical institutions before and after the release of 5 standards such as Standard for Medication Reconciliation Services in
          Medical  Institutions(“standards”  for  short,in  2021  and  2022).  Descriptive  statistical  analysis  was  conducted  on  the  survey  results.
          RESULTS  After  the  promulgation  of  the  standards,  the  medication  reconciliation  service  rate  of  all  types  of  medical  institutions
          increased  from  15.10% (434/2  874)  in  2021  to  27.84%(363/1  304)  in  2022.  In  2022,  in  the  363  medical  institutions  providing
          drug  reconciliation  services,  the  median  number  of  pharmacists  involved  in  drug  reconciliation  was  6.  The  participation  rate  of
          pharmacists  in  standardized  training  for  drug  reconciliation  services  was  75.00%,  among  which  the  participation  rate  of  third-class
          hospitals  was  higher,  reaching  85.71%. The  main  stages  covered  by  medication  reconciliation  services  included  patient  admission,
                                                             transfer  between  departments,  and  discharge.  The  main
             Δ 基金项目 中国医学科学院中央级公益性科研院所基本科研业                   problems  found  in  the  service  included  repeated  medication
          务费项目(No.2022-RW350-01);中央高水平医院临床科研专项(No.
                                                            (252,  69.42%) ,  inappropriate  usage  and  dosage  (228,
          2022-PUMCH-A-199)                                  62.81%),  drug  interactions  and  adverse  reactions  (218,
             *第一作者 药师。研究方向:医院药学。电话:010-69156533。
          E-mail:cputianxin@163.com                          60.06%).  Only  69  institutions  (19.01%)  had  a  separate
             #  通信作者 主 任 药 师 。 研 究 方 向 :医 院 药 学 。 电 话 :010-  electronic  information  recording  system,  while  48  institutions
          58516003。E-mail:zhenjiancun@vip.163.com           (13.22%)  had  established  comprehensive  quality  management


          中国药房  2024年第35卷第10期                                              China Pharmacy  2024 Vol. 35  No. 10    · 1163 ·
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