Construction Of Monitoring Index System Based On Current Situation Of Rational Drug Use In Pediatric Outpatient Department

Objective: To understand the situation of rational drug use in pediatric outpatient department of a Grade A hospital in Xi ’an.Determine the rational drug use monitoring index of 3 armour hospital pediatric clinic,ascertain the weight of each index,and discuss about the 3 armour hospital pediatric clinic rational drug use monitoring index system building.To establish evaluation system to provide certain reference for the rational use of drugs in children in the future,and from the overall angle put forward reasonable suggestions to improve children’s clinical rational drug use.Methods: First of all,1200 prescriptions were selected from the pediatric outpatient department of a Grade A hospital in Xi ’an from January 2019 to December 2019 by random sampling method.After eliminating anesthesia and psychiatric prescriptions and special prescriptions,a total of 1099 prescriptions were investigated,and these prescriptions were statistically analyzed.Second,through the literature research to understand and combing the domestic and foreign some typical monitoring indicators and methods for the rational use of drugs,using Delphi method,the part of physicians,pharmacists,medical institutions,research institutes,head of the researchers,college teachers and other scholars on two rounds of expert consultation,the first step of monitoring index scores,screening,modification and adjustment,finally established the 3armour hospital pediatric outpatient monitoring index system for the rational use of drugs.Finally,some suggestions are put forward to further improve the level of rational drug use in children.Results: After experts determine the pediatric clinic rational drug use monitoring index system including prescription situation index(26.51%),cost index(26.27%),special drug use index(22.72%),safe drug use index(24.38%)of the four primary index and single prescription basic drug usage,the average number of drugs,oral drug use,drug use common name,intravenous drug delivery ratio,average single prescription drug costs of essential medicines,the expense proportion,antibacterial drugs accounted for,with glucocorticoid costs accounted for the body,and antimicrobial usage,duplex and above antibacterial drug usage.There were 17 secondary indexes of Chinese patent medicine use rate,repeated drug use rate,drug interactivity rate and off-label drug use rate.Among the secondary monitoring indicators,the top four weighted ones were "A1 : average number of drug use per single prescription(6.72%)","A2: utilization rate of essential drugs(6.66%)","B1: average drug cost per single prescription(6.60%)" and " D3: rate of off-label drug use(6.37%)".Conclusions: The utilization rate of pediatric outpatient prescription drugs in essential drugs was significantly lower than the optimal value required by WHO,and the utilization rate of antimicrobial drugs and intravenous drugs was higher than the optimal value required by WHO.The hospital should improve the use of national essential drugs,reduce the use of intravenous drugs and antibiotics,pay attention to the application of Chinese patent drugs in children’s diseases,and further improve the level of rational drug use of children.The monitoring index system of rational drug use in the outpatient department of pediatrics constructed in this study finally includes 4 first-level indicators and 17 second-level indicators,which is scientific and practical to a certain extent and can provide some reference for the construction of the evaluation system of rational drug use in children in the future.