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Objective:To analyze the effects of prescription reviews of key monitored drugs using the drug regulatory platform in a district of Shanghai, and the influencing factors for the rate of unqualified prescriptions.Methods:A drug regulatory platform in a district in Shanghai began to implement prescription reviews since June 2018, extracting the reviewed prescriptions of all key monitored drugs and related information from June to December. Taking the unqualified rate of prescription in June as the baseline data, the χ2 test and the logistics regression model were used for data analysis. Results:From June to December 2018, clinical pharmacists reviewed 19 084 outpatient and emergency prescriptions and 10 607 inpatient prescriptions. The unqualified rates of outpatient and emergency prescriptions and inpatient prescriptions dropped from 16.52% and 23.28% in June to 4.45% and 13.80% in December, respectively. Logistics regression analysis showed that the rate of unqualified reviews of outpatient and emergency prescriptions was lower than that of inpatient prescriptions, and the rate of unqualified prescriptions in hospital was significantly lower than that in community health service centers; the rate of unqualified prescriptions for auxiliary drugs and nutritional drugs was significantly lower than that of antibacterial drugs.Conclusions:The prescription reviews of key monitored drugs can effectively promote the rational use of drugs. In the future, it is recommended to strengthen technical support for community health service centers and professional training for clinicians and pharmacists.
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OBJECTIVE：To provide referenc e for the construction of prescription review model in medical institution and key monitored drugs management. METHODS ：A multidisciplinary collaborative prescription review mode was established in the First Affiliated Hospital of University of Science and Technology of China （called“our hospital ”for short ）. The prescription management group （composed of the president in charge ，the director of pharmacy department ，the director of medical department and the person in charge of pharmacy ，medicine，nursing and administrative management ）was set up under the Pharmaceutical Affairs Management and Drug Treatment Committee ；and then prescription review expert group （be responsible for providing professional technical consultation and final evaluation of prescriptions ）and prescription review working group （be responsible for the initial evaluation of prescriptions ）were set up. According to the Drug Administration Law ，the Law of Licensed Doctors and the Law of Anti-unfair Competition Act and so on ，the Measures for the Supervision and Administration of Drug Purchase ，Sale and Use in our hospital was formulated. The multi-disciplinary collaborative prescription review procedure was established to intervene key monitored drugs prescriptions. The utilization rate of key monitored varieties and prescription reasonability in our hospital were investigated before （Jun. 2019）and after the intervention （Sept. 2019）by the mode. RESULTS ：The multidisciplinary collaborative prescription review mode was established sucessfully. The proportion of key monitored drugs in total drug sales amount decreased from 1.322％ before intervention to 0.735％ after intervention （P＝0.010）. The irrational rate of prescriptions decreased from 46.76％ before intervention to 15.70％ after intervention （P＝0.023）. The main types of irrational prescriptions were inappropriate usage and dosage （18.52％），inappropriate indications（12.50％），inappropriateroute of administration （9.26％）before intervention changed into inappropriate usage and dosage （15.70％）after intervention ； other irrational prescription types had been significantly improved. CONCLUSIONS ： The multidisciplinary collaborative prescription review model shows significant effect on key monitored drugs and reduce irrational use of this variety in the clinic significantly.
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OBJECTIVE:To explore the management mode of key monitored drugs in hospital and to improve their rational use. METHODS:The pharmaceutical administration mode of key monitored drugs in our hospital was interpreted in respects of nontrol plan,control measures and control effect(using types and ranking of key monitored drugs among top 10 drugs in the list of consumption sum,ratio of consumption sum of key monitored drugs in total consumption sum,consumption sum per capita of key monitored drugs in the inpatients as indexes). RESULTS:Our hospital confirmed and implemented control plans as control target and control index by formulating key monitored drug list. Key monitored drug control was included in performance assessment management,procurement source management,supernormal early warning management,etc. The key monitored drug control was implemented from May 2016,up to May 2017,key monitored drugs ranked and decreased in number from the top 10 drugs in the list of consumption sum. The ratio of consumption sum of key monitored drugs in total consumption sum and consumption sum per capita of key monitored drugs in the inpatients decreased from 34.33% and 2 318.98 yuan before control(Jan. 2016-Apr. 2016)to 21.72% and 1 209.31 yuan in May 2017(decreasing by 36.73%,47.85%). CONCLUSIONS:Key monitored drug control obtains significant achievement in our hospital,can effectively promotes rational use of key monitored drug,saves medical insurance costs and reduces the economic burden of patients.