Bian Jing, Li Quanzhi, Li Jing, Yang Nan, Zhang Wei, Mei Dan, Zhong Mingkang, Miao Liyan, Lu Xiaoyang, Jiang Ling, Du Guang, Gao Shen, Jiang Xuehua, Lu Jin, Yan Bing, Kong Fancui, Chen Yaolong, Zhen Jiancun
Department of Pharmacy, Beijing Jishuitan Hospital, Beijing, China.
Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.
Ann Transl Med. 2021 Aug;9(16):1352. doi: 10.21037/atm-20-7502.
Evaluation of prescriptions is a necessary process of evaluating the appropriateness of clinical drug usage, discovering existing problems, and formulating solutions. There are challenges for professionals within hospital medical departments and for clinicians and pharmacists who have clinical questions relating to inappropriate or abnormal prescriptions as identified by the electronic evaluation system of prescription. Medications are usually used correctly according to the drug instructions or guidelines. At present, there are no relevant domestic or international guidelines, or principles or standards for identifying inappropriate or abnormal prescriptions. To develop the guideline for evaluation of prescriptions appropriateness in clinical practice, the Pharmaceutical Affairs Commission of the Chinese Hospital Association formed the guideline working group consisting of multidisciplinary experts. The guideline working group summarized clinical questions in the evaluation of prescriptions, searched for supporting evidence, and reached a consensus for recommendations. The guideline contains 6 recommendations for evaluating prescription appropriateness, and the general principle of these recommendations is that clinicians should provide drug instructions, guidelines, or moderate evidence supporting the prescription, and the evaluators will then judge the prescription to be either appropriate or irrational. The recommendations resolve common clinical questions, using supporting examples, explanations and a flow chart. The evaluation of prescription appropriateness could be made more systematic and transparent based on this guideline's conclusions.
处方评估是评估临床用药合理性、发现现存问题并制定解决方案的必要过程。对于医院内科专业人员以及对于那些有与电子处方评估系统识别出的不恰当或异常处方相关临床问题的临床医生和药剂师而言，存在着挑战。药物通常是按照药品说明书或指南正确使用的。目前，国内外尚无识别不恰当或异常处方的相关指南、原则或标准。为制定临床实践中处方适宜性评估指南，中国医院协会药事管理专业委员会组建了由多学科专家组成的指南工作组。该指南工作组总结了处方评估中的临床问题，查找了支持证据，并就建议达成了共识。该指南包含6条评估处方适宜性的建议，这些建议的总体原则是临床医生应提供药品说明书、指南或支持该处方的适度证据，然后评估人员将判断该处方是适宜还是不合理。这些建议通过示例、解释和流程图解决常见的临床问题。基于本指南的结论，处方适宜性评估可以变得更加系统和透明。
