我院门急诊处方超说明书用药的分析与干预对策探讨

Analyzing drug use inaccordant with the drug manual in out-patient and emergent service to promote its proper management

目的调查分析我院门急诊处方超说明书用药情况,通过干预,促进合理用药。方法随机地抽取我院2013年6—12月门急诊处方,参照药品说明书的内容分别进行统计分析,并采取合理的整改措施。结果抽取1200张处方,共发现超说明书用药处方113张,类型主要包括超适应症(18.58%)、超用法用量(30.09%)、改变给药途径(26.55%)及超年龄(24.78%),其中未出现超禁忌症用药。超说明书用药示例主要包括去氧孕烯炔雌醇片用于子宫功能性出血、注射用青霉素钠静脉滴注1次/d、盐酸氨溴索注射液雾化吸入及2岁儿童发热咳嗽使用热毒宁等。结论超药品说明书用药虽有些符合循证医学、循证药学,但大部分还是存在一定的安全风险,医院应重视并加以控制,建立相应的用药规章制度与流程,保障患者的用药安全。

Objective Investigating the prescriptions inaccordant with the drug manual to promote its proper management and rational use of drug. Methods Randomly check the prescriptions between June, 2013 and December, 2013 in the department of outpatient and emergency, according to the drug manual. Then summarize and perform statistical analysis to promote some methods. Results 113 among 1200 pieces of prescriptions, were found to be inaccordant with the drug manuals. They were prescribed not according to the indication （18.58%）, the frequency or dosage （30.09%）, the administration method （26.55%）, or the age （24.78%） , in the manual. There were no prescription violating the contraindication. Conclusions Drug use not according to the manual may be safe when considering evidence-based medicine, but in most situation, it is dangerous. The hospital administrators should pay more attention to it and construct proper regulations or procedure, to ensure drug safety of patients.