综合性医院门诊患者口服质子泵抑制剂的回顾性处方点评

Retrospective comments on Prescriptions of Oral Proton Pump Inhibitors for Outpatients in A General Hospital

目的了解口服质子泵抑制剂（PP1）的临床应用模式，并促进其合理用药。方法利用医院信息系统药房管理子系统，对2007年1月10日～1月21日期间某综合性三甲医院门诊患者含口服PPI的处方进行回顾性点评。合理性标准为药品说明书、国内外循证医学研究结果、PPI临床应用指导原则。结果该院的口服PPI应用总体较为合理，但临床诊断与适应证的吻合程度存在一定欠缺。部分处方的临床诊断不能反映就诊科室的专科特点。一些处方在用法用量和合并用药方面的合理性值得商榷。结论临床医生应对药品说明书有更多的了解，适应证以外用法时应告知患者。药师在加强处方审核力度的同时，也应注意灵活性，应注意学习治疗学的最新进展。

OBJECTIVE To know the pattern of clinical use of oral proton pump inhibitors （PPIs） and enhance their rational drug use. METHODS Retrospective comments on prescriptions containing oral PPIs in a 3-A-grade general hospital between Jan 10, 2007 and Jan 21,2007 were performed using a pharmacy administration software. The criteria for judging rationality included package insert of product, results of related evidence-based medicine studies, standard therapeutic guidance for PPIs use enacted by The National Institute for Clinical Excellence, UK. RESULTS In generally,the clinical use of oral PPIs are reasonable. However,there are certain discrepancies between diagnose and indications. Diagnoses in some prescriptions could not reflect the specialty of clinical departments. Rationality in dosage, administration and combined medication of PPIs in some prescriptions is worth discussing. CONCLUSION Doctors should know more about the package insert of the product and should let their patients know when PPI could be used beyond approved indications. Pharmacists should pay attention to the flexibility principle while strengthening prescription cheek and should learn the latest developments in clinical therapeutics.