Pollock Madelyn, Bazaldua Oralia V, Dobbie Alison E
Dept. of Family Medicine, University of Kansas Medical Center, Kansas City 66160, USA.
Am Fam Physician. 2007 Jan 15;75(2):231-6.
A systematic approach advocated by the World Health Organization can help minimize poor-quality and erroneous prescribing. This six-step approach to prescribing suggests that the physician should (1) evaluate and dearly define the patient's problem; (2) specify the therapeutic objective; (3) select the appropriate drug therapy; (4) initiate therapy with appropriate details and consider nonpharmacologic therapies; (5) give information, instructions, and warnings; and (6) evaluate therapy regularly (e.g., monitor treatment results, consider discontinuation of the drug). The authors add two additional steps: (7) consider drug cost when prescribing; and (8) use computers and other tools to reduce prescribing errors. These eight steps, along with ongoing self-directed learning, compose a systematic approach to prescribing that is efficient and practical for the family physician. Using prescribing software and having access to electronic drug references on a desktop or handheld computer can also improve the legibility and accuracy of prescriptions and help physicians avoid errors.
世界卫生组织倡导的系统方法有助于将低质量和错误处方降至最低。这种六步法处方建议医生应:(1)评估并明确界定患者的问题;(2)明确治疗目标;(3)选择合适的药物治疗;(4)详细开始适当治疗并考虑非药物治疗;(5)提供信息、说明和警告;(6)定期评估治疗(如监测治疗结果、考虑停药)。作者又增加了两个步骤:(7)处方时考虑药物成本;(8)使用计算机和其他工具减少处方错误。这八个步骤,再加上持续的自主学习,构成了一种对家庭医生高效且实用的系统处方方法。使用处方软件以及在台式机或手持计算机上能够获取电子药物参考资料,也可以提高处方的清晰度和准确性,并帮助医生避免错误。