我院老年住院患者使用注射用益气复脉(冻干)超说明书情况分析

An analysis of off label medication in the elderly inpatients in our hospital with the use of Yiqifumai for Injection

目的:回顾性调查某院老年住院患者使用注射用益气复脉(冻干)的超说明书现状,分析其临床使用合理性。为促进临床合理用药提供基础依据。方法:调取该院2015年1月-2017年6月期间使用注射用益气复脉(冻干)的老年住院患者住院医嘱。采取随机抽样方法,筛选部分患者医嘱,依据药品使用说明书,对其适应证、用法用量、用药疗程、适用溶媒的合理性,进行有效分析。结果:调取使用注射用益气复脉的老年住院患者1 433人,住院医嘱总数1 516例,超说明书用药医嘱1 505例,超说明书用药发生率为99.27%。其中超说明书医嘱中超适应证(10.17%),超用法用量(10.83%),超疗程(99.40%),配伍禁忌(4.85%),超溶媒量(0.80%)。其中4个科室超说明书用药发生率为100%,主要原因是超疗程和超用法用量。在此期间发生过5次不良反应事件,有3例属超说明书用药医嘱。结论:注射用益气复脉(冻干)在我院老年住院患者中使用率相对较高,被广泛应用于我院多个科室。一方面希望超说明书合理用药情况能够被证实,相关负责人能够根据现状参考相关数据,使得说明书更加精细化。另一方面,面对药品的超说明书不合理使用情况,能够引起有关部门的高度重视,并且医院应该对其制定相应措施,使得老年患者的用药问题得以合理化管理,规范用药。

OBJECTIVE To conduct a retrospective study to investigate the current status of off label medication in the elderly inpatients in our hospital, and to analyze the rationality of its clinical use, promote the clinical rational use of drugs. METHODS The retrospective investigation method was used. The elderly hospitalized patients received Yiqifumai for Injection from January 2015 to June 2017 were collected. The random sampling method was adopted to screen some doctor orders, according to the instructions of drugs, to make effective analysis of the indications, dosage, course of medication, and the rationality of the solvent. RESULTS A total of 1 433 elderly inpatients received Yiqifumai for Injection were enrolled, with a total of 1,516 orders, 1 505 off label medication orders, and the incidence rate of off label medication was 99.27%, including over indication (10.17%), over dose (10.83%), over course (99.40%), contraindication (4.85%), and over solvent volume (0.80%). The incidence rate was 100% for off label medication in four departments, mainly over treatment and over dose. During this period, 5 adverse events occurred, including 3 cases of off label medication. CONCLUSION The use of Yiqifumai for Injection is relatively more in elderly patients in our hospital, and it is widely used in many departments of our hospital. On one hand, it is hoped that the reasonable medication situation of the off label medication can be confirmed, and the relevant responsible person can refer to relevant data according to the current situation, so as to make the specification more detailed. On the other hand, relevant authorities should pay adequate attentions to off label medication, and the hospital should develop corresponding measures to for rational drug use to standardize the medication.