干预前后南阳油田总医院住院患者质子泵抑制剂应用合理性分析

Analysis on Rationality of Application of Proton Pump Inhibitors Among Inpatients in General Hospital of Nanyang Oilfield Before and After Intervention

目的:了解临床药师干预前后南阳油田总医院(以下简称"我院")住院患者质子泵抑制剂(proton pump inhibitor,PPI)应用的合理性,探讨干预效果。方法:随机抽取2016年1—9月我院使用过PPI的完整出院病历,其中1—3月(干预前)301份、4—6月(第一阶段干预后)339份和7—9月(第二阶段干预后)306份,对PPI的适应证、用药剂量、溶剂选择、给药途径、疗程及联合用药等方面的合理性进行评价与分析。结果:我院住院患者PPI不合理使用率由干预前的33.22%(100/301)降至第一阶段干预后的17.11%(58/339),并进一步降至第二阶段干预后的9.48(29/306);干预后,PPI使用指征不明确、疗程偏长、重复用药、用法与用量不合理及联合用药不当等情况均较干预前明显改善。结论:经过临床药师的有效干预,我院住院患者PPI的使用趋于合理、规范,体现了临床药师参与PPI合理应用管理的积极作用。

OBJECTIVE： To investigate the rationality of application of PPI among inpatients in General Hospital of Nanyang Oilfield（ hereinafter referred to as ＂our hospital＂） before and after the intervention of clinical pharmacists,and probe into the intervention effects. METHODS： Complete medical records with application of PPI during Jan.-Sep. 2016 in our hospital were randomly extracted,of 301 records were during Jan.-Mar.（ before intervention）,339 records were during Apr.-Jun.（ after the first stage of intervention） and 306 records were during Jul.-Sep.（ after the second stage of intervention）,the medical records were evaluated and analyzed on the rationality in terms of indications,dosages,solvent selections,administration routes,courses of treatment and drug combinations of PPI. RESULTS： The irrational application rate of PPI among inpatients in our hospital had been decreased from 33. 22%（ 100/301） of before intervention to 17. 11%（ 58/339） of the first stage of intervention,and further decreased to 9. 48%（ 29/306） of the second stage of intervention; after intervention,the incidences of unclear indications,overlong courses of treatment,repetitive medications,irrational usages and dosages,inappropriate drug combinations of PPI had been significantly improved than those of before intervention. CONCLUSIONS： After the effective intervention of clinical pharmacists,the application of PPI among inpatients in our hospital is tending to be more rational and standard,which has reflect the positive effects of clinical pharmacists participate in the management of rational application of PPI.