| 曹靓,王凤玲,冯正平,毛俊.合肥市第二人民医院门诊抗肿瘤处方点评分析[J].中国医药导报,2024,21(2):179-183 |
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| 合肥市第二人民医院门诊抗肿瘤处方点评分析 |
| Analysis of anti-tumor prescription comments in outpatient department of Hefei Second People’s Hospital |
| 收稿日期：2023-01-12 |
| DOI：10.20047/j.issn1673-7210.2024.02.38 |
| 关键词: 抗肿瘤 专项点评 帕累托图 管理指标 |
| Key Words: |
| 基金项目:国家自然科学基金青年科学基金资助项目（82003849） |
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| 摘要:目的 了解合肥市第二人民医院（以下简称“本院”）门诊抗肿瘤处方情况，提高专项点评整体水平。 方法 筛选本院2020年1月至2021年12月门诊开具的抗肿瘤处方和不良反应报告，利用帕累托图分析处方不合理的原因，并结合临床应用管理指标进行评价。 结果 共纳入抗肿瘤处方2 463张，经点评得到不合理处方294张。普通和限制使用级抗肿瘤药物处方数分别为1 857张和606张，使用金额分别为3 452 438.04元和847 884.90元，处方合格率为88.06%，处方干预成功率为90.14%。门诊全部不良反应报告份数为2 296份，其中抗肿瘤药物全部不良反应报告份数为285份，抗肿瘤药物严重及新的不良反应报告份数分别为8份和7份。不合理处方中主要人群为60岁以上人群。泌尿外科、血液肿瘤科、呼吸内科和神经内科是不合理处方涉及的主要科室；肿瘤、高血压、糖尿病、脑梗死是不合理处方的主要诊断；处方超量和适应证不适宜是不合理处方的主要和次要类型。结论 本院门诊抗肿瘤处方合格率和干预成功率偏低，不合理原因较多，临床药师应结合临床应用管理指标和帕累托图定期进行专项点评并采取措施，确保肿瘤患者用药安全。 |
| Abstract:Objective To understand the anti-tumor prescriptions in the outpatient department of Hefei Second People’s Hospital (hereinafter referred to as “our hospital”) and improve the overall level of special comments. Methods The anti- tumor prescriptions and adverse reaction reports issued by the outpatient department of our hospital from January 2020 to December 2021 were screened, the reasons for unreasonable prescriptions were analyzed by Pareto chart, and the evaluation was carried out in combination with clinical application management indicators. Results A total of 2 463 anti-tumor prescriptions were included, a total of 294 unreasonable prescriptions were obtained. A total of 1 857 were common and 606 were restricted anti-tumor drug prescriptions, and the consumption amount was 3 452 438.04 yuan and 847 884.90 yuan, respectively. The qualified rate of prescriptions was 88.06%, and the success rate of prescription intervention was 90.14%. The total number of adverse reaction reports in outpatient department was 2 296, among which the total number of adverse reaction reports of anti-tumor drugs was 285, and the number of serious and new adverse reaction reports of anti-tumor drugs was eight and seven, respectively. The main groups of irrational prescriptions were people over 60 years old. Urology, hemato-oncology, respiratory medicine, and neurology were the main departments involved in unreasonable prescription. Tumor, hypertension, diabetes, and cerebral infarction were the main diagnoses of irrational prescription. Over- prescribing and inappropriate indications were the main and secondary types of irrational prescribing. Conclusion The qualified rate of antitumor prescriptions and the success rate of intervention in the outpatient department of our hospital are low, and there are many unreasonable reasons. Clinical pharmacists should regularly make special comments and take measures based on clinical application management indicators and Pareto chart to ensure the drug safety of tumor patients. |
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