基本药物制度实施对门诊糖尿病患者口服降糖药物利用影响

Effect of the system for basic pharmaceutical on oral antidiabetic drugs utilization for outpatient

目的:研究基本药物制度实施后对医院门诊口服降糖药物利用的影响变化,为卫生政策的制订和临床合理用药提供参考。方法:采用回顾性方法,对某院2011年第一季度和2012年第一季度门诊口服降糖药的主要使用品种、销售金额、用药频度(DDDs)、限定日费用(DDC)、药物利用指数等进行统计、分析。结果:基本药物制度实施后口服降糖药总体销售金额增加28.33%,除1个落标而停止销售外,7个药品种有6个的用药频度明显增加,最高为格列美脲,增幅达137.50%。同步性较好的品种比例在下降,不同药品的DDC有升有降,没有一个相对明确的变化趋势。DUI值≤1.0的药物比例由2011年第一季度的62.50%降到了14.29%。结论:基本药物制度实施后属于基本药物的一线口服降糖药临床治疗作用加强,但有过度使用的趋势,卫生行政部门和医疗机构应持续加强临床合理使用基本药物的培训和检查。

OBJECTIVE To investigate the utilization of oral anti-diabetic drugs for outpatient after implementation of the es- sential drug system, and provide reference for rational drug use and health policy-making. METHODS The varieties, consump- tion sum, DDDs, DIN2 and drug utilization index（DUD of oral anti-diabetic drugs for outpatient in the first quarter of 2011 and the first quarter of 2012 were analyzed. RESULTS The consumption sum of oral antidiabetic drugs increased by 28.33% after implementation of the essential drug system, of which glimepiride , increased by 137. 50%, is the highest. There is no clear variation tendency for DDC. The proportion of drugs （DUI≤1. 0） decreased from 62. 5% in the first quarter of 2011 to 14. 29% after implementation of the essential drug system. CONCLUSION There is a tendency of overusing oral anti-diabetic drugs after implementation of the essential drug system. The health administrative department and medical institutions should strengthen the training and inspection to promote the rational use of essential drugs.