Eckert G M, Ioannides-Demos L L, McLean A J
St George Hospital, Kogarah, NSW.
Med J Aust. 1991 May 6;154(9):587-92. doi: 10.5694/j.1326-5377.1991.tb121218.x.
Various methods are available to quantitate medicinal drug use in hospitals. These represent a hierarchy of clinical specificity, complexity and cost of acquisition. Similarly, various strategies and methods are available to modify prescribing patterns. The objectives of this study are to illustrate these processes of measurement of drug use and modification of prescribing patterns using specific examples derived from practice at three major Australian teaching hospitals over 15 years.
DESIGN, SETTING, MAIN OUTCOME MEASURES: Methods to measure and modify drug usage in the three hospitals are outlined and 12 examples are presented by specific drug or drug category. Each example includes details of the methods used to detect inappropriate drug use (pharmacy purchases, pharmacy issues, prescription analysis, clinical record review, performance and outcome assessment), the intervention strategies used (re-educative, persuasive, facilitative, power), the methods employed to alter drug prescribing and the relative effectiveness and cost-efficiency of the interventions.
Readily available, relatively cheap quantitative methods provide significant information and an efficient basis for planning definitive studies, and substantial modification of prescription patterns is possible through the strategic use of limited manpower and resources.
有多种方法可用于量化医院的药物使用情况。这些方法在临床特异性、复杂性和获取成本方面存在层级差异。同样，也有多种策略和方法可用于改变处方模式。本研究的目的是通过澳大利亚三家主要教学医院15年来实践中的具体实例，阐述这些药物使用测量及处方模式改变的过程。
设计、背景、主要观察指标：概述了三家医院测量和改变药物使用的方法，并按特定药物或药物类别给出了12个实例。每个实例包括用于检测不当药物使用的方法（药房采购、药房发放、处方分析、临床记录审查、绩效和结果评估）的详细信息、所采用的干预策略（再教育、说服、促进、强制）、用于改变药物处方的方法以及干预措施的相对有效性和成本效益。
现成的、相对廉价的定量方法能提供重要信息，并为规划确定性研究提供有效基础，通过战略性地利用有限的人力和资源，可对处方模式进行实质性改变。
