静脉配置中心药师对医院病区超说明书用药情况的调查与干预

Investigation and intervention for PIVAS prescriptions with off-label use

目的回顾性调查我院住院患者的超说明书用药现状,分析相关危险因素,为静脉配置中心审方药师、住院药房配置药师和发药药师提供药品超说明书使用依据。方法随机抽取我院2012年10月至2013年3月、2013年4-10月静脉配置中心电子处方,依据药品说明书,分析各超说明书的用药情况、用药类型,对超说明书用药患者的年龄、性别和基本药物、非处方药物进行分类统计。结果共抽取130 000张处方,涉及有关药品192种。静脉配置中心总超说明书的用药发生率为0.4%,2012年10月至2013年3月为0.57%,2013年4-10月为0.2%。超说明书用药的类型主要包括给药次数、适应证和剂量。医嘱超说明书用药前3位为:抗感染药、中成药、心血管系统药。结论随着静脉配置中心审方药师逐渐熟练,医院信息化设施的完善,医院住院患者超说明书用药有所减少,医生和临床药师及时沟通,保证了最新指南和临床实际用药相结合,保障患者安全用药。

Objective To investigate the off-label prescriptions in Pharmacy Intravenous Admixture Service （PIVAS） of our hospital and analyze the relevant risk factors,to provide off-label use rules for pharmacists.Methods PIVAS electronic prescriptions in our hospital from October 2012 to March 2013 and from April 2013 to October 2013 were randomly selected.According to the package insert,prescriptions with off-label use were picked out.Then the clas sification for incompliant prescriptions,age and gender of patients,kinds of essential drugs and nonprescription drugs were statistically analyzed.Results Totally 130 000 prescriptions covering 192 kinds of medicines were selected.The rate for prescriptions with off-label use was 0.4％ in total,and the rate was 0.57％ from October 2012 to March 2013 and 0.2％ from April 2013 to October 2013.The types of incompliant use mainly included the incompliant medication frequency,dosage and off-label use.The three top kinds of drug were antibiotics,Chinese traditional medicine and cardiovascular system drugs.Conclusion With the construction of PIVAS,improvement of hospital information setting,the increasing level of skill in pharmacists,the off-label use of our hospital is reduced.The timely communication between physicians and clinical pharmacists ensures the combination of latest guidelines and clinical practice,ensures the safety in drug use.