目的 分析信息系统辅助抗肿瘤药物处方及医嘱审核的问题,针对性完善审核规则,为提高抗肿瘤药物处方审核的质量提供参考.方法 收集四川省肿瘤医院 2020-2022 年信息系统辅助抗肿瘤药物处方及医嘱审核的问题,数据来源于医院美康合理用药监测系统(PASS),由临床药师对相关问题进行点评,对点评结果及相关问题进行分析.结果 共收集抗肿瘤药物处方审核问题9 325 条,其中门诊处方6 279 条(67.3%),住院医嘱3 046 条(32.7%);适应证不适宜 6 153 条(66.0%),药物禁忌证 1 933 条(20.7%),给药途径不适宜 449 条(4.8%),药品配伍不适宜 345 条(3.7%),用药频次不适宜 177 条(1.9%),用药人群不适宜 133 条(1.4%),单次剂量不适宜 74 条(0.8%),药物相互作用不适宜 39条(0.4%),药品总量不适宜 22 条(0.2%).临床药师点评结果为合理的 4 459 条,假阳性率为 47.8%,假阳性问题包括:适应证不适宜 2 264 条(50.8%),药物禁忌证 1 933 条(43.3%),给药途径不适宜 231 条(5.2%),用药人群不适宜 31 条(0.7%).结论 信息系统辅助抗肿瘤药物处方审核可有效拦截不合理用药问题,提升处方和医嘱的审核质量,但抗肿瘤药物循证医学证据更新快,药师应结合最新的循证医学证据,不断维护和完善审方规则.
Objective To analyze the problems of review of anti-tumor drug prescriptions and medical orders assisted by an information system to improve the review rules,and to provide a reference for improving review quality of anti-tumor drug prescription.Methods The problem with the pre-review of anti-tumor drug prescriptions and medical orders assisted by the information system in Sichuan Cancer Hospital during 2020-2022 were collected.The data came from the MEDICOM PASS system in Sichuan Cancer hospital.Clinical pharmacists made comments on relevant problems and analyzed the results.Results A total of 9 325 antitumor drug pre-approval problems,including 6 279 outpatient prescriptions(67.3%)and 3 046 inpatient orders(32.7%),among which 6 153(66.0%)were unsuitable indications,1 933(20.7%)were drug contraindications,449(4.8%)were problematic routes of administration,345(3.7%)were unsuitable drug compatibility,177(1.9%)were inappropriate drug frequency,133(1.4%)were problematic drug populations,74(0.8%)were unsuitable single doses,39(0.4%)were unacceptable drug interactions,22(0.2%)were unsuitable drug total.The results of clinical pharmacists'comments were 4 459 reasonable cases,with a false positive rate of 47.8%.The false positive problems included 2 264(50.8%)cases of unsuitable indications,1 933(43.3%)cases of drug contraindications,231(5.2%)cases of problematic routes of administration,and 31(0.7%)cases of unsuitable populations.Conclusion The review of anti-tumor drug prescriptions assisted by an information system can effectively intercept irrational drug use and improve the review quality of prescriptions and medical orders.However,the evidence-based medicine date of antitumor drugs is updated quickly.Pharmacists should constantly improve the prescription review rules based on the latest evidence-based medicine data.