中国临床药学杂志2025，Vol.34Issue(9)：669-674,6.DOI:10.19577/j.1007-4406.2025.09.005
临床药师主导的PDCA循环管理法在吸入用布地奈德混悬液适应证管理中的应用效果
Effect of PDCA-driven indication managememt of budesonide suspension for inhalation:a pharmacist-led intervention study
摘要
Abstract
AIM To investigate the effectiveness of a clinical pharmacist-led PDCA cycle management approach in the indication-specific management of budesonide suspension for inhalation,aiming to promote its rational clinical use.METHODS Prescriptions for budesonide suspension for inhalation were collected from pediatric emergency and outpatient departments during 3 distinct periods:October to December 2023(pre-intervention),February to April 2024(first intervention phase),and May to July 2024(second intervention phase).Using the pre-intervention prescriptions as baseline data,the distribution of indications for budesonide was analyzed and evaluated using the Thomson classification system from Micromedex.For evidence-supported off-label indications,documentation was completed based on the hospital's off-label medication management protocol,and refined prescription review rules for off-label budesonide use were established.From February 2024,a PDCA cycle intervention was implemented by clinical pharmacists,with key indicators such as the monthly average drug cost,indication rationality rate,and overall prescription rationality rate compared before and after the intervention,as well as the changes in the efficacy of prescription audit in the two-stage intervention.RESULTS The rationality rate of budesonide indications improved significantly from(18.93±3.61)％(pre-intervention)to(80.93±2.12)％(post-intervention,P＜0.05).The monthly average drug cost decreased from 48 153.84 Yuan to 21465.04 Yuan(P＜0.05).Compared with the prior intervention,the off-label prescription review rate among outpatient and emergency cases dropped from 36.13％to 9.22％(P＜0.05),while the revision rate of prescriptions by physicians after pharmacist review increased from 9.08％to 72.41％(P＜0.05).CONCLUSION The clinical pharmacist-led PDCA cycle management approach,combined with evidence-based medicine,effectively standardizes the use of budesonide indications,prevents irrational use of budesonide suspension for inhalation,reduces healthcare costs,and enhances the efficiency of prescription audit,which is worthy of promotion.关键词
PDCA/布地奈德/临床药师/适应证管理/处方前置审核/循证医学证据Key words
PDCA/budesonide/clinical pharmacist/indication management/prescription pre-audit/evidence-based medicine分类
医药卫生引用本文复制引用
赵丹,郭星..临床药师主导的PDCA循环管理法在吸入用布地奈德混悬液适应证管理中的应用效果[J].中国临床药学杂志,2025,34(9):669-674,6.基金项目
2024年度蚌埠医科大学科技项目(编号2024byzd585sk) （编号2024byzd585sk）
