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        關于談述西藥藥房退藥的原因及解決策略網站位置: >> 醫藥學論文 >> 生物藥物論文 >> 瀏覽文章
        談述西藥藥房退藥的原因及解決策略

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        西藥藥房退藥的原因及解決對策探析【摘要】近些年來,“就醫難看病貴”的理由受到了人們的廣泛關注,在實施醫療改革服務大眾的同時,醫療機構面對著嚴峻的挑戰。西藥退藥理由越來越突出,通過對醫院西藥退藥情況的分析與研究,了解退藥理由,針對實際情況,提出有效的解決策略,減少退藥情況的發生。
          【關鍵詞】西藥藥房;退藥;理由;策略
          1004-4949(2014)09-0637-02
          藥品是預防、診斷、治療患者疾病,有目的調節人體機能的物質,也是一種特殊商品,與民眾的健康以及生命安全有著密切的關系。在實際醫療實踐中,因為藥品的不良反應、處方差錯、不合理用藥、藥品價格等因素,導致退藥情況越來越多。本文主要分析西藥藥房退藥理由,結合實際情況,提出有效的解決策略。
          1.西藥藥房退藥理由分析
          1.1醫務人員理由
          醫務人員理由主要包括兩點:①門診、急診科室醫生工作強度大,接觸患者時間較少,經常會忽視對患者以往病史的問詢,導致在用藥的時候,普遍存在著患者過敏、不適等情況。比如,給患者糖尿病的患者開具含糖量較高的顆粒劑。②一些藥品名稱較為相似,醫生在開具處方的時候,普遍存在著差錯現象,尤其是一些新畢業以及年老的醫生;一些藥品品種規格較為相近,導致醫生混亂,進而開錯處方;部分醫生對用藥禁忌了解不建全面,導致在開藥的時候,存在著互相作用的情況,導致患者在知道沖突之后退藥。
          1.2藥物不良反應理由
          不良反應指的就是抗菌藥物以及中藥注射劑導致的一些藥疹、過敏反應等癥狀,不良反應是導致患者退藥的主要理由。大部分患者的不良反應程度較輕,如各種皮疹、惡心、嘔吐、頭痛等。抗風濕藥雙氯滅痛、抗菌藥甲硝唑等會引起惡心、嘔吐等不良反應,一些生物制品如降依降鈣素會引起皮疹、發熱、胃腸道反應等不良反應癥狀[1]。在患者出現不良反應之后,就會停藥,進而要求退藥。
          1.3患者理由
          患者因為病情變化,需要住院治療,剩余藥品不再需要,就會退藥。除此之外,患者并不了解自身的疾病情況,在閱讀完藥品說明書之后,認為醫生開的藥不符合自身病癥,或者不信任醫生,或者對說明書中羅列的不良反應過多而拒絕服藥。部分患者因為不知道藥品的通用名,導致出現重復開藥的情況,而要求退藥。還有一些患者因為經濟條件的限制,對醫生開具的藥品無法予以支付,進而退藥。
          1.4其他理由
          藥房藥品庫存信息管理系統不完善,藥品有效期管理工作中存在著嚴重的人為缺陷,致使患者發現藥品快到期之后進行退藥。除此之外,部分醫院使用電子處方,一般電子處方系統的默認時間為一天3次,如果不注意調整,就會是很多一天1次、一天2次的藥品出現超量配送,進而出現退藥的情況[2]。
          2.西藥藥房退藥的解決策略
          2.1減少醫務人員因素導致的退藥情況
          2.1.1提高醫生的綜合素質
          全面提高醫生的職業道德與責任心,強化用藥的合理性與科學性,同時,堅持以患者為中心的服務理念,逐漸提升診療質量。強化醫患之間的交流,在開具處方的時候,認真問詢患者的病史、過敏史、用藥史等;盡可能選擇效價比較高的藥品,降低患者的經濟壓力。還要加強對醫生的業務培訓,不斷豐富醫生的藥學知識,對藥品的適應癥、不良反應、禁忌、互相作用等進行全面的了解,詳細告知患者,讓患者有所準備;與此同時,強化對醫生法律法規的培訓,提高醫生的嚴謹性與科學性,保證臨床診斷和用藥的一致,盡可能提高用藥的安全性、經濟性與科學性。除此之外,還要加強對醫生信息化的培訓,熟練掌握各種軟件操作,避開出現不熟悉或者疏忽而開錯處方的情況,減少退藥。
          2.1.2提高藥師的業務水平
          在日常工作中,一定要不斷提高藥師的業務素質,積累更多的新知識,增加藥學理論知識,對各種藥物的藥理、適應癥、不良反應、禁忌、互相作用等進行牢固掌握[3]。同時,加強藥師對處方的審核,尤其是藥品互相作用的時候,一定要避開出現用藥錯誤或者搭配不合理的情況,及時告知處方醫生,請求其更改。在進行藥品調配的時候,主動解答患者的疑問,消除患者的顧慮,指導患者進行合理用藥,減少退藥。
          2.2減少患者因素導致的退藥情況
          強化藥師咨詢服務的展開,為患者解答相關用藥疑問。通過面對面的交流,向患者傳遞藥物知識以及用藥注意事項,并且詳細講解用藥的副作用,保證患者具有知情權,這樣可以有效提高患者的安全感與依從性,對減少退藥現象有著積極作用。除此之外,還可以建立計算機咨詢平臺,讓患者可以自行查閱相關藥物的詳細情況,進而為患者服藥提供參考依據,幫助患者合理用藥,減少了退藥情況。
          2.3完善醫院信息化系統
          在醫院中構建完善的信息化系統,可以有效減少出現差錯的幾率,對減少醫患矛盾有著重要作用。比如,在醫生工作站中合理嵌入用藥系統,對各種藥品的互相作用、禁忌等情況進行提示,如果需要聯合用藥,并且存在互相作用關系,就可以紅色警示。通過此項功能的運用,可以有效降低處方差錯,提高醫療服務質量,進而減少退藥情況。在開具一天1次、一天2次的藥品時,一定要關閉一天3次或者其它的選項,防止出現因為疏忽導致超量處方的理由。除此之外,在藥房藥品庫存信息管理系統中,一定要設置到期提醒功能,當某一藥品還有3個月就要到期的時候,系統給予紅色警示,這樣就可以避開藥品浪費,并且有效減少了醫患矛盾,對減少退藥現象有著積極作用[4]。
          3.結語
          總而言之,西藥藥房退藥是一種普遍存在的現象,導致出現此種情況的理由有很多,可以采取相應的策略予以解決,減少退藥現象,降低退藥的負面影響。在實際工作中,一定要重視醫生綜合素質以及醫師業務水平的提高,設置醫師咨詢窗口與計算機咨詢平臺,為患者提供更多的藥物知識,完善醫院信息化系統,進而減少退藥現象。
          參考文獻
          [1]廖群仙,梁偉澤,謝燕萍,等.366例門診西藥房退藥理由分析及解決策略[J].醫學信息(上旬刊),2011,24(08):5231-5232.
          [2]張曉峰,劉玉平.我院門診退藥理由分析及策略研究[J].中國當代醫藥,2012,19(24):161-162.
          [3]陳睿,鐘興繼.醫院門診西藥房退藥分析及應對措施[J].醫藥前沿,2012,02(04):366-366.
          [4]劉全峰.門診西藥房退藥處方情況分析及解決策略[J].中國藥事,2009,23(07):721-722. 全文地址:http://www.qdhlgm.com/swywlw/lw50498.html
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