Objective  To analyze the early warning of eighteen incompatible medicaments and nineteen medicaments of mutual restraint of outpatient Chinese medicine and Chinese patent medicine through the prescription review system.

Methods  Through the statistical analysis function of the rational drug use pre-prescription system, the early warning of eighteen incompatible medicaments and nineteen medicaments of mutual restraint in outpatient and emergency prescriptions by the prescription review software of Hubei Provincial Hospital of Traditional Chinese Medicine from June 2023 to July 2024 was reviewed, and the distribution of drugs involved in eighteen incompatible medicaments and nineteen medicaments of mutual restraint of Chinese medicine and Chinese patent medicine, the frequency of forbidden use, the distribution of departments and diseases, and the acceptance of system early warning by doctors  were analyzed.

Results  A total of 8 481 early warning tasks related to eighteen incompatible medicaments and nineteen medicaments of mutual restraint of Chinese medicine and Chinese patent medicine were included in the analysis. The eighteen incompatible medicaments involved 9 kinds of Chinese medicine and 14 kinds of Chinese patent medicine. In the eighteen incompatible medicaments, the use of anti-drug compatibility in the Aconitum group was more common, among which the Heishun tablets (Attached tablets) appeared the most, followed by Radix aconiti preparata, with the highest frequency of compatibility with Pinellia ternata, followed by Fritillaria, and ranked third with Trichosanthis fructus. Among the nineteen medicaments of mutual restraint, there were 10 kinds of Chinese medicine, 14 kinds of Chinese patent medicine, and the Ginseng-vinegar Wuling grease was the most compatible, followed by Cloves-Tulip, and cinnamon-red stone grease ranked third. The distribution of departments and diseases showed that the doctors who used the drugs prohibitively were mainly concentrated in the outpatient clinics with many famous and old experts, and the diseases mainly involved complicated diseases. When the system prompted unreasonable information of eighteen incompatible medicaments and nineteen medicaments of mutual restraint, the modification rate of the doctor was 29.58%, and the implementation of double signature was 70.42%.

Conclusion  The prescription review software has a certain effect on the early warning of the eighteen incompatible medicaments and nineteen medicaments of mutual restraint of Chinese medicine, but the use of the ban by clinicians still account for a large proportion. In response to the situation of persistent violations of the eighteen incompatible medicaments and nineteen medicaments of mutual restraint, the system implements tiered management based on whether the reverse drug compatibility contains toxic Chinese medicine, reminding doctors to assess risks and control dosages when using reverse drug combinations containing toxic ingredients in order to ensure patient medication safety.

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