结合药理作用与疾病结构制定药品采购计划的尝试

Practice on drug purchasing plan design combined with pharmacological action and disease structure

目的:根据药品的药理作用和医院疾病结构制定采购计划,以调整药品结构、促进合理用药。方法:选择急性缺血性脑卒中和急性颅脑创伤两种疾病,统计上月和上年同期出院人数,根据药品的药理作用、适应症、用法用量和疾病的病理特点,参考诊疗指南,制定当月药品的采购计划。结果:通过规范采购计划,超说明书用药现象减少,药品结构逐步得到调整,药品比例明显下降。结论:部分药品说明书和诊疗指南存在一定的局限性,临床用药应该掌握疾病的发病机制,了解药品的作用机理,才能做到合理用药。

Objectives：To design drug purchasing plan combined with pharmacological action and disease structure to adjust drug structure and promote rational drug use. Methods： Discharged patient with acute cerebral ischemic stroke and acute craniocerebral trauma in last month and the same moth in last year were selected. According to pharmacological actions, indications, dosage and administration and disease clinicopathological features and referrers to treatment guideline, the drug purchasing plan in this month was designed. Results：By regulating purchasing plan, drug off label use has been reduced. Drug structure has been adjusted step by step and drug proportion has been significantly decreased. Conclusions：Some of drug package insert and treatment guideline has limitations. It needs to know pathogenesis and drug action mechanism to improve rational drug use.