门诊西药房退药情况分析及对策

目的:探讨医院门诊药房退药现象的原因,提出相应对策,以减少退药,促进合理用药。方法:收集2007年3月5日-2007年5月11日门诊西药房的退药情况,详细记录退药原因、退药种类、申请退药科室等,并对结果进行统计。结果:患者用药后发生不良反应占总退药原因的31.6%,其次为门急诊患者住院或改变医嘱而退药,占17.9%;退回药品类别以抗微生物类药物居多,占53.1%;科室主要集中在急诊科、妇产科、呼吸科等。结论:绝大多数的退药可以通过加强管理,提高医务人员的用药合理性而加以避免。     

我院门诊西药房退药原因分析及对策

目的了解退药原因,总结经验,为减少和规范退药提供参考。方法对我院2007年1~6月门诊西药房患者的退药情况及其原因进行统计分析。患者退药处方为334张,退药原因是药品不良反应、患者的依从性差、医生的原因及患者的经济情况等。患者用药后发生不良反应（副作用和过敏）是最主要的退药原因,占退药比例的54.79%。结果与结论医生在开药前,应详细询问患者的药物过敏史及用药史,谨慎对待特殊人群的用药,综合患者的经济情况制定治疗方案,规范和减少退药,提高医疗服务质量。     

我院门急诊药房退药处方分析与对策

目的减少医院退药情况发生,促进合理用药。方法选取医院2010年6月至2012年5月235张患者退药处方,按退药患者年龄、科室、退药品种及原因进行统计和分析。结果退药原因包括药品不良反应、药品质量、医生原因、患者拒用、患者住院等。结论应建立规范的退药制度,加强与患者沟通,提高医务人员业务水平、责任心及主动服务意识,以减少退药行为的发生。     

分析医院门诊退药情况及改进措施

目的调研我医院门诊退药情况加以分析退药原因,提出相应改进措施,保证患者用药安全、合理、有效,以达到更好的为患者服务。方法收集我医院2010年1月至12月门诊药房退药处方共556张,对患者退药情况进行汇总分析。结果退药种类以抗感染药、中成药、心脑血管用药等为主;退药科室以内科、急诊室、儿科等为主;退药原因以药品不良反应、病情变化调整用药、患者拒绝用药等为主。结论医院要重视退药问题的存在,加强药学服务,增强医患沟通,建立完善退药制度,以减少医院门诊退药发生。     

我院门诊西药房退药情况分析及改进措施

目的了解退药原因,总结经验,为减少和规范退药行为提供参考。方法对医院门诊西药房2009年1月至10月间退药情况进行分析。结果患者退药共398例,原因涉及发生药品不良反应、不合理用药、患者拒绝用药及医生处方因素等6个方面。结论应建立严格的退药制度,以减少退药、保障医疗服务质量。     

门诊退药处方调研与安全合理用药

目的：调研门诊2008年的退药处方,通过统计归类,找出退药原因,减少退药,保障患者安全、有效、合理用药。方法：统计门诊2008年1—12月的退药处方2207张,分析退药情况,按分布科室、退药品种和剂型、退药原因进行归类。结果：退药率为1．0％,内科退药多,品种主要是抗菌药物退药最多,剂型以注射剂多。退药最主要的原因是发生不良反应（ADR）和患者要求退药。结论：总结退药特点,加强管理,应提高医师、药师业务水平,合理用药,减少不良反应的发生,降低退药率,保障患者安全、有效、合理、经济用药。     

我院门诊药房退药情况分析

目的:总结退药原因,提高医疗服务质量,保证用药安全.方法:收集门急诊退药单(2006年6月-2007年5月)共计719例,对患者退药情况进行汇总分析.结果:患者门诊退药原因主要有发生药品不良反应、不合理用药、医生错误操作电脑、患者住院、患者拒绝取药和患者死亡等方面,其中药品不良反应和不合理用药以及医生电脑操作失误为主要退药原因,共计562例,占退药总数的78.16%.结论:建立退药措施,加强医患沟通,减少处方出错,保证用药安全.     

我院住院药房退药原因分析与对策

对我院2014年3~5月的1841张退药申请单进行统计,分析退药原因。我院住院药房退药原因主要是调整医嘱、患者出院、患者转科、患者拒绝用药、药物不良反应、医嘱录入错误、患者死亡、药房缺药等。应建立完善的退药管理制度,加强相关法律法规宣传教育,提高医务人员专业水平和责任心及相互间与患者的用药沟通,减少退药情况的发生。     

我院住院患者退药情况及原因分析

目的调查住院患者退药情况,分析原因,促进临床合理用药。方法采用回顾性调查方法,对我院2011年1月至6月间退药资料进行统计、分析。结果导致退药的主要原因有患者拒用、更改医嘱、不良反应等,退药品种以抗肿瘤药物及抗感染药物较多。结论应加强用药管理,规范退药程序、增强医患间的沟通,提高患者用药的依从性,减少退药现象的发生,保障临床用药安全、合理、有效。     

451例住院患者退药情况调查及分析

目的:调查医院住院患者退药情况。方法:对2006年1～11月的退药申请单,按退药原因和退药品种进行统计分析。结果:退药较多的是外科和内科,占退药构成比的75.61%。退药原因多见于录入错误、更改医嘱、患者出院或死亡、药物不良反应、患者用药不依从性等;退药品种以抗生素居多。结论:应从管理抓起,提高医生用药水平,加强工作责任心,减少退药现象的发生,保证临床用药安全、有效。     

我院门诊退费原因分析及评价

目的：评价和分析我院门诊的退费原因。方法：整理并统计我院门诊药房2006年后半年的退费记录本及退药单。结果：我院门诊涉及退费事件的科室有21个，其中25．0％是因药品不良反应造成的退费，6．7％是因病情变化或死亡造成的退费。结论：我院应加强对相关科室及责任人的管理力度，提高对患者的医疗水平及服务技能。     

从生产者角度分析药品临床供应短缺的原因

目的：从生产者角度分析药品短缺原因，提出应对药品短缺问题的政策建议。方法：采用文献综述法和归纳总结法，分析药品短缺原因；在此基础上提出相关建议。结果与结论：对于药品生产企业来说，药品短缺原因分为生产原因和非生产原因。生产性原因分为主观原因和客观原因。主观原因主要有价格太低、需求量少、成本上升等造成企业不愿生产；客观原因主要有原料获取困难、生产条件不符合规定等。非生产性原因主要有流通环节利润太低、流通垄断、意外情况等。应进一步调动生产企业积极性、净化原料和流通环节、落实保障政策，提高相应药品的可及性。     

Reasons for alcohol use in young adulthood: validation of a three-dimensional measure

OBJECTIVE: To evaluate the reliability and validity of a measure of reasons for use, which is based on a cognitive mediational view of alcohol use as a means for affect regulation. METHOD: Data for this study were obtained from the Rutgers Health and Human Development Project. Self-reports of young men and women aged 25 to 31 years (N = 1,176; 598 women) were used to obtain measures of reasons for use, coping use, sex-enhancing use, use intensity and use problems. Regression analyses and structural equation modeling were used to assess a hypothesized model of relationships between these variables. RESULTS: Factor analysis of 33 reasons for use yielded three hypothesized dimensions: social reasons, disinhibition reasons and suppression reasons. Although moderately correlated with each other, they exhibited distinct relationships with other use variables. Increases in social reasons were related to decelerating increases in use intensity, but increases in disinhibition and suppression reasons were associated with accelerating increases in use intensity Social reasons did not relate to use problems, whereas suppression reasons were strongly related to use problems even when controlling for use intensity. CONCLUSIONS: Suppression reasons not only motivate reactive coping use in response to the appraisal of stressful situations, they are also likely to instigate "prophylactic" or proactive coping use in anticipation of the possible occurrence of stressors, thereby blunting the emotional impact of encounters that would otherwise have been appraised as stressful and aversive.     

应用帕累托图法分析门诊药房不合理处方的原因

目的查找门诊处方不合理的主要原因,提出对策,保证用药安全。方法通过对处方不合理原因进行整理,利用帕累托图法对本院主要退药原因进行分析。结果造成处方不合理的前2项因素（药物相互作用和给药频次不合理）为主要因素,用药与临床诊断不符和超剂量用药为次要因素,其余为一般因素。结论针对造成处方不合理的主要原因,应加强对临床医师合理用药知识培训,同时药房审核药师应加大审核力度,保证用药安全。     

The role of alcohol-related problematic events in treatment entry

This is an analysis of alcohol-related problematic events experienced by alcohol treatment clients in the year before treatment and the reporting of these events as major reasons for treatment entry. A probability sample of new intakes (N = 316) of the 8 contracted alcohol programs of a California county was interviewed. Data were collected on demographics, drinking patterns and a series of ten problematic events. Events (N = 982) are the unit of analysis. The analysis examines the events reported as major reasons for entering treatment. Logistic regression is used to investigate the socio-demographic and drinking variables associated with that reporting. Drinking driving, relapses and serious drinking episodes were reported as being major reasons for entering treatment a significant proportion of the times they occurred. Public drunkenness and non-traffic accidents had significant proportions of individuals reporting them as not being major reasons for treatment when they occurred. Age, gender, ethnicity, marital status, employment and frequency of drunkenness were predictors of some types of events being major reasons, but there was no pattern across all events. The variables associated with experiencing an event were not the same as those which predicted the event would be reported a major reason for treatment.     

A cross-ethnic comparison of reasons given for using alcohol, not using alcohol or ceasing to use alcohol

In a study that included six different racial-ethnic groups in Hawaii, the reasons given by drinkers for drinking, abstainers for not drinking and former drinkers for ceasing to drink were assessed. Although there were group differences in frequencies of endorsement of given reasons for drinking, for not drinking or for ceasing to drink, the findings of similarity were most impressive. Drinkers, abstainers and former drinkers were similar across racial-ethnic groups in their proportions of endorsement of given reasons for drinking, abstaining or ceasing to use alcohol. Although reasons for drinking varied across racial-ethnic groups, they varied much more across groups that differed in alcohol consumption independent of ethnicity, with all reasons for drinking being more often endorsed as consumption increased. In addition, the citation of more pathological reasons for drinking was associated with a greater number of drinking problems.     

Predictors of relapse: interaction of drinking-related locus of control and reasons for drinking

Pretreatment scores from the drinking-related locus of control scale (DRIE) and reasons for drinking were investigated as predictors of drinking relapse over a nine-month follow-up in a sample of 232 male alcoholics. A significant relationship was found between reasons for drinking and the probability of relapse, with the lowest relapse rates occurring among patients who identified interpersonal conflicts or positive emotional states as the most important reasons for their pretreatment drinking. Results of a reasons for drinking by relapse status ANOVA on DRIE scores revealed no significant main effects. There was, however, a significant interaction. Among patients who attributed their drinking to negative emotional states, those who either relapsed or were lost to follow-up had significantly more external DRIE scores. Among patients who identified negative physical states (i.e., craving) as their primary reason for drinking, relapse or attrition was associated with significantly more internal DRIE scores. Results support assessment of these cognitive social learning constructs for differential treatment planning with patients at increased risk of relapse.     

门诊药房退药原因的排列图法分析

目的查找退药现象的主要原因,优化服务流程,提高调剂质量,保证用药安全。方法利用Excel软件进行退药数据处理,利用排列图法找出退药的主要原因。结果造成退药现象的前3项因素（药物不良反应,不合理用药,入院、院外治疗）为主要因素,收费问题、检查项目取消2项为次要因素,其余5项为一般因素。结论针对造成退药现象的主要原因,应采取加强制度建设、加强处方点评、提高医生的诊治水平和服务意识、加强药师素质等措施,把影响退药现象的主要因素及次要因素限制在可控范围内。     

Development and validation of a scale for assessing reasons for substance use in schizophrenia: The ReSUS scale

This paper reports on the development of a questionnaire to assess self reported reasons for substance use in schizophrenia: the ‘reasons for substance use in schizophrenia’ (ReSUS) scale and explores the relationship between reasons for use, psychiatric symptoms and substance use in a sample of 230 people with psychosis. Principal components analysis revealed three subscales: “coping with distressing emotions and symptoms', “social enhancement and intoxication” and “individual enhancement”. Predicted associations were partially supported. ‘Coping’ reasons for use were related to positive symptoms, general symptoms, global functioning, depression and suicide behaviour as well as substance use (quantity of use and problems related to use). ‘Individual enhancement’ reasons were related to positive symptoms, to global functioning and to negative consequences of substance use. ‘Social enhancement and intoxication’ reasons were related to negative consequences of use but not to psychopathology. The findings suggest that the ReSUS is a reliable and valid instrument which can be used to explore self reported reasons for substance use and their relationship to psychotic symptoms in people with schizophrenia and other psychotic disorders.     

剖宫产的社会因素分析及对策

目的探讨影响剖宫产率上升的社会因素并采取对策控制剖宫产率上升。方法采用问卷调查方法对本院2006年1月至2007年12月间的1100例社会因素所致剖官产进行原因分析。结果社会因素所致剖宫产占手术分娩率62．7％,而因错误观念和孕妇心理状态占社会因素的主要部分,医务人员对孕妇分娩方式选择也有着重要影响。结论剖宫产率的上升应该作为一个社会问题来整体看待;要从根本上改变社会因素对剖宫产的影响,必须从社会、家庭和个人观念三个方面进行变革。