Wen Qiang, Yang Chuang, Deng Bangjian, Zhang Yi, Song Lin
Department of Pharmacy, Children's Hospital of Chongqing Medical University, Chongqing, China.
Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.
Ther Adv Drug Saf. 2025 Jan 6;16:20420986241311448. doi: 10.1177/20420986241311448. eCollection 2025.
Medication safety is crucial in clinical care. Although many hospitals have implemented prospective prescription review systems to manage medication use, the impact of these systems on pediatric patients is not yet fully understood.
We explore the characteristics and economic impacts of pediatric prospective prescription review and identify factors influencing intervention success rates.
This study adopted a cross-sectional design.
Prospective prescription review tasks were compared in the outpatient of our hospital between 2021 and 2023 to assess medication rationalization rates and cost variability. Data were collected using the PASS PharmReview system, including patient information, medication indications, prescribing physicians, intervention pharmacists, prescription rationality rate, and medication costs. SPSS 26.0 software was used to compare changes in medication rationality and medication costs between the initial (2021) and stable (2023) periods and to analyze factors affecting intervention success during the stable period by the logistic regression model.
The study included 11,533,807 prospective prescription review tasks. The medication rationalization rate increased from 92.0% to 95.7% ( < 0.05) between the initial ( = 5,392,551) and stabilization periods ( = 6,141,256). Outpatient medication costs per capita decreased by 3.2%, from ¥320.7 to ¥310.5. Factors influencing intervention success included the following: the greater age is negatively associated with success( < 0.001, odds ratio (OR) = 0.98); internal medicine demonstrates a superior intervention success rate compared to the surgical department ( < 0.001, OR = 1.37); higher physician titles were associated with lower success rates ( < 0.001, OR = 0.59); and success increased with pharmacists of higher educational levels ( < 0.001, OR = 1.18).
Implementing a prospective prescription review system in pediatric outpatient settings improves medication rationality and reduces errors and costs, with intervention success influenced by patient age, department, physician titles, and the educational level of pharmacists.
用药安全在临床护理中至关重要。尽管许多医院已实施前瞻性处方审核系统来管理用药，但这些系统对儿科患者的影响尚未完全了解。
我们探讨儿科前瞻性处方审核的特点和经济影响，并确定影响干预成功率的因素。
本研究采用横断面设计。
比较了2021年至2023年我院门诊患者的前瞻性处方审核任务，以评估用药合理性率和成本变化。使用PASS PharmReview系统收集数据，包括患者信息、用药指征、开处方医生、干预药师、处方合理性率和用药成本。使用SPSS 26.0软件比较初始阶段（2021年）和稳定阶段（2023年）用药合理性和用药成本的变化，并通过逻辑回归模型分析稳定阶段影响干预成功的因素。
该研究包括11533807项前瞻性处方审核任务。初始阶段（n = 5392551）和稳定阶段（n = 6141256）之间，用药合理性率从92.0%提高到95.7%（P < 0.05）。门诊人均用药成本下降了3.2%，从320.7元降至310.5元。影响干预成功的因素包括：年龄越大与成功率呈负相关（P < 0.001，比值比（OR） = 0.98）；内科的干预成功率高于外科（P < 0.001，OR = 1.37）；医生职称越高，成功率越低（P < 0.001，OR = 0.59）；药师学历越高，成功率越高（P < 0.001，OR = 1.18）。
在儿科门诊实施前瞻性处方审核系统可提高用药合理性，减少差错和成本，干预成功受患者年龄、科室、医生职称和药师学历的影响。
