合理用药监测系统在肿瘤专科医院的应用实践★

Application of prescription automatic screening system in a cancer hospital★

摘要:

目的 探索肿瘤专科医院合理用药监测系统在实际工作中的应用及存在的问题，推动临床安全用药。方法 通过构建合理用药监测系统的审方规则，开展以抗肿瘤药物为主的前置审方工作，并构建一系列指标监测系统，持续改进审方规则。结果 2020年1月至2021年12月，我院共新建或修订1 000余个药品的9 408条规则，其中数量位居前5位的新规则分别为超适应证、超多日用量、剂量范围、配伍浓度、给药途径。系统干预率从门诊37.91%、住院43.85%分别下降至门诊14.19%、住院18.96%，系统和人工干预成功率大幅提高。通过系统配合人工干预，我院全年处方点评合理率共计上升35.45%。结论 合理用药监测系统经过肿瘤专科药师修订和维护审方规则后运用，能够在一定程度上防范用药差错、提高处方审核效率、提升临床合理用药水平。

Abstract:

Objective To explore how to use prescription automatic screening system (PASS) to promote medication safety use in a cancer hospital.Methods By establishing prescription review rules in the PASS and the preliminary prescription review work mainly focused on antitumor drugs was carried out, and a series of monitoring indexes were constructed to continuously improve the prescription review rules. Compare the index including accuracy of prescriptions and intervention rates before and after application of this system.Results From Jan. 2020 to Dec. 2021, a total of 9 408 rules were established or revised by pharmacists, involving more than 1 000 medications. The top five categories in the number of new rules were off-label use, multi-day use, dosage range, diluted concentration and route of administration. The rate of automatic intervention by system decreased from 37.91% to 14.19% in outpatient pharmacy, and from 43.85% to 18.96% in inpatient pharmacy. The acceptance rate of systematic and human intervention was greatly increased. The total rate of rational prescription in our hospital was increased by 35.45%.Conclusion After the revision and maintenance of prescription review rules by tumor pharmacists, the prescription automatic screening system could help to prevent medication errors, improve the efficiency of prescription review and enhance the rational use of medication in cancer hospitals.