2023 年第 3 期 第 18 卷

药师基于PDCA循环管理法对前蛋白转化酶枯草溶菌素9抑制剂处方规范性管理的效果分析

Effect analysis of pharmacists′ standardized prescription management of proprotein convertase subtilis/Kexin type 9 inhibitors based on PDCA cycle management

作者：赵强1刘鑫宇2孙亚红1贾娜1石佳1周洋1石秀锦1仇琪1林阳1

英文作者：Zhao Qiang1 Liu Xinyu2 Sun Yahong1 Jia Na1 Shi Jia1 Zhou Yang1 Shi Xiujin1 Qiu Qi1 Lin Yang1

单位：1首都医科大学附属北京安贞医院药事部，北京100029；2首都医科大学药学院，北京100069

英文单位：1Department of Pharmacy Beijing Anzhen Hospital Capital Medical University Beijing 100029 China; 2School of Pharmaceutical Sciences Capital Medical University Beijing 100069 China Corresponding author: Lin Yang Email: linyang3623@163.com

关键词：PDCA循环管理法；前蛋白转化酶枯草溶菌素9抑制剂；处方合理性

英文关键词：PDCAcyclemanagement;Proproteinconvertasesubtilis/Kexintype9inhibitors;Rationalityofprescription

• 摘要：

• 目的 评价PDCA循环管理法（即按照计划-实施-检查-处理循环法进行质量管理）干预前蛋白转化酶枯草溶菌素9（PCSK9）抑制剂处方规范性的效果，提高PCSK9抑制剂的处方合理性。方法 以首都医科大学附属北京安贞医院PCSK9抑制剂PDCA循环管理实施前（2022年1月1日至2022年3月31日）的医嘱数据作为对照组，PDCA循环管理实施后（2022年4月1日至2022年6月30日）的医嘱数据作为干预组。回顾性分析对照组和干预组PCSK9抑制剂（依洛尤单抗注射液和阿利西尤单抗注射液）的处方数量、处方不合格率、例均使用数量等指标。结果 干预组依洛尤单抗注射液和阿利西尤单抗注射液的医嘱不合格率均低于对照组［7.9%（251/3 165）比17.7%（448/2 534）、6.4%（140/2 173）比17.9%（234/1 308）］，差异均有统计学意义（χ2=124.30、111.57，均P<0.01）。干预组依洛尤单抗注射液和阿利西尤单抗注射液的例均使用数量分布较对照组有显著改善，差异均有统计学意义［（2.03±0.49）支比（1.99±0.66）支、（2.03±0.50）支比（1.99±0.66）支］（t=176.09、97.74，均P<0.01）。结论 PDCA循环管理法能有效降低PCSK9抑制剂处方不合格率，提升其临床使用的合理性。

• Objective  To evaluate the effect of PDCA cycle management (Plan-Do-Check-Action cycle management) on the prescription standardization of proprotein convertase subtilis/Kexin type 9(PCSK9) inhibitors, so as to improve the prescription rationality of PCSK9 inhibitors. Methods  The medical order data in Beijing Anzhen Hospital, Capital Medical University before implementating PDCA cycle management of PCSK9 inhibitors(January 1, 2022 to March 31, 2022) were collected as the control group, and the medical order data after implementing PDCA cycle management(April 1, 2022 to June 30, 2022) were collected as the intervention group. The number of prescriptions, unqualified rate of prescriptions, per case use and other indicators of PCSK9 inhibitors (evolocumab injection and alirocumab injection) in the control group and the intervention group were analyzed retrospectively. Results  The unqualified rates of medical orders of evolocumab injection and alirocumab injection in the intervention group were lower than those in the control group［7.9%(251/3 165) vs 17.7%(448/2 534), 6.4%(140/2 173) vs 17.9%(234/1 308)］（χ2=124.30, 111.57, both P<0.01). The distributions of per case use of evolocumab injection and alirocumab injection in the intervention group were significantly improved compared with the control group［(2.03±0.49) vs (1.99±0.66), (2.03±0.50) vs (1.99±0.66)］（t=176.09, 97.74, both P<0.01). Conclusion  PDCA cycle management can effectively reduce the unqualified rate of prescriptions of PCSK9 inhibitors and improve the rationality of clinical use.