某院2014-2016年阿片类镇痛药使用分析

Analysis of the Utilization of Opioid Analgesic Drugs in a Hospital during 2014-2016

目的:了解阿片类镇痛药在某院的使用情况,为促进临床合理用药提供参考。方法:对该院2014-2016年阿片类镇痛药的销售金额、用药频度(DDDs)、日均费用(DDC)和排序比(B/A)等进行回顾性分析与比较。结果:该院阿片类镇痛药的年销售金额在2015年略有增长,在2016年则出现了明显的下降;芬太尼透皮贴剂(8.4 mg)、氨酚羟考酮片和注射用盐酸瑞芬太尼的DDDs一直稳居前3位,枸橼酸芬太尼注射液(0.1 mg)和硫酸吗啡缓释片的DDDs呈逐年上升趋势,芬太尼透皮贴剂(4.2 mg)和芬太尼透皮贴剂(8.4 mg)的DDDs呈逐年下降趋势;2016年底因取消了药品加成,所有药品的DDC值均出现了下降;多数药物的B/A值均接近1.0,只有盐酸羟考酮缓释片(40 mg)的B/A值连续3年明显小于1.0,芬太尼透皮贴剂(8.4 mg)和氨酚羟考酮片的B/A值连续3年明显大于1.0。结论:该院2014-2016年阿片类镇痛药的品种规格较齐全,使用情况基本合理;可进一步细化监管工作,促进该类药物的规范使用。

OBJECTIVE：To investigate the utilization of opioid analgesic drugs in a hospital,so as to provide reference for rational drug use in clinic. METHODS：The utilization of opioid analgesic drugs in the hospital during 2014-2016 was analyzed and compared retrospectively in terms of consumption sum,DDDs,DDC,B/A,etc. RESULTS：Annual consumption sum of opioid analgesic drugs in the hospital increased slightly in 2015,but decreased significantly in 2016. Fentany transdermal patches（8.4 mg）,Oxycodone and acetaminophen tablets and Remifentanil hydrochloride for injection always took up the first 3 places in the list of DDDs. DDDs of Fentanyl citrate injection（0.1 mg） and Morphine sulfate sustained-release tablets increased year by year;while DDDs of Fentany transdermal patches（4.2 mg）and Fentany transdermal patches（8.4 mg）decreased year by year. DDC of all opioid analgesic drugs decreased in 2016,with the cancel of drug price addition at the end of 2016. B/A values of most drugs were close to 1.0;while B/A value of Oxycodone hydrochloride sustained-release tablets（40 mg）was much less than 1.0,and that of Fentany transdermal patches（8.4 mg）and Oxycodone and acetaminophen tablets were significantly more than 1.0 for consecutive 3years. CONCLUSIONS： The variety and specifications of opioid analgesic drugs in the hospital is comprehensive during2014-2016. The clinical utilization of opioid analgesic drugs is generally rational,but still needs to be supervised effectively and particularly,so as to improve standard use of opioid andalgesic drugs.