2018 年第 8 期 第 13 卷

眼科处方不合理用药情况的调查研究与分析结果

Irrational drug use in ophthalmic prescriptions

作者：宋智慧王丽李荔王兴龙赵环宇

英文作者：

单位：100730首都医科大学附属北京同仁医院药学部（宋智慧、李荔、王兴龙、赵环宇）；030002太原，山西省眼科医院药剂科（王丽）

英文单位：

关键词：眼科用药；处方点评；合理用药

英文关键词：

• 摘要：

• 【摘要】目的    了解眼科处方不合理用药情况，为眼科合理用药提供依据。方法    对首都医科大学附属北京同仁医院2017年4月8日—5月7日的所有眼科处方通过系统点评与临床药师复核的方式进行点评分析，共计54 997张处方，211 884条处方条目。了解眼科处方的不合理用药情况，分析系统点评与人工点评的差异，并根据点评结果对眼科用药提出建议。结果    系统点评不合理条目数占10.5%（22 353/211 884）。不合理类型主要是适应证不适宜，占81.2%（18 161/22 353）；其次是用法用量不适宜，占16.2%（3 612/22 353）。经临床药师复核后，不合理条目数下降为4 169条；不合理类型与系统点评结果类似，最多者仍为适应证不适宜，占87.6%（3 650/4 169）；其次是用法用量不适宜，占10.2%（424/4 169）。两次结果差异较大的原因主要为系统中嵌入的说明书与本院实际使用情况不符、放宽围术期用药的评价标准、点评标准增加超说明书用药已备案的内容等。结论    眼科处方存在不合理用药情况，主要表现为适应证不合理以及用法用量不合理。为规范眼科用药，可通过实行系统点评联合药师复核的方式提高处方点评的准确性，并将结果及时反馈临床，提高眼科合理用药水平。

• Objective    To investigate the irrational drug use in ophthalmic prescriptions and to provide rational suggestions. Methods    A total of 211 884 records in 54 997 prescriptions from April 8th to May 7th in 2017 were reviewed in ophthalmology department of Beijing Tongren Hospital, Capital Medical University. Irrational drug use was assessed by software testing and clinical pharmacists. Suggestions for rational drug use were summarized based on the assessment Results    . Results    There were 22 353 records of irrational drug use assessed by the software, accounting for 10.5%（22 353/211 884）. Main reasons of irrational drug use included inappropriate indication［81.2%（18 161/22 353）］, inappropriate usage and dosage［16.2%（3 612/22 353）］. There were 4 169 records of irrational drug use defined by pharmacists; inappropriate indication accounted for 87.6%（3 650/4 169）; inappropriate usage and dosage accounted for 10.2%（424/4 169）. The differences between assessment Results     of software and pharmacists might be caused by mutiple reasons, such as the inappropriate instructions set in software system, the different standards of perioperative drug use and the appropriate off-label drug use conforming with authoritative medical records. Conclusions    Main reasons of irrational drug use in ophthalmology department are inappropriate indication, usage and dosage. Pharmacists should strengthen the standard prescription assessment system through systematic comment and manual review to promote rational drug use.