国家科技部中国科技论文统计源期刊   中国科技核心期刊   WHO西太平洋地区医学索引(WPRIM)收录期刊   湖北优秀期刊
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某三甲医院从被动收集到主动监测药品不良反应监测管理水平干预效果评价
Impact on Improving Management of Adverse Drug Reaction Monitoring from Passive Collection to Active Monitoring in a Chinese Tertiary Hospital
  
DOI:
中文关键词:  药品不良反应  监测管理  志愿报告  主动监测  干预
英文关键词:Adverse drug reaction  Monitoring and management  Spontaneous reporting  Active monitoring  Intervention
基金项目:国家卫生健康委员会医政医管局委托研究课题(2019)
作者单位
滕威1# 李明爽2# 于鲁海1 孙力1 姜文燕1 孙静2 刘远立2 1.新疆维吾尔自治区人民医院 乌鲁木齐 8300002.中国医学科学院北京协和医学院公共卫生学院 
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中文摘要:
      摘 要 目的:通过总结和评价某三甲医院提高药品不良反应(ADR)监测管理水平干预措施和干预效果,推动医院ADR主动监测,提高监测管理水平,保障患者用药安全。 方法:系统梳理某三甲医院采用以主动监测为核心的多维度干预措施和持续质量改进的方法,总结成功经验。通过描述性统计分析及间断时间序列分段回归分析,对上述干预措施提高ADR上报率和质量的效果进行评估。 结果:2018年度,该院上报的ADR例数较上一年度同期增长了545%;上报科室从10个增加至59个,基本覆盖了全院科室。采取干预措施的第一个月,ADR上报例数增加了15例(P=0.092),上报科室数增加了9个(P=0.003)。采取干预措施的第一年,全院ADR上报例数和上报科室数量均呈显著上升趋势,且有统计学意义(P=0.001/0.000 1),从干预前的平稳状态改变为干预后的显著上升趋势,变化有统计学意义(P=0.011/0.000 1)。 结论:该院〖CS0,0,0,255〗采取的以主动监测为核心的多维度干预和持续质量改进措施,充分发挥临床药师的作用和与临床医生的密切协作,显著提高了ADR上报数量,并扩大了上报科室范围,干预效果持续。但新的和严重ADR上报数量仍较少,门、急诊患者ADR的监测力度仍有待加强,需进一步提高ADR监测水平。
英文摘要:
      ABSTRACT Objective:Through a summary of the intervention strategies and an evaluation of its effect on enhancing adverse drug reaction (ADR) monitoring and reporting, this study aims to promote active ADR reporting , improve management of ADR monitoring, and to promote rational use of medicines, in order to ensure the safety of patients. 〖WTHZ〗Methods:〖WTBZ〗Systematically review the experience of a Chinese tertiary hospital in adopting comprehensive multiple intervention strategies and continued quality improvement by making the active monitoring as a core. Descriptive analysis and interrupted time series study design were used to evaluate the effect of the comprehensive multiple intervention strategies and continued quality improvement on improving the management of ADR monitoring. 〖WTHZ〗Results:〖WTBZ〗In 2018, the number of reported ADRs increased 545% compared with that in 2017. The number of reported departments increased from 10 to 59, covered all the departments of the hospital. In the first month of implementing the interventions, the number of ADRs reported increased 15 cases (P=0.092); the number of reported department increased by 9 (P=0.003). In the first year of implementing the interventions, the number of reported ADRs and departments both increased significantly (P=0.001/0.000 1), both trends shifted from stable status before the interventions to significant increase after the interventions (P=0.011/0.000 1). 〖WTHZ〗Conclusion:〖WTBZ〗With active monitoring as a core, the comprehensive multiple interventions and continued quality improvement in the study hospital significantly raised the number of reported ADRs and departments, and the effects were long lasting during the first year of implementing the interventions. Clinical pharmacists played an important role and worked proactively with doctors. However, few new and severe ADRs were reported, outpatient and emergency departments were yet in the loop of the interventions, continued efforts are needed to further improve the quality of ADR monitoring.
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