OBJECTIVE:To investigate the situation of irrational medication and pharmacists’manual intervention in prescriptions of grassroots medical institutions by the Prescription review Center of Tianhe District

Guangzhou

so as to provide reference for the implementation of internet-based accurate intervention of preliminary prescription review and the operation of regional prescription review center.METHODS:Prescriptions reviewed by the regional prescription review system from Sept.2019 to Feb.2020 were counted and classified

with emphasis on the analysis of the first and second level warning of irrational medication.RESULTS:A total of 297 429 prescriptions were reviewed by the system

among which 782 prescriptions（0.26%） were returned with the first level warning of the regional prescription review system

the main irrational types were contraindications for special populations

excessive daily doses of drugs and inappropriate routes of administration.The second level warning of the prescription review system sent 23 812 prescriptions（8.01%） to pharmacists for manually review

the main irrational types were repeated medication

improper indications

improper usage and dosage.The overall acceptance rate of clinicians for the manual reviewed prescriptions was 84.37%（20 089 prescriptions）.There were 2 601 false positive prescriptions and 899 false positive prescriptions.CONCLUSIONS:There are too many prescriptions for first level and second level warning

and clinicians’acceptance of manual review opinions needs to be improved.The number of false positive prescriptions and false negative prescriptions are large

which shall be optimized through revising the principles for reviewing prescriptions.Manual pre-review is helpful to find and reduce the irrational medication in primary medical institutions

and to ensure the safety of patients’medication

which is a kind of intensive review mode and worth popularizing.