摘要
目的促进临床合理用药。方法通过计算机检索中国知网、万方、维普、中国生物医学文献等数据库中我国静脉用药调配中心(PIVAS)不合理医嘱的相关文献,检索时限为自建库起至2020年12月,文献语种限定为中文。统计不同地区医疗机构的不合理医嘱情况,以及不合理医嘱类型、药品种类、相关科室,并计算不合理率。结果共纳入111篇文献,87篇文献报道处方总量及不合理处方数量,不合理处方占0.21%(140021/65471982)。其中,4篇来自二级医疗机构,其余均来自三级医疗机构,涉及19个省(自治区)及4个直辖市,处方不合理率较高的地区为宁夏(5.60%)、湖南(1.38%)、江西(1.23%)、海南(1.21%)、内蒙古(1.11%)等,广西(0.06%)、重庆(0.09%)、上海(0.09%)的不合理率较低;最常见的不合理医嘱类型为用法用量不适宜(29.51%)、溶剂选择不适宜(23.76%)、药物浓度不适宜(20.23%);抗菌药物不合理医嘱占比最高(31.67%),其次为中药类(22.99%);不合理医嘱排名前3的科室为消化内科、血液科、神经内科。结论医疗机构药学人员应依托PIVAS平台,运用药学知识及信息化系统软件,对临床不合理用药予以干预,加强医疗机构合理用药的集中管理,以降低用药错误的发生风险,促进临床合理用药。
Objective To promote clinical rational drug use.Methods The literature related to unreasonable intravenous medical orders of China's pharmacy intravenous admixture services(PIVAS)in the CNKI,WanFang,VIP and CBM database was searched from the inception to December 2020,and the language was limited to Chinese.The data of unreasonable medical orders in medical institutions in different regions,and the types of unreasonable medical orders,types of drugs and relevant departments were collected,and the unreasonable rate was calculated.Results A total of 111 studies were included,of which 87 studies reported total prescriptions and unreasonable prescriptions with an unreasonable rate of 0.21%(140021/65471982).Among them,four studies were from secondary medical institutions,and the rest were from tertiary medical institutions,involving nineteen provinces(autonomous regions)and four municipalities directly under the central government.The areas with high unreasonable rates were Ningxia(5.60%),Hunan(1.38%),Jiangxi(1.23%),Hainan(1.21%),Inner Mongolia(1.11%),and the areas with low unreasonable rates are Guangxi(0.06%),Chongqing(0.09%)and Shanghai(0.09%).The most common types of unreasonable medical orders were inappropriate usage and dosage(29.51%),inappropriate solvent selection(23.76%)and inappropriate drug concentration(20.23%).The proportion of unreasonable medical orders of antibiotics was the highest(31.67%),followed by traditional Chinese medicine(22.99%).The top three departments of unreasonable medical orders were the Department of Gastroenterology,Hematology and Neurology.Conclusion Pharmacy staff in medical institutions should use pharmaceutical knowledge and information system software to intervene the irrational drug use in the clinic through the PIVAS platform,strengthen the centralized management of rational drug use in medical institutions,reduce the risk of medication errors and promote rational drug use in the clinic.
作者
刘国强
杨警囡
LIU Guoqiang;YANG Jingnan(The Third Hospital of Hebei Medical University,Shijiazhuang,Hebei,China 050051)
出处
《中国药业》
CAS
2022年第5期120-123,共4页
China Pharmaceuticals
