目的 探讨不同用药方案治疗慢性阻塞性肺病所致肺部感染的药物经济学。方法 本次医学研究选择我院2012年1月—2014年1月收治的200例慢性阻塞性肺病所致肺部感染患者为观察对象,随机将其分为A组、B组、C组和D组,A组观察对象接受盐酸莫西沙星治疗,B组观察对象接受硫酸依替米星治疗,C组观察对象接受头孢哌酮钠治疗,D组观察对象接受他唑巴坦钠/哌拉西林钠治疗,回顾分析四组观察对象药物经济学。结果 四组观察对象药物敏感度对比差异有统计学意义(P<0.05),而临床治疗效果和不良反应发生率对比则差异无统计学意义(P>0.05)。结论 慢性阻塞性肺病所致肺部感染患者接受C方案治疗,具有理想的临床效果和较高的药物经济学效率。
目的 对86例青春期多囊卵巢综合症(polycystic ovary syndrome,PCOS)患者进行随访,探讨患者长期治疗的依从性。方法 选择2009年11月—2012年6月在我院门诊首次诊断为青春期PCOS患者进行前瞻性队列研究。按随诊方法不同分为常规随访组和可及与连贯病人服务(ACC)组,前瞻随访6个月。分别在初次就诊时、3个月及6个月后对比两组的身体质量指数(Body Mass Index, BMI)、复诊率和遵医嘱服药率。结果 共86名患者入组,其中常规随访组43人,ACC组43人。两组基线资料基本一致。随访3月时,两组的BMI、复诊率和遵医嘱服药率的差异无统计学意义(P>0.05)。随诊6月时,ACC组的复诊率和服药依从性均优于常规随访组分别为(97.7% 比 81.4%,97.7% 比 76.7%,P＜0.05),BMI比常规随访组下降(22.33±7.31 比 24.59±7.8 kg/m2,t<0.05)。结论 可及与连贯的病人服务可以改善青春期PCOS患者BMI及长期随诊的复诊率和服药依从性。
Objective To investigate the compliance of adolescent patients with polycystic ovary syndrome (PCOS) in long-term treatment by access to care and continuity of care(ACC) on 86 cases. Methods A prospective cohort study was taken for 6 months on adolescent patients diagnosed as PCOS for the first time in out-patient department from November 2009 to June 2012. These patients were selected and divided into ACC group and regular follow-up group according to the different modes of follow-up visit. The relevant data including body mass index (BMI), clinic visit rate and rate of medication adherence were compared in the first visit and 3rd, 6th month in the follow-up visit. Results 86 patients were enrolled with 43 in ACC group and 43 in regular follow-up group. The baseline information was similar between the two groups. There were no statistically significant difference between groups in BMI, clinic visit rate and rate of medication adherence after 3 months (P>0.05). However, after 6 months, BMI, clinic visit rate and rate of medication adherence were significantly improved in the ACC group compared to the regular follow-up group (22.33±7.31 vs 24.59±7.8 kg/m2, 97.7% vs 81.4%, 97.7% vs 76.7%, P＜0.05, respectively). Conclusion ACC could improve BMI, clinic visit rate and medication adherence of adolescent patients with polycystic ovary syndrome in long-term treatment.
处方前置审核工作是推动临床合理用药的重要措施，对转变医院药学服务模式具有重要意义。传统处方点评为回顾性的事后点评，存在滞后性和局限性，不能实时监控合理用药。相比而言，处方前置审核可以及时、有效地干预问题处方，简化不合格处方修改流程，提高就诊患者的取药效率，而人机结合更能发挥药学信息智能化等多重优势。前置审核工作在各医院开展形式及发展水平不一，探讨新型模式，建立自主维护知识库，制定基本化原则，完善个性化原则，对前置审核系统进行全面人工筛查，可从源头上拦截或干预医生的不合理处方，促进用药规范性，提高处方或医嘱合理率，实现药学智慧信息化，辅助临床合理用药。
Pre-prescription audit is an important measure to promote clinical rational use of drugs，which is of great significance to the transformation of hospital pharmaceutical care mode．Traditional prescription review for retrospective review has lag and limitations，can not real-time monitoring rational drug use．By contrast，pre-prescription audit can timely and effective intervene problem prescription，simplify the unqualified prescription modification process，improve the efficiency of patients take medicine，and man-machine combination can make more pharmaceutical information intelligent multiple advantages．Advanced audit work in various hospitals presents different forms and development level，exploring the new mode，establishing independent maintenance knowledge base，developing basic principles，perfecting personalized principle，comprehensive check of advanted audit system，can intercept or intervene doctors unreasonable prescription from the source，contribute to normative，improve the prescription or advice reasonable rate，realize pharmaceutical wisdom informatization，auxiliary clinical rational use of drugs．
