Qiang Wen, Chuang Yang, Bangjian Deng, Yi Zhang, Lin Song
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引用次数: 0
Abstract
Background: Medication safety is crucial in clinical care. Although many hospitals have implemented prospective prescription review systems to manage medication use, the impact of these systems on pediatric patients is not yet fully understood.
Objectives: We explore the characteristics and economic impacts of pediatric prospective prescription review and identify factors influencing intervention success rates.
Design: This study adopted a cross-sectional design.
Methods: Prospective prescription review tasks were compared in the outpatient of our hospital between 2021 and 2023 to assess medication rationalization rates and cost variability. Data were collected using the PASS PharmReview system, including patient information, medication indications, prescribing physicians, intervention pharmacists, prescription rationality rate, and medication costs. SPSS 26.0 software was used to compare changes in medication rationality and medication costs between the initial (2021) and stable (2023) periods and to analyze factors affecting intervention success during the stable period by the logistic regression model.
Results: The study included 11,533,807 prospective prescription review tasks. The medication rationalization rate increased from 92.0% to 95.7% (p < 0.05) between the initial (n = 5,392,551) and stabilization periods (n = 6,141,256). Outpatient medication costs per capita decreased by 3.2%, from ¥320.7 to ¥310.5. Factors influencing intervention success included the following: the greater age is negatively associated with success(p < 0.001, odds ratio (OR) = 0.98); internal medicine demonstrates a superior intervention success rate compared to the surgical department (p < 0.001, OR = 1.37); higher physician titles were associated with lower success rates (p < 0.001, OR = 0.59); and success increased with pharmacists of higher educational levels (p < 0.001, OR = 1.18).
Conclusion: Implementing a prospective prescription review system in pediatric outpatient settings improves medication rationality and reduces errors and costs, with intervention success influenced by patient age, department, physician titles, and the educational level of pharmacists.
背景：用药安全在临床护理中至关重要。尽管许多医院已经实施了前瞻性处方审查系统来管理药物使用，但这些系统对儿科患者的影响尚未完全了解。目的：探讨儿科前瞻性处方审查的特点和经济影响，并确定影响干预成功率的因素。设计：本研究采用横断面设计。方法：比较我院门诊2021年至2023年前瞻性处方审查任务，评估用药合理化率和成本变异性。采用PASS PharmReview系统收集数据，包括患者信息、用药指征、开处方医师、干预药师、处方合理性率、用药费用等。采用SPSS 26.0软件比较初始期（2021年）和稳定期（2023年）用药合理性和用药费用的变化，并采用logistic回归模型分析稳定期干预成功的影响因素。结果：该研究包括11,533,807项前瞻性处方回顾任务。用药合理化率从92.0%增加到95.7% (p n = 5,392,551)，稳定期（n = 6,141,256）增加。人均门诊用药费用下降3.2%，从320.7元下降到310.5元。影响干预成功的因素包括：年龄越大与干预成功呈负相关（p p p p）结论：在儿科门诊实施前瞻性处方审查制度，可提高用药合理性，减少错误和成本，干预成功受患者年龄、科室、医师职称和药师学历的影响。
期刊介绍：
Therapeutic Advances in Drug Safety delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies pertaining to the safe use of drugs in patients.
The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in drug safety, providing a forum in print and online for publishing the highest quality articles in this area. The editors welcome articles of current interest on research across all areas of drug safety, including therapeutic drug monitoring, pharmacoepidemiology, adverse drug reactions, drug interactions, pharmacokinetics, pharmacovigilance, medication/prescribing errors, risk management, ethics and regulation.
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