临沧市人民医院抗肿瘤药物临床应用评价

Evaluation of the Clinical Application of Antineoplastic Drugs in Lincang People's Hospital

目的评价抗肿瘤药物的临床应用合理性,以提高该类药物临床应用的合理、有效和安全性.方法从临沧市人民医院HISS管理系统中抽取2015年1月至2016年12月每季度使用抗肿瘤药物病历,用等距离随机抽样法从每季度使用抗肿瘤药物的病历中抽取30份,应用该院临床药师设计的《抗肿瘤药物医嘱点评表》对30份病历进行实时专项点评,点评结果及时反馈给临床科室整改.对8个季度的点评结果再次进行汇总、统计、分析并反馈给临床科室整改落实.点评依据参照《抗肿瘤药物处方点评指南》、药品说明书、专家共识、《抗肿瘤药物临床应用指导原则(征求意见稿)》、《临沧市人民医院抗肿瘤药物临床应用管理规范》等制订.点评内容主要为:用药适应证、用法用量、溶媒选择适宜性、用药顺序、化疗方案是否明确、是否执行既定化疗方案、执行抗肿瘤药物分级管理、发生不良反应后病程中是否有记录等.结果抽取的240份病历中有120份抗肿瘤药使用不合理,占总抽取病历的50%.各季度抗肿瘤药不合理使用率依次为:65%、60%、50%、60%、50%、44%、40%、35%.结论临床药师应积极开展并加大抗肿瘤药物临床应用专项点评力度和强度,为医师提供合理用药参考,确保抗肿瘤药物应用的合理、有效和安全性.

Objective To evaluate whether antineoplastic drugs are rationally used,in order to improve the ffectiveness and safety of the clinical use of antineoplastic drugs.Methods A total of240medical records of hospital patiens were collected by equal number of random sampling every quarter from January2015to December2016.The records were reviewed and evaluated on the usage of antineoplastic drugs against national guidelines,including drug indications,drug choice,usage and dose,solvent selection suitability,order of medication,whether chemotherapy was clear or not,whether chemotherapy was performed as scheduled,whether antineoplastic drugs were managed by classification,and whether adverse reactions were recorded along with the patient's progress.Results120out of240records had unreasonable drug use,accounting for50%of the total records.Ratio of unreasonable antineoplastic drugs utilization in each quarter was65%,60%,50%,60%,50%,44%,50%and35%,respectively.Conclusion Clinical pharmacists should actively strengthen the review and evaluation of antineoplastic drugs'clinical use and provide evidence for rational use of drugs to physicians,so as to reasonable,effective and safe drug use.