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In the context of "internet plus health care", the annual internet outpatient prescriptions of a tertiary children′s hospital (Beijing Children′s Hospital affiliated to Capital Medical University, hereinafter referred to as the hospital) were taken as the objects, and the rationality of prescriptions was analyzed based on the rational drug use system, and the types, causes and drug characteristics of unreasonable treatments were identified to provide data support for the rational drug use management of pediatric Internet outpatient.
All prescriptions from the hospital′s internet outpatient hospital information system (HIS) in 2024 were collected and summarized. Review results were obtained by relying on the Puhua Hecheng Rational Drug Use System, and true positive irrational prescriptions were determined by combining with pharmacists′ manual re-evaluation. Statistical analysis was performed using Excel software.
A total of 58 560 internet outpatient prescriptions were included. The rational drug use software reviewed 1 334 machine-screened positive irrational prescriptions, and 438 true-positive irrational prescriptions were confirmed after manual re-evaluation, with an overall irrational rate of 0.75%. Among the 438 prescriptions, 93.61% involved only one irrational drug item, and a total of 559 medication problems were detected. Among these, inappropriate indication accounted for the highest proportion (63.51%), which was identified as the primary factor by Pareto analysis. Among the problems of inappropriate dosage and usage, 80.22% involved two combined issues (primarily single-dose overdose and daily-dose overdose, accounting for 61.54%). Inappropriate administration route was mainly attributed to non-standard labeling of "as needed" (70.00%), primarily involving nebulized drugs and nutritional supplements. The top three medications involved in irrational prescriptions were all nutritional supplements and vitamins, with this category ranking first among medication classifications.
The overall rationality of prescriptions in the hospital's pediatric internet-based outpatient service is relatively high. However, inappropriate indications and non-standard dosage and usage remain core issues. Targeted optimization of rational drug use system rules, enhanced pharmaceutical intervention, strengthened physician training, and improved remote consultation processes are needed to enhance medication safety and achieve continuous improvement.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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