曹文佳 杨婉花 阮晓芳 杨莉

中图分类号 R95 文献标志码 A 文章编号 1001-0408（2018）09-1185-05

DOI 10.6039/j.issn.1001-0408.2018.09.08

摘 要 目的：促进门诊药房药品不良事件管理的信息化，减少用药风险。方法：从药房问题处方管理和药品不良反应监测记录及其报告两大信息化平台建设两方面，介绍我院门诊药房实施的药品不良事件管理的信息化实践，通过成功实时在线记录的调剂差错和不良事件数及门诊医师上报药品不良反应数等，评价实施成效。结果：我院开发的门诊药房药品不良事件管理模块，经使用后实现了对发药中“疑方”的实时在线记录、问题处方的查询汇总、药品不良事件的及时报告及电子版药品不良反应监测并上报的功能；其实时且信息化地记录了我院门诊药房2017年4月-6月发生的148次调剂内差（占处方总数的0.035%）、2016年6月-2017年6月发生的15次药品不良事件（占处方总数的0.008‰），同期由门诊医师通过操作方便的电子版药品不良反应监测并上报的门诊药品不良反应共计82起（占我院不良反应总数的36.94%）。结论：信息化的建设，使我院门诊药房能及时记录相关的工作差错和不良事件并及时进行针对性的管理，同时促进了门诊医师上报药品不良反应，降低了用药安全风险。

关键词 药品不良事件；门诊药房；信息化；调剂差错；药品不良反应上报

ABSTRACT OBJECTIVE： To promote the informatization of adverse drug event （ADE） management in outpatient pharmacy so as to reduce the risk of drug use. METHODS： From the aspect of the construction of two information platforms as problematic prescription management and ADR monitoring record and report， the practice of the informatization of ADE management in outpatient pharmacy of our hospital was introduced； the effects of information management were evaluated by real-time online record for the number of dispensing error and ADE and the number of ADR reported by outpatient pharmacists. RESULTS： The application of ADE management module for outpatient pharmacy developed by our hospital realized the following functions as real-time online record of “suspected prescription”， problematic prescription inquiry and summary， ADE report without delay， electronic ADR monitoring and reporting. 148 times of dispensing internal errors during Apr.-Jun. 2017 （accounting for 0.035% of total prescription） and 15 ADEs during Jun. 2016-Jun. 2017 （accounting for 0.008‰ of total prescription） were recorded in outpatient pharmacy of our hospital. There were 82 ADR cases reported by outpatient physicians using user-friendly electronic ADR monitoring and reporting （accounting for 36.94% of total ADR）. CONCLUSIONS： The construction of informatization promotes timely record of related error and adverse events， targeted management and ADR reporting and reduces the risk of drug use.

KEYWORDS Adverse drug event； Outpatient pharmacy； Informatization； Dispensing error； ADR reporting

藥品不良事件（Adverse drug event，ADE）是指药品在治疗过程中出现的不良临床事件[1]，如药品本身的质量缺陷、临床用药不合理、药品滥用及药品不良反应（Adverse drug reaction，ADR）等，其概念宽泛、覆盖面广。……