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| 门诊药学服务合理化随访研究 |
| Following-up Investigation of Pharmaceutical Care Indicators after Intervention in Rational Drug Use |
| 投稿时间：2005-09-22 修订日期：2006-01-17 |
| DOI： |
| 中文关键词: 药学服务 现场调研 合理用药 干预 药物利用 |
| 英文关键词:Pharmaceutical care On-site survey Rational drug use Intervention Drug utilization |
| 基金项目: |
| 陈莲珍 杨军 王淑洁 王海莲 徐燕侠 王育琴 |
| 首都医科大学宣武医院,北京100053 |
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| 中文摘要: |
| 目的：探索推进合理用药的工作模式，考察干预措施影响合理用药的持续时间，探讨持续影响合理用药的主要因素。方法：分干预前（2000～2001年）、干预后1年（200l～2002年）和干预后4年（2004～2005年）3个组别。用对照方法，对合理用药国际指标的核心指标进行现场调查，选择3年各5个月门诊随机抽样处方和当日门诊就医的病人，数据用SPSS11．1软件进行统计分析。结果：平均用药品种数从干预前2、76个降到干预后1年2、09个，到干预后4年还保持在2、08个（P〈0、01）。抗菌药使用百分率干预前34．0％，干预后1年28．0％，干预后4年又上升为30．0％。药师平均调配药品时间从干预前11．8S增加干预后1年的13．88，干预后4年持续增加到15、6s。3组现场调研药品调配百分率、药品标示完整率及患者了解正确用药方法百分率各项指标均为100．0％。结论：干预措施有效、可行。宣传教育是合理用药非常重要的一项干预措施。全方位合理用药集中干预后效应可以持续4年左右。在人力、物力、财力不能保证时常进行干预时，每4年左右集中全方位干预一次是可行的，也是必须的。 |
| 英文摘要: |
| Objective: To set a model of objective and scientific evaluation and research method to promote the development of rational drug use ( RDU) in China and explore the effective length after intervention in RDU and the factors of impacting RDU. Method: The method of comparison was adopted to undertake an on-site survey to prescriptions and patients seeing doctors that day at our hospital according to the international RDU indicators of WHO/INRUD. The investigations were divided 3 parts: before intervention (2000 -2001), after 1 year's intervention (2001 -2002) and after 4 years' intervention (2004 -2005). The implemented strategies included their education, management and regulation. 100 or 200 prescriptions and 20 or 30 patients were surveyed for 5 months in each part. Their data statistics was made by SPSS 11.1 software. Result: Prescription indicators: the average number of drugs per encounter was reduced from 2.76 before intervention to 2.09 after lyear, and 2.08(P<0.01) after4 years'intervention; the percentage of encounters with prescribed antibiotics was reduced from 34.0% to 28.0% , but increased to 30.0% after 4 years'intervention; and the percentage of encounters with injection prescribed was almost not changed. The percentage of drugs prescribed from essential drug list ( EDL) was reduced from 78.2% to 74.8% , but increased to 84.9% (P <0.05). Patient care indicators: pharmacist dispensing time was increased from 11.8 seconds to 13.8 and to 15.6; doctors'consulted times were 7.4 seconds, 5.9 and 7.5; each indicator of percentage of drugs dispensed, percentage of drugs labeled and percentage of adequate knowledge in 3 parts was 100%. Conclusion: It was a practicable and effective method to promote RDU. The continuous education after intervention was a very important strategy. It must be implemented from time to time. It was practicable and necessary to implement the intervention by using all education, management and implementation in RDU every 4 years under inadequate manpower, material resources and finance support. |
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