医院重点监控药品管理的探索与实践

Exploration and Practice of Key Monitoring Drugs Management in Hospital

关键词:  合理用药管理系统|重点监控药品|辅助药品|管控

Key words:  management platform for rational drug|key monitoring drugs|adjuvant drugs|control

摘要:

目的 通过合理用药管理系统，与行政干预相结合，加强对医院重点监控药品的管控，促进合理用药。方法 制定宁波市北仑区人民医院重点监控药品目录；基于合理用药管理系统，依据药品说明书和指南、共识等证据，对重点监控药品进行规则精细化设置；建立重点监控药品动态监测与预警制度，开展处方/医嘱专项点评，结合行政干预手段，对重点监控药品进行管理；对宁波市北仑区人民医院应用合理用药管理系统后重点监控药品各季度人工抽样点评不合理率、使用强度、使用金额和占比等进行统计分析，考察合理用药管理系统上线后对重点监控药品管控成效。结果 通过合理用药管理系统规则精细化设置，结合行政干预，加强了对重点监控药品的管理。合理用药管理系统上线后重点监控药品的不合理率从2018年第4季度的34.2%降至2019年第4季度的14.6%，使用强度从101.4降至74.7，销售金额占总药品金额的占比由7.8%下降至5.7%。结论 应用合理用药管理系统加强对重点监控药品的管控，不仅能减少药品费用，还能促进医院合理用药。

Abstract:

OBJECTIVE To strengthen the management and control of the key monitoring drugs and to promote the rational use of drugs in hospital through the management platform for rational drug and administrative intervention. METHODS Set up the key monitoring drug directory in the Ningbo Beilun People's Hospital. Set up the rules of the key monitoring drugs in detail based on the rational drug use system according to the drug instructions, guidelines, consensus and other evidence. Establish a dynamic monitoring and early warning system for key monitoring auxiliary drugs, carry out special comments on prescriptions/medical orders, and manage key monitoring drugs combined with administrative intervention means. Statistical analyse rational rate of manual review, use intensity, use amount and drug proportion of the key monitoring drugs after the application of management platform for rational drug in the Ningbo Beilun People's Hospital in each quarter to check the effectiveness of management platform for rational drug. RESULTS The management of key monitoring drugs was strengthened through setting the rules of rational drug use management system combined with administrative intervention. After the launch of management platform for rational drug, the irrational rate of the key monitoring drugs decreased from 34.2% in the fourth quarter of 2018 to 14.6% in the fourth quarter of 2019, the use intensity decreased from 101.4 to 74.7, and the proportion of the sales amount to the total drug amount decreased from 7.8% to 5.7%. CONCLUSION Strengthen the management and control of the key monitoring drugs through the management platform for rational drug can not only reduce the hospital drug expenditure, but also promote the rational use of drugs in hospital.