四川地区各级医院合理用药情况调查

目的调查医师、护师、药师对合理用药相关知识的知晓程度,以及各级医院促进合理用药政策的制定及执行情况,了解影响医务工作者用药的主要因素,为更好地推广合理用药提供决策参考。方法采用方便抽样抽取成都市、自贡市各级医院作为研究对象,用自制问卷对医师、护师、药师等医务工作者进行面对面调查。医院等级与合理用药指南制订的差异性分析采用Monte Carlo卡方分析,对影响调查对象合理用药知识知晓度的因素采用二分类logistic回归分析。结果共发放问卷700份,回收有效问卷672份,有效回收率96.0%。调查对象中对药事委员会、药物和治疗委员会熟悉的分别有217人(32.29%)和83人(12.35%);理解基本药物概念的有502人(74.71%);参加过合理用药知识培训的有411人(61.16%)。199名(29.61%)调查对象否认其所属医院设有药物和治疗委员会;60.71%的调查对象表示其所属医院对药物的使用进行监测和反馈。logistic回归分析发现职称、基本药物了解程度和合理用药培训参与情况是影响调查对象合理用药知识知晓度的因素(其P值分别为0.038,<0.001,0.008)。结论提高合理用药水平应注意管理和教育双管齐下。应健全合理用药监督机构、提升合理用药知识水平,推进合理用药;建立治疗或用药指南,提高用药合理性;规范制度、加强管理、注重教育、促进医患交流,改善医务工作者个人知识、科学信息和用药习惯。

Survey on Rational Use of Drug in Different Ranks of Hospitals in Sichuan Province

Objective To investigate the awareness of rational use of drug （RUD） on medical workers in hospitals of different ranks, the establishment and execution of relevant strategies in hospitals of different ranks, and the main factors affecting RUD on medical workers, so as to provide references for the generalization of RUD. Methods A certain number of different ranks of hospitals in Chengdu and Zigong were randomly selected by the convenience sample method. Medical workers in each hospital were selected through face-to-face interviews with a self-designed questionnaire. Monte Carlo Chi-square analysis was applied on the hospital ranks and formulation of RUD guidelines, and logistic regression analysis was performed on the awareness of RUD knowledge of the respondents. Results Among 700 questionnaires distributed, 672 were retrieved （response rate 96.0%）. The numbers of respondents who were familiar with the Pharmaceutical Affairs Councils （PACs） as well as the Pharmacy and Therapeutics Committees （PTCs） were 217 （32.29%） and 83 （12.35%）, respectively. The number of respondents who understood the concept of essential medicine was 502 （74.71%）. A total of 441 （61.16%） medical workers had been trained on RUD, 199 （29.61%） medical workers denied therewere PTCs in their hospitals, and 60.71% of the medical workers mentioned that the use of drug was monitored and controlled with the feedback in their hospitals. The result of logistic regression analysis indicated that the professional title （P=0.038）, awareness of essential medicine （P〈0.001） and participation of RUD training （P=0.008） were the factors influencing the awareness of RUD. Conclusion Both management and education should be executed at the same time to elevate the level of rational use of drug. In order to increase the level of RUD we should complete monitoring institution and improving RUD awareness of workers. Additionally enhancing the rationality of medication should be performed by establishing guidelines of treatment or medication. Improving personal knowledge, scientific information and medication custom should be performed by standardizing regulations, strengthening management, emphasizing education and pro-moting communication between doctors and patients.