Objective  To explore the practical path of constructing a prescription review center for county-level medical communities in Shandong Province based on the “Five Unifications” model of central pharmacy, evaluate its improvement effect on the level of rational medication practices at the grassroots, and provide practical references for the reform of pharmaceutical services.

Methods  Taking 35 pilot units in 16 cities as the research objects, a before-and-after self-control design was adopted to analyze the operational data of the pilot units from May 2024 to March 2025. By analyzing the operational date,  the effectiveness of this model was evaluated in improving prescription rationality rate, increasing the number of intercepted irrational prescriptions, and avoiding adverse drug events.

Results  The average prescription rationality rate of the pilot units had significantly increased from 73% to 91%, with a total of 3.46 million irrational prescriptions intercepted and approximately 600,000 potential adverse drug events effectively averted. Typical cases further confirmed that this model has successfully achieved full coverage of medical institutions at the county, township, and village levels.

Conclusion  The county-level medical community prescription review center constructed based on the central pharmacy model can significantly improve the prescription rationality rate and ensure the medication safety at the grassroots level. “Five Unifications” management framework and “intelligent system+pharmacist review” prescription review mechanism may provide a replicable ‘Shandong Path’ for similar regions.

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