Effect and Practice of Sub-category Management of Chinese Patent Medicine in the Improvement of the Qualified Rate for Outpatient Prescriptions of Chinese Patent Medicine / 中国药房

ABSTRACT

OBJECTIVE：To provide reference for improving the qualified rate of outpa tient prescriptions of Chinese patent medicines and ensuring the rational use of medicines. METHODS：Refering to the Beijing Basic Medical Insurance Medicines Catalog， Clinical Medicine Instructions and （No.17Z13） MCDEX，Chinese patent medicine were classified according to the main functions indications and disease syndromes types. The classification results were reviewed by the member of expert group of Hospital Pha rmacy Committee ，and were recorded by medical department of the management department ，finally were embedded into the outpatient HIS and were docked with prescription pre-audit and comment system. Total number of reviewed Chinese patent medicine prescriptions ，the number of repeated prescriptions ，the number of repeated prescriptions intercepted by HIS system ，the number of prescriptions actively modified by the prescribing physician ，the ratio of repeated prescriptions ，the frequency of active modification by the prescribing physician and average cost of each prescription were compared between the third quarter of 2017（initial stage of sub-category management of Chinese patent medicine ）and the forth quarter of 2019. RESULTS ：Chinese patent medicines in our hospital could be divided into eight categories as internal medicine ，surgery medicine ，oncology medicine ，gynecology medicine ，ophthalmology medicine，otorhinolaryngology medicine ，orthopedics medicine and dermatology medicine ；they contained 14，1，2，4，2，2，3， 1 sub-categories，respectively；some sub-categories were subdivided again . In the third quarter of 2017，159 610 prescriptions of Chinese patent medicines were reviewed ，and 421 prescriptions were unreasonable. Among which ，there were 200 prescription of repeated prescriptions ，accounting for 47.15％；676 repeated prescriptions were actively intercepted by HIS and 476 intercepted prescriptions were actively modified by prescribing physicians ，with active modification rate of 70.14％. In the forth quarter of 2019，138 869 prescriptions of Chinese patent medicines were reviewed ，and 381 prescriptions were unreasonable. Among which ， there were 47 prescription of repeated prescriptions ，accounting for 12.43％；266 repeated prescriptions were actively intercepted by HIS and 259 intercepted prescriptions were actively modified by prescribing physicians ，with active modification rate of 97.37％. There were statistical significances in the ratio of repeated prescription and the rate of active modification by physicians between initial stage and the forth quarter of 2019（P＜0.01）. The average cost of each prescription were 278.78 yuan in the third quarter of 2017 and 220.85 yuan in the forth quarter of 2019，decreasing by 20.78％ . CONCLUSIONS ：The sub-category management of Chinese patent medicine is adopted in the pharmacy department of our hospital ，which realize the pre-audit of all prescriptions of Chinese patent medicines ，and increased the pass rate of outpatient chinese patent medicine prescriptions . It i s helpful for doctors to dialectically use drugs ，memorize the varieties of Chinese patent medicines and improve their professional level；it is helpful for prescription reviewers to rapidly identify repeated prescriptions ，improve the information audit and management level of prescriptions. It is convenient for facilitate prescription reviewers to check the amount of prescriptions used and found out the deficiency of the medicine list in our hospital. However ，there are also some problems such as the conflict between individualized medication and part of management system ，and doctors and pharmacists have different opinions on medicine classification.