上海陆家嘴地区9家医疗联合体医院降糖药临床合理应用调查与分析

Investigation and Analysis of Clinical Rational Use of Antidiabetic Drugs in 9 Medical Union Hospitals from Shanghai Lujiazui District

目的:调查上海陆家嘴地区9家医疗联合体医院的降糖药处方,对药物利用情况及用药合理性进行分析。方法:采用回顾性调查方法,对9家医院2011年4月1-30日处方中降糖药用药频度(DDDs)、药物利用指数(DUI)、日均费用等进行药物利用度分析,同时调查处方的合理性。结果:降糖药处方共计15 843张,DDDs排前3位的是格列奇特、二甲双胍和预混胰岛素;处方出现频率最高的是阿卡波糖、二甲双胍、格列齐特;处方中单药使用率为77.95%,联合用药率为22.05%;DUI>1的有2种。降糖药在药物选择、用法用量、联合用药上存在不合理现象。结论:被调查医院降糖药应用基本合理,个别处方存在不合理,应引起临床医师的关注;同时药师在审核处方时应加强与医师的沟通,做好用药干预,提高合理用药水平。

OBJECTIVE： To investigate the prescription of antidiabetic drugs in 9 medical union hospitals from Shanghai Lujiazui District, and to evaluate utilization and rationality of drug use. METHODS： Using the cross-section research technique, the application of antidiabetic drugs in 9 hospitals in Apr. 2011 was analyzed in respects of DDDs, DUI, DDC, etc., the rationality of prescription was checked simultaneously. RESULTS： Among a total of 15 843 antidiabetic drugs prescriptions, top 3 drugs in the list of DDDs were glimepiride, metformin and premixed insulin; top 3 drugs in the list of fi＇equency were acarbose, metformin and glimepiride. Single drug accounted for 77.95% in prescription, and drug combination accounted for 22.05%. DUI of 2 drugs was〉 1. It was irrational in fields of drug selection, usage and dosage, drug combination. CONCLUSIONS ： The application of antidiabetic drugs is rational gener- ally, and some prescriptions are somehow unreasonable, which should arouse clinicians＇ concern; simultaneously, pharmacists should strengthen the communications with doctors, complete the medication intervention and improve the reasonable medication when they check prescriptions.