OBJECTIVE: To provide reference for improving prescription review mode and the level of rational drug use in medical institutions of Chongqing. METHODS: The prescription review expert group was established by Chongqing Municipal Committee for Health and Family Planning, and 1 600 outpatient and emergency prescriptions and 300 inpatient medical orders were collected from respiratory department, general surgery department and infection department of 16 municipal medical institutions by equal distance sampling method in Aug. 23rd and Sept. 13th in 2017. Special prescription review was conducted for 3 core indexes (utilization rate of antibiotics, combined use and adjuvant drug) of outpatient and emergency prescriptions, non-standard prescriptions, unsuitable prescriptions and abnormal prescriptions, the use of antibiotics for special use or expensive antibiotics and adjuvant drugs in the inpatient medical orders. RESULTS: The utilization rate of antibiotics in outpatient prescriptions was 9.28%(<20%), and that of antibiotics in emergency prescriptions was 23.83%(<40%). The rate of combined use of antibiotics was 3.04%, and utilization rate of adjuvant drugs was 5.02%. The rate of irrational prescriptions was 21.03%, including irrational use of antibiotics, irrational use of adjuvant drugs, incomplete writing of clinical diagnosis, unsuitable indication, unsuitable drug selection, unsuitable route of administration, unsuitable dosage and usage and unsuitable drug combination. In the inpatient medical orders, the utilization rates of carbapenems, glycopeptides, quinolones and third-generation cephalosporins were 20.67%, 3.33%, 31.10% and 30.03%, respectively. The rate of combined use of antibiotics was 37.67%; the microbiological specimen detection rate of antibiotics for special use was 87.08%. The rate of irrational inpatient medical orders was 49.67%, including unsuitable indication, unsuitable dosage, unsuitable medication course, no consultation record about antibiotics for special use, no microbiological specimen detection record about antibiotics for special use, unsuitable drug combination and no medical record about antibiotics use. There were some problems in prescription review, such as disunity of hospital information system, low efficiency of overall manual prescription review, absence of uniform and authoritative prescription review rules. CONCLUSIONS: It is suggested to establish uniform and normative centralized prescription review standard, integrate different hospital information systems, improve the efficiency of prescription review by means of informatization, so as to improve clinical drug use in medical institutions.
关键词
重庆医疗机构处方点评集中点评合理用药
Keywords
ChongqingMedical institutionsPrescription reviewCentralized reviewRational drug use