Implementation and effect evaluation of medication rule homogeneity for prescription pre-review in medical treatment partnership system
Objective To investigate the homogenisation of medication rules for prescription pre-reviews within a medical treatment partnership system to enhance prescription review capabilities.Methods The research was conducted in a medical treatment partnership system where a central hospital is a third-class a hospital supported by six subordinate township hospitals.From September to November 2022,data on high-frequency unreasonable reviews from prescription pre-review systems of a third-class A hospital and a township health center were collected.These data were used to screen and optimise pre-review medication rules through verification and consultation of relevant evidence.The optimized rules were then homogenised across the remaining five township health centers.The effectiveness of these homogenised medication rules was evaluated by comparing several metrics before and after rule optimisation,including the irrational rate of system reviews,physician modification rate after system reviews,pharmacist review rate,and pharmacist intervention rate for outpatient and emergency prescriptions.Results Across the medical association,medications not matched in the hospital management system were synchronised with the prescription pre-review system.Antibiotic grades and physician prescription authorities within the pre-review system were validated and adjusted as necessary.Specific review rules were optimized,leading to the standardisation of 32 super indications and 15 dose ranges.Following rule optimisation,the irrational rate of system audits for emergency prescriptions in medical treatment partnership system outpatient departments decreased from 14.37%before optimisation to 11.37%after optimisation.The physician modification rate after system audit increased from 21.47%before optimisation to 38.22%after optimisation.The pharmacist review rate slightly decreased from 1.52%before optimisation to 1.12%after optimisation,while the pharmacist intervention rate increased from 21.87%before optimisation to 42.33%after optimisation.These changes were statistically significant before and after rule optimisation(P<0.001).Conclusion The homogenisation of prescription pre-examination services and the optimisation of medication rules within the medical treatment partnership system demonstrated high efficiency in optimisation and significant positive impacts.
medical treatment partnership systemprescription pre-reviewhomogenisation
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NSTL
万方数据
