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  [摘要] 目的 调查宿迁市医院门诊退药现象产生的原因，提出相应的改进措施，以保障用药安全，提高合理用药水平。 方法 收集宿迁市10所医院2011年1~7月门诊药房退药处方4 275张，按退药品种、原因、退药患者年龄分布及退药科室，分析退药现象的产生及特点。 结果 退药处方以抗感染类药物和中药注射剂为主，分别为1 130张和859张；退药原因中排名第1位的是药物不良反应，占1 612张，其次为医师处方错误，占1 091张。 结论 建议医院建立相应的退药制度，加强退药管理，规范医师处方行为，同时提高医患之间、药剂科与临床科室间的沟通效率，以减少退药现象的发生。

 [关键词] 门诊药房；退药；原因分析；建议

 [中图分类号] R954 [文献标识码] C [文章编号] 1673-7210(2012)02(a)-0132-03

 Investigation and analysis of the causes of drug returning in outpatient pharmacy of our city

 JIA Zengyong

 Department of Pharmacy, Traditional Chinese Medicine Hospital of Suqian City, Jiangsu Province, Suqian 223801, China

 [Abstract] Objective To investigate the causes of drug returning in outpatient department of hospitals in Suqian city, in order to make improvement measure to ensure the safety of drug use and improve the level of rational drug application. Methods 4 275 pieces of returning drugs prescriptions in outpatient pharmacy of 10 hospitals in Suqian city from January to July 2011 were collected. The phenomenon of returning drugs and the characteristics were analyzed according to the drugs returning categories, causes, age distribution and department. Results The commonest categories of drugs returning were anti-infective drugs and traditional Chinese medicine injections, which had 1 130 pieces and 859 pieces respectively. Among all causes of drug returning, adverse drug reaction was occupied the first place, which had 1 612 pieces, prescription error was followed, which had 1 091 pieces. Conclusion In order to reduce the occurrence of drug returning, hospitals should establish drug returning system, strengthen the management of drug returning, standardize prescription behavior of physicians, while increase the communication efficiency between patients and doctors, pharmacy department and clinical departments.

 [Key words] Outpatient pharmacy; Drug returning; Cause analysis; Recommendation

 2011年国家卫生部、中医药管理局和总后勤部卫生部联合颁布的《医疗机构药事管理规定》第四章第二十八条规定：“为保障患者用药安全，除药品质量原因外，药品一经发出，不得退换”[1]。该规定为确保医院药品安全，防止假劣药品流入医院药房提供了制度依据。然而实际操作中各种原因导致的门诊药房退药时有发生，给医院药房的药品管理带来了诸多困难。为此，笔者就2011年1~7月间我市10所医院门诊退药情况进行统计分析，总结门诊药房退药原因，探讨对策，以期为保证安全、优化服务及促进合理用药提供建议。现报道如下：

 1 资料与方法

 1.1 一般资料

 按不同医院级别随机选取我市10所医院为调查对象，其中，三级医院2所，二级医院4所，一级医院4所。10所医院2011年1~7月门诊药房退药处方共计4 275张，其中，三级医院692张，二级医院1 673张，一级医院1 910张。

 1.2 方法

 以《医疗机构药事管理暂行规定》为依据，对4 275张退药处方进行调查分析，并提出相应的建议。调查内容包括：退药品种、退药科室、退药原因等。

 1.3 统计学方法

 采用SPSS 16.0统计学软件进行数据分析，计数资料用率表示，组间比较采用χ2检验，以P
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