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1.陆军特色医学中心药剂科,重庆 400042
2.陆军特色医学中心医研部医疗办公室,重庆 400042
主管药师。研究方向:循证临床药学。电话:023-68746968。E-mail:yangxue198902@163.com
主管药师,博士。研究方向:新药研发与合理用药评价。电话:023-68746952。E-mail:haiyanxing@aliyun.com
纸质出版日期:2023-05-30,
收稿日期:2022-11-09,
修回日期:2023-04-19,
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杨雪,李晨,蔡永青等.药品临床综合评价思维在医院药品临时采购管理中的应用实践 Δ[J].中国药房,2023,34(10):1172-1176.
YANG Xue,LI Chen,CAI Yongqing,et al.Application practice of drug clinical comprehensive evaluation thinking in management of temporary drug purchase in hospital[J].ZHONGGUO YAOFANG,2023,34(10):1172-1176.
杨雪,李晨,蔡永青等.药品临床综合评价思维在医院药品临时采购管理中的应用实践 Δ[J].中国药房,2023,34(10):1172-1176. DOI: 10.6039/j.issn.1001-0408.2023.10.04.
YANG Xue,LI Chen,CAI Yongqing,et al.Application practice of drug clinical comprehensive evaluation thinking in management of temporary drug purchase in hospital[J].ZHONGGUO YAOFANG,2023,34(10):1172-1176. DOI: 10.6039/j.issn.1001-0408.2023.10.04.
目的
2
探索构建药品临时采购的科学化管理新模式,为医疗机构提升合理用药水平提供参考。
方法
2
我院以临床诊疗需求和患者用药安全为导向,通过优化审评流程、创建审评团队、基于药品临床综合评价制定事前审核及事后跟踪评价标准,开展临时采购药品全程化管理实践,并通过临时采购申请数量、执行率、药品目录结构优化情况等指标评价实践效果。
结果
2
2021年1月我院开始实施药品临时采购科学化管理新模式,截至2022年12月,我院临床药师共审核药品临时采购申请111份,有效拦截不合理申请13份(11.71%),药品临时采购执行率整体下降了8.36%,提出药品目录结构优化建议5次;我院先后引进了卡瑞利珠单抗、索拉非尼、白消安等24种药品。管理模式优化后,药品临时采购申请次数由2019年的133次和2020年的138次,减少到2021年的66次和2022年的45次,降幅达一半以上。
结论
2
该模式有助于优化医疗机构药品目录,提升合理用药水平,保障患者用药安全,充分体现了临床药师在医疗机构药事管理与合理用药中的专业价值。
OBJECTIVE
2
To explore the construction of a new scientific management model for temporary drug purchase,and to provide a reference for hospitals to improve the level of rational drug use.
METHODS
2
Guided by clinical diagnosis and treatment needs and patient medication safety, our hospital carried out the whole process management practice of temporarily purchased drugs by optimizing the review process, creating a review team, formulating pre-audit and post follow-up evaluation standards based on comprehensive drug evaluation, and evaluated the practice effect through the number of temporary purchase applications, implementation rate, drug structure optimization and other indicators.
RESULTS
2
Since January 2021, our hospital had implemented a new mode of temporary drug purchase management. By December 2022, clinical pharmacists had reviewed 111 temporary drug procurement applications, effectively intercepted 13 irrational drug use applications (11.71%), reduced the overall implementation rate of temporary drug procurement by 8.36%,and proposed five batches of drug structure optimization suggestions; 24 drugs were successively introduced such as camrelizumab,sorafenib,busulfan. After optimizing the management mode,the number of temporary drug procurement applications decreased by more than half from 133 in 2019 and 138 in 2020 to 66 in 2021 and 45 in 2022.
CONCLUSIONS
2
The model is helpful to optimize the hospital drug catalog, strengthen rational drug use,ensure the safety of patients’ drug use, and fully reflects the professional value of clinical pharmacists in hospital pharmacy management and rational drug use.
药品临时采购药品临床综合评价目录优化合理用药临床药师
comprehensive evaluation of drugscatalog optimizationrational drug useclinical pharmacist
陈慧,苏广全,刘晓,等.中国医疗机构药品目录管理评价指南[J].中国药房,2022,33(6):641-652.
国家卫生健康委,教育部,财政部,等. 关于印发加强医疗机构药事管理促进合理用药的意见的通知:国卫医发〔2020〕2号[EB/OL].(2020-02-26)[2022-11-01]. http://www.nhc.gov.cn/yzygj/s7659/202002/ea3b96d1ac094c47-a1fc39cf00f3960e.shtmlhttp://www.nhc.gov.cn/yzygj/s7659/202002/ea3b96d1ac094c47-a1fc39cf00f3960e.shtml.
赵志刚,董占军,刘建平.中国医疗机构药品评价与遴选快速指南[J].医药导报,2020,39(11):1457-1465.
国家卫生健康委办公厅.国家卫生健康委办公厅关于规范开展药品临床综合评价工作的通知:国卫办药政发〔2021〕16号[EB/OL].(2021-07-28)[2022-11-01]. http://www.nhc.gov.cn/yaozs/s2908/202107/532e20800a47415-d84adf3797b0f4869.shtmlhttp://www.nhc.gov.cn/yaozs/s2908/202107/532e20800a47415-d84adf3797b0f4869.shtml.
邓建华,吴海坤,李薇,等. 北京协和医院基于SMART原则的泌尿外科专科腔镜规范化培训的经验总结[J]. 中国医学科学院学报,2023,45(1):88-91.
卫生部.抗菌药物临床应用管理办法:卫生部令第84号[EB/OL].(2012-04-24)[2022-11-01]. http://www.nhc.gov.cn/wjw/c100022/202201/8fcae32c3f1f467eb795ee816e23-87d6.shtmlhttp://www.nhc.gov.cn/wjw/c100022/202201/8fcae32c3f1f467eb795ee816e23-87d6.shtml.
国家卫生健康委.国家卫生健康委关于印发抗肿瘤药物临床应用管理办法(试行)的通知:国卫医函〔2020〕487号[EB/OL].(2020-12-28)[2022-11-01]. http://www.nhc.gov.cn/yzygj/s7659/202012/a7600740bed44d1db7015ca5-a1be2cc0.shtmlhttp://www.nhc.gov.cn/yzygj/s7659/202012/a7600740bed44d1db7015ca5-a1be2cc0.shtml.
国家医疗保障局,国家卫生健康委. 国家医疗保障局国家卫生健康委关于适应国家医保谈判常态化持续做好谈判药品落地工作的通知:医保函〔2021〕182号[EB/OL].(2021-09-10)[2022-11-01]. http://www.nhsa.gov.cn/art/2021/9/10/art_104_6543.htmlhttp://www.nhsa.gov.cn/art/2021/9/10/art_104_6543.html.
国家卫生健康委,科学技术部,工业和信息化部,等. 关于公布第一批罕见病目录的通知:国卫医发〔2018〕10号[EB/OL].(2018-06-08)[2022-11-01]. http://www.nhc.gov.cn/yzygj/s7659/201806/393a9a37f39c4b458d6e830f40a4-bb99.shtmlhttp://www.nhc.gov.cn/yzygj/s7659/201806/393a9a37f39c4b458d6e830f40a4-bb99.shtml.
北京协和医院罕见病多学科协作组,中国罕见病联盟.多准则决策分析应用于罕见病药品临床综合评价的专家共识:2022[J].协和医学杂志,2022,13(2):235-254.
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