J Am Pharm Assoc (2003). 2021 Mar-Apr;61(2):e176-e182. doi: 10.1016/j.japh.2020.12.008. Epub 2020 Dec 30.
To reduce the occurrence of inappropriate prescription in primary care through the introduction of a cloud-based pre-prescription review system.
We aimed to describe the implementation of a cloud-based pre-prescription review system in the pharmacy practice of Chinese community health centers (CHCs), which currently have few qualified pharmacists.
The cloud-based pre-prescription review system featured reviews by remote clinical pharmacists and targeted the prevention of inappropriate prescription in primary care.
This study describes the implementation of remote pharmacy at 22 CHCs in Futian District, Shenzhen, China. A pre-prescription system was developed and deployed in the cloud, which is linked to CHCs, and a consortium of qualified clinical pharmacists located in tertiary hospital. All prescriptions were mandatorily reviewed before printing and payment. First, prescriptions were reviewed using cloud-based rational drug use software. Then any detected potentially inappropriate prescriptions were reviewed by the remote pharmacist. The pharmacist consortium also modified review rules to improve efficiency and accuracy.
The frequency and proportions of potentially inappropriate prescriptions identified by the review software and the remote pharmacist consortium were analyzed descriptively.
During the 6-month study period (July 1, 2019-December 31, 2019), 340,117 prescription entries from general practitioners in 22 community health care centers were reviewed. Of these, 6479 (3.0%) unique potential entries were suspended for pharmacist review, of which 3230 (49.9%) needed correction from prescribers in the CHCs. The most common corrections were related to improper administration routes or drug-drug interactions or had no justified indications.
Inappropriate prescription is not uncommon in CHCs. The cloud-based prescription prereview model proposed in this study can serve as an important tool for the prevention of inappropriate prescription in primary care. The pre-prescription review system also provided opportunities for pharmacists to participate in the enhancement of patient care in primary care.
通过引入基于云的预处方审查系统，减少初级保健中不适当处方的发生。
描述在中国社区卫生服务中心（CHC）药剂实践中引入基于云的预处方审查系统，目前该中心合格药剂师人数较少。
基于云的预处方审查系统的特点是远程临床药剂师进行审查，旨在预防初级保健中的不适当处方。
本研究描述了在中国深圳福田区的 22 家 CHC 实施远程药学。开发并在云端部署了一个预处方系统，该系统与 CHC 以及位于三级医院的合格临床药剂师联盟相连。所有处方在打印和支付前都必须进行审查。首先，使用基于云的合理用药软件对处方进行审查。然后，由远程药剂师对发现的任何潜在不适当处方进行审查。药剂师联盟还修改了审查规则，以提高效率和准确性。
描述性分析审查软件和远程药剂师联盟识别的潜在不适当处方的频率和比例。
在 6 个月的研究期间（2019 年 7 月 1 日至 2019 年 12 月 31 日），22 家社区卫生保健中心的普通医生共审查了 340117 份处方条目。其中，有 6479 个（3.0%）独特的潜在条目因需要药剂师审查而被暂停，其中 3230 个（49.9%）需要 CHC 的开方医生进行更正。最常见的更正与不当给药途径或药物相互作用有关，或没有合理的适应症。
CHC 中不适当处方并不少见。本研究提出的基于云的处方预审查模型可以作为预防初级保健中不适当处方的重要工具。该预处方审查系统还为药剂师提供了参与加强初级保健患者护理的机会。
