医改后医联体心血管系统用药情况调查与合理性分析

Clinical Utilization Investigation and Rationality Analysis of the Cardiovascular System Medication in the Medical Treatment Combination after Medical Reform

目的:了解医改后北京市朝阳区南部医联体心血管系统用药的临床应用情况,分析和评价其用药合理性。方法:回顾性调查该医联体2017年5月～2018年4月的心血管系统用药处方16 582张,采用限定日剂量法对心血管系统用药的用药频度(DDDs)和药物利用指数(DUI)等进行分析,并根据制定的该类药物合理性评价标准进行用药合理性评价,对处方问题进行分类整理。结果:该医联体心血管系统用药DDDs排序前25位药品的DUI范围为0. 91～1. 08;处方合理性评价发现不规范处方1 146张(6. 13%),用药不适宜处方1 983张(10. 60%),其中用法用量不适宜、遴选的药品不适宜、存在不良药物相互作用为主要问题。结论:医改后该医联体心血管系统用药存在部分不合理问题。开展药物使用评价及处方点评工作有助于发现典型问题,为社区医疗机构合理用药干预及持续改进提供参考。

Objective：To explore the clinical application of the cardiovascular system medication after medical reform in the Southern Medical Treatment Combination of Chaoyang District in Beijing,and to evaluate the rationality of the medication use. Methods：A retrospective survey of 16 582 prescriptions for the cardiovascular system drug use between May 2017 and April 2018 was conducted on the use of the cardiovascular system and was based on the criteria for assessing the rationality of the medications,and medication rationality assessment,classification of prescription problems. Results：The drug use index（ DUI） ranged from 0. 91 to 1. 08 for DDDs of the medical treatment combination. 1 146（6. 13%） undisciplined prescriptions and 1 983（10. 60%） prescriptions of inappropriate medication use were found for the rationality evaluation,in which,irrational dosage,improper drug selection and adverse drug interactions were the major problems.Conclusion：There were some unreasonable problems in the use of the cardiovascular system medication in the medical treatment association after medical reform. Conducting drug use assessment and prescription review work can help identify typical problems and provide reference for rational drug intervention and continuous improvement in community hospitals.