我国门诊癌症患者阿片类镇痛药使用的现状研究

Study on Current Status of Opioid Analgesic in Ambulatory Patients with Cancer Pain in China

目的:分析我国门诊癌症患者阿片类镇痛药的使用情况。方法:从医院处方分析合作项目数据库中随机提取我国5个城市89家医院门诊癌痛患者2016年中40 d的使用阿片类镇痛药处方数据,对其用药频度(DDDs)及限定日费用(DDC)、总费用等指标进行分析。结果:共纳入13 803例患者的阿片类镇痛药处方,其中男8 522例,患者年龄分布在3～96岁。按照阿片类镇痛药使用人次由多到少的顺序排列依次为羟考酮及其复方制剂、曲马多及其复方制剂、可待因及其复方制剂、吗啡和芬太尼。羟考酮及其复方制剂的处方总金额和DDDs均最高。口服是最主要的给药途径,人次占比和金额占比分别为86. 6%和83. 3%。结论:阿片类镇痛药使用的基本面比较合理,但是在部分药品使用方面与国外情况有所区别,其合理性需要通过处方点评等方法进行进一步研究。

Objective: To evaluate the status of opioid analgesic application in ambulatory patients with cancer pain. Methods: Prescription data of 40 randomized days in 2016 were extracted from the database of Hospital Prescription Analysis Program of China. The prescriptions prescribed opioid analgesic to ambulatory cancer patients were included in the study. Then the information was gathered and further calculated for DDDs,defined daily cost( DDC),total cost and analyzed. Results: A total of 13 803 prescriptions from 89 hospitals in 5 major cities( Beijing,Shanghai,Hangzhou,Chengdu,Guangzhou) were included in the study. 8 522 of the prescriptions were given to male patients. The age of patients ranged from 3 to 96 years. The most frequently prescribed opioid analgesic was oxycodone and its compound preparation,followed by tramadol and its compound preparation,codeine and its compound preparation,morphine and fentanyl. Oxycodone and its compound preparation also had the highest cost,DDDs and DDC. The use of morphine was relatively low.The main administration route was orally,which took 86. 6% and 83. 3% in total prescriptions and cost,respectively.Conclusion: Most of the opioid analgesic was used reasonably,but some drug utilization was different from abroad. Further action such as prescription review was needed to improve the use of opioid analgesic.