天津市某医疗机构2016年糖尿病治疗药物的利用分析

Utilization of hypoglycemic drugs in a primary healthcare clinic of tianjin in 2016

目的:评估天津市某医疗机构2016年糖尿病治疗药物利用的合理性。方法:采用金额统计、排序、处方统计及基于WHO ATC/DDD的用药频度、用药指数和日用药金额等指标进行药物利用合理性分析。结果:该医疗机构2016年药品金额排在前3位的分别是瑞格列奈片、阿卡波糖片和两种预混胰岛素制剂,占全年总降糖药消费金额的94.48%,含四种药物的处方数占到全部糖尿病处方数的91.2%;DDDs前三位的分别是阿卡波糖片、瑞格列奈片和精蛋白生物合成人胰岛素30R笔芯;瑞格列奈片DDC最高,只有少数患者服用;瑞格列奈和格列美脲的DUI均大于1,提示用药剂量偏大;该医疗机构全年糖尿病治疗不合理处方9张,占全部糖尿病处方的1.1%。结论:该医疗机构2016年糖尿病治疗药物应用基本合理,但也存在一些不合理的用药,在优化降糖药物方面仍有潜力可挖。

Purpose To evaluate both the economical and pharmacological rationality for anti - diabetic drug utilization in a primary healthcare clinic of Tianjin in 2016. Mehtods Drug utilization research was conducted based on summing up and sorting expenditure, DDDs, DDC and DUI; prescriptions were analyzed for their therapeutic rationality. Results The expenditure for repaglinide, aearbose and two premix insulin injections accounted for 94.48% of the total annual hypoglycemic drugs consumption, ranking in the top three, respectively. The prescriptions in which these four drugs were used made up 91.2% of the total anti -diabetic prescriptions. DDDs of acarbose, repaglinide and isophane protamine biosynthesis human insulin injection 30R held the top three places, but DDC of repaglinide was the largest, which restricted it to only a few patients. DUIs of repaglinide and glimepride were greater than one, which meant their actually prescribed dose was greater than WHO DDD. In prescription analysis, nine pre- scriptions were found to be irrational, accounting for 1.1% of the total prescriptions for hypoglycemic drugs. Conclusions The utilization of hypoglycemic drugs in the primary healthcare clinic of Tianjin is basically rational, but still there is a way to go for optimizing its anti -diabetc drug species and regimen.