王钰莹 丁树祥

[摘要] 目的 分析北京大学人民医院（以下简称“我院”）门诊药房用药干预实例，为制订统一规范的处方干预措施提供参考，促进临床合理用药，保障患者用药安全。 方法 根据医院处方点评管理规范中处方点评结果判定标准，对我院2013年1 ～7月门诊药师干预的处方进行统计分析，判定不合理处方类型，探讨问题处方解决方法。 结果 门诊药师共收集干预处方60张，占总处方数的0.13‰，其中不规范处方占40.00%，用药不适宜处方占56.67%，超常处方占3.33%。 结论 我院门诊存在不合理处方，处方干预能一定程度上促进处方规范性和合理性，应不断完善不合理处方干预的各项措施，提高处方质量和合理用药水平，保证患者用药安全。

[关键词] 门诊药房；处方干预；规范性；合理性

[中图分类号] R969.3 [文献标识码] A [文章编号] 1673-7210（2015）06（b）-0043-04

Example analysis of irrational prescriptions in outpatient pharmacy of our hospital

WANG Yuying1 DING Shuxiang1，2

1.Healthcare Management Department， Peking University International Hospital， Beijing 102206， China； 2.Department of Pharmacy， Peking University People's Hospital， Beijing 100044， China

[Abstract] Objective To analyze example of irrational prescriptions in outpatient pharmacy of Peking University People's Hospital （“our hospital” for short）， in order to provide reference for specification of intervention on prescriptions， promote the rational use of medicine and protect the safety of patients. Methods From January to July 2013， the examples of irrational prescriptions in outpatient pharmacy of our hospital were analyzed retrospectively， according to the standard management of hospital prescription comment， irrational prescriptions were classified and countermeasures were suggested. Results The pharmacist intervened 60 irrational prescriptions in advance， 0.13‰ of the total outpatient prescription. Among of the irrational prescriptions， non-standard prescription was 40.00%， drug using inappropriate prescription was 56.67%， and ultra conventional prescription was 3.33%. Conclusion Irrational prescriptions still appear in our outpatient， timely and effectively intervene in irrational prescription can facilitate the normalization and the rational use of drugs partly. Multiple intervention measures in advance aimed at irrational prescriptions should be improved and perfected constantly to improve the prescription quality and rational drug use and ensure medication safety.

[Key words] Outpatient pharmacy； Intervention on prescriptions； Normalization； Rationalisation

不合理处方会造成用药错误，影响临床治疗效果，严重者会导致患者器质性损伤甚至死亡，用药不合理引起的不良反应和药源性疾病已经成为不可忽视的问题，处分点评和处方干预能有效促进用药合理性已在医院药学界达成共识[1-2]，但目前处方干预尚未形成标准的工作模式和参考标准[3-4]。本研究对北京大学人民医院（以下简称“我院”）2013年1～7月门诊药师干预的不合理处方进行统计分析，明确不合理处方分类及不合理处方具体情况，提出相应的解决措施和改进方法，旨在为制订统一规范的处方干预措施提供参考，促进临床合理用药，保障患者用药安全。……