我院2013-2014年静脉药物超说明书用药分析

Analysis of Off-label Use of Intravenous Drugs from 2013 to 2014 in Our Hospital

目的:为减少因超说明书用药引起的不良事件,促进静脉药物临床合理应用提供参考。方法:对上海交通大学医学院附属仁济医院2013年7月-2014年6月42个病区静脉用药医嘱进行审核,对超说明书用药情况进行分析,主要统计超剂量用药和超浓度用药(包括浓度过高和过低)。结果:不合理用药医嘱共计622条,其中超说明书用药60条,占不合理医嘱的9.6%。超说明书用药中,最多的是用药浓度过高,共40例(占超说明书用药的66.7%);其次是超剂量用药,17例(占超说明书用药的28.3%);用药浓度过低3例(占超说明书用药的5.0%)。结论:静脉用药调配中心药师通过与医师的沟通,可对以上发现的不合理医嘱(包括超说明书用药)拒绝调配或要求医师根据说明书修改后再行调配,以减少超说明书用药情况的发生,从而促进临床合理用药。

OBJECTIVE：To provide a reference for reducing adverse events due to off-label use of drugs and promoting rational use of intravenous drugs in Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine. METHODS：The prescriptions of intravenous drugs in 42 wards of our hospital from Jul. 2013 to Jun. 2014 were reviewed,and then off-label use of drugs were analyzed,where statistics was made mainly to drug overdose,the use of drugs at the concentration beyond the standards（including concentrations too high and too low）and associated conditions. RESULTS：There were 622 irrational prescriptions,including 60 concerning off-label use of drugs,accounting for 9.6% of irrational prescriptions,in which 40 were involved with the concentration which was too high,accounting for the highest percentage（66.7% of prescriptions related to off-label use of drugs）,17 were related to drug overdose（28.3% thereof）,and 3 were in relation to the concentration which was too low（5.0% thereof）.CONCLUSIONS：Pharmacy intravenous admixture service may,through the communication between the pharmacist and the doctor,refuse to make up the above-mentioned prescription which was found to be irrational（including that involving in off-label use of drugs）or make up such prescription after it is modified according to the requirements as specified in the label to reduce the occurrence of off-label use of drugs so as to promote rational drug use.