【摘要】 目的 调查基层医院信息辅助前置审方工作的开展情况，并提出解决策略，为深入推进相关工作提供参考。方法 对上海市16个区的120家基层医院的临床药师进行在线问卷调查，调查内容包括基层医院信息辅助前置审方的开展现状及基层药师在前置审方工作中面临的挑战等，并对问卷结果进行统计和分析。结果 共收回80家基层医院的有效问卷，有效回收率为66.7%。80家基层医院中有23家医院（占28.7%）开展了信息辅助前置审方工作，分布在7个区（静安区、闵行区、徐汇区、长宁区、松江区、杨浦区和黄浦区），均由各区卫生健康委员会牵头组织。23家基层医院的前置审方系统审核的处方以门诊处方为主，月审核条目数为[16 000(9 000,22 000)]条。开展信息辅助前置审方工作的23家基层医院的23名药师中，有20名药师（占86.9%）认为前置审方系统的应用可以降低错误处方发生率，19名药师（占82.6%）认为前置审方系统的规则库覆盖不完全，18名药师（占78.3%）认为自己的药学专业知识无法覆盖审方工作。23名药师对前置审方系统的满意度评分为[7(5,8)]分。未开展信息辅助前置审方的57家基层医院的57名药师中，46名药师（占80.7%）认为所在医院审方人员数量不足，37名药师（占64.9%）认为自己的药学专业知识无法覆盖审方工作，14名药师（占24.6%）提出了对前置审方系统的需求，43名药师（占75.4%）表示不知晓前置审方系统。结论 由各区卫生健康委员会牵头建设的区域前置审方中心正成为基层医院开展信息辅助前置审方工作的主要方式，但仍有部分基层医院尚未开展信息辅助前置审方工作。目前基层医院使用的前置审方系统存在规则库不完善、因药师专业知识不足导致审方效率低等问题。建议可从完善审方规则库建设，建立区域审方专家组，以及提升基层药师审方能力等方面着手，进一步推进基层医院的信息辅助前置审方工作。更多还原

【Abstract】 AIM To understand the implementation of information-assisted preliminary prescription review（PPR） in primary hospitals and propose solutions to common problems, providing a reference for further promoting the work. METHODS An online survey was conducted among clinical pharmacists from 120 primary hospitals in various districts of Shanghai. The survey investigated the implementation of PPR systems in primary hospitals and the challenges faced by primary pharmacists in implementing the system. The results were then summarized and analyzed. RESULTS Pharmacist representatives from 80 primary hospitals in 16 districts of Shanghai participated in the survey, achieving an effective recovery rate of 66.7 %. Among them, 23 hospitals（28.7%） had implemented PPR systems, covering 7 districts（Jing’an District, Minhang District, Xuhui District, Changning District, Songjiang District, Yangpu District and Huangpu District）, all of which were organized by the respective district health commissions, primarily reviewing outpatient prescriptions, and the average monthly review volume was 16 000（Q₁=9 000, Q₃=22 000）. Out of the 23 pharmacists surveyed in these 23 hospitals, 20（86.9%） believed that PPR systems could reduce the incidence of erroneous prescriptions, and 19（82.6%） thought that the rule library of the PPR systems was incomplete. Additionally, 18 surveyed pharmacists（78.3%） felt that their pharmaceutical knowledge was insufficient to cover the requirements of PPR tasks. The satisfaction score of the 23 pharmacists for the PPR systems was 7（Q₁ = 5, Q₃ = 8）. Among the 57 primary hospitals without PPR systems, 46 surveyed pharmacists（80.7%） reported insufficient staffing for PPR tasks, and 37 pharmacists（64.9%） felt their pharmaceutical expertise was insufficient to cover prescription review duties. Furthermore, 14 pharmacists（24.6%） expressed a need for PPR systems, while 43 pharmacists（75.4%） were unaware of PPR systems. CONCLUSION Regional PPR centers organized by district health commissions are becoming the primary method for implementing PPR in primary hospitals, but some primary hospitals have not yet implemented this work. However, common issues such as incomplete rules libraries and low prescription review efficiency are due to pharmacists’ insufficient professional knowledge coverage. It is recommended to enhance the construction of rule libraries, establish regional PPR expert groups, and improve the PPR capabilities of pharmacists in primary hospitals to further promote the successful implementation of PPR in primary hospitals.更多还原