喹诺酮类药物在抗结核病治疗中合理使用MTP干预的研究

Fair Use of Quinolones by MTP Intervention in Anti-tuberculosis Therapy

目的通过施行监测-培训-计划(MTP)合理用药干预模式对喹诺酮类药物在抗结核治疗中合理使用的干预,进行干预效果的统计学评估。方法按照WHO和合理用药国际指标(SDUSI),结合中国结核病防治规划实施工作指南(2008年版)设定研究指标,选取2008年3～8月份抗结核病处方作为调研基线,以自然月为单位,采用循环监测-培训-计划进行干预;每次干预后统计分析研究指标,然后不断循环进行干预、调研。结果经过6次MTP循环后,喹诺酮类药物在抗结核病新涂阴、新涂阳、复治涂阴、复治涂阳使用百分率、每次就诊平均药费由干预前的41.30%、76.10%、89.20%、95.60%、297.7元分别下降到干预后的12.00%、36.50%、51.10%、68.90%、212.3元(均P<0.05)。结论 MTP合理用药干预模式能有效提高喹诺酮类药物在抗结核病治疗中的合理使用水平。

Objective To make a statistical assessment of intervention effects by means of fair use of quinolones through monitoring - training - planning （MTP） intervention in antituberculosis therapy. Methods According to the Implementation of Tuberculosis Control Program Guide in China （2008 edition） and（SDUSI）, we set research target, and selected the anti- tuberculosis prescriptions from March to August 2008 as the research baseline. We intervened the use of quinolones by a cyclic MTP rational drug mode and set one month as a unit, and make the statistic analysis of the research indicators after every intervention, and repeated the cycle. Results After 6 cycles of MTP, the use rates of quinolones in the new smear negative, new smear positive, re-treatment smear negative, and re-treatment smear positive cases were 41.30%, 76.10%, 89.20% and 95.60% before intervention, with the average drug cost as 297.7 yuan and reduced to 12.00%, 36.50%, 51.10% and 68.90% after intervention （212.3 yuan ）, respectively （P〈0.05）. Conclusion MTP rational drug intervention mode can improve the fair use of quinolones in antituberculosis therapy.