临床药师对原发性高血压住院患者的用药调查与分析

Investigation and Analysis of Drug Use in Primary Hypertensive Inpatients by Clinical Pharmacists

目的:为临床合理使用抗高血压药提供参考。方法:选择2014年1月-2015年10月我院原发性高血压住院患者118例,采用查阅医嘱及问卷调查的方法对其抗高血压药的使用情况和用药依从性进行汇总、分析。结果:我院临床常用的抗高血压药包括利尿药、β受体阻滞药、钙离子拮抗药、血管紧张素转化酶抑制剂、血管紧张素Ⅱ受体拮抗药和醛固酮受体拮抗药。118例患者中,采用单药治疗的患者较少(10例,8.47%),采用三药联用的患者最多(51例,43.22%);内科相关科室使用抗高血压药的患者(94例)多于外科相关科室(24例);不合理使用抗高血压药的患者共25例,且主要集中于内科、心病科和脑病科等科室,以给药频次不合理(8例,32.00%)、破坏了药物框架结构(5例,20.00%)、药物选择不合理(4例,16.00%)等为主。有16例患者用药依从性差,主要原因包括治疗方案复杂(6例,37.50%)和忘记服药(5例,31.25%)等。结论:我院原发性高血压住院患者存在不合理使用抗高血压药的情况。临床药师应利用自身优势,加强与医护人员的业务交流,深入开展药学服务,大力推进临床合理用药。

OBJECTIVE：To provide reference for rational use of antihypertensive drugs in the clinic.METHODS：One hundred and eighteen primary hypertensive inpatients were selected from our hospital during Jan.2014-Oct.2015.The application of antihypertensive drugs and medication compliance were summarized and analyzed by reviewing the doctor＇s advice and the questionnaire survey method.RESULTS：Commonly used antihypertensive drugs of our hospital included diuretic,β receptor blocker,calcium antagonist,angiotensin converting enzyme inhibitor,angiotensin Ⅱ receptor antagonist and aldosterone receptor antagonist.Among 118 patients,fewer patients treated with monotherapy（10 cases,8.47%）,and three-drug regimen took up the greatest proportion（51 cases,43.22%）.The number of patients receiving antihypertensive drugs in related internal medicine departments（94cases） was more than in related surgical departments（24 cases）.25 patients used antihypertensive drugs irrationally,mainly from internal medicine department,heart disease department,cerebropathy department,etc.Irrational medication mainly included irrational frequencies（8 cases,32.00%）,pharmaceutical frame structure damage（5 cases,20.00%）,irrational drug selection（4 cases,16.00%）,etc.The poor medication compliance was found in 16 patients,mainly resulted from complex therapy plan（6 cases,37.50%）,forgetting to take medicine（5 cases,31.25%）.CONCLUSIONS：Irrational use of antihypertensive drugs exist in primary hypertensive inpatients of our hospital.Clinical pharmacists should use their own advantage to strengthen communication with medical staff,develop in pharmaceutical care and promote rational drug use in the clinic.