用药干预对促进临床合理用药的效果分析

Analysis on Effect of Medication Intervention on Promoting Rational Drug Application

目的:探讨用药干预对临床合理用药的促进作用,为进一步干预药品的不合理应用提供参考。方法:采用多种用药干预措施促进临床合理用药,并采用回顾性统计方法,对2015—2017年北京大学口腔医院(以下简称"我院")药品使用情况进行统计与分析。结果:2015—2017年,我院药品总销售金额分别为3 130.81万、3 005.88万和2 804.34万元,药占比分别为3.26%、2.84%和2.29%;辅助用药销售金额分别为185.00万、116.25万和84.11万元,辅助用药销售金额占药品总销售金额的比例分别为5.91%、3.87%和3.00%,呈逐年降低趋势;国家基本药物销售金额分别为419.88万、433.54万和461.28万元,国家基本药物销售金额占药品总销售金额的比例分别为13.41%、14.42%和16.45%,呈逐年升高趋势;抗菌药物的使用以非限制使用级抗菌药物为主,其DDDs构成比分别为94.34%(182 428/193 369)、93.89%(191 028/203 461)和96.21%(225 440/234 317),限制使用级抗菌药物的DDDs构成比分别为5.60%(10 838/193 369)、6.07%(12 358/203 461)和3.77%(8 843/234 317),其中2017年大幅度降低。结论:用药干预起到了降低患者药费负担、减少辅助用药的使用、促进国家基本药物的使用和提高抗菌药物品种使用合理性等作用,有效促进了临床合理用药。

OBJECTIVE:To investigate the effect of medication intervention on promoting rational drug application, so as to provide reference for further intervention in irrational drug application. METHODS: Multiple medication interventions were adopted to promote rational drug application, and retrospective statistical method was used to collect and analyze the drug application in Peking University Hospital of Stomatology(hereinafter referred to as “our hospital”) during 2015-2017. RESULTS: During 2015-2017, the total consumption sums of our hospital were respectively 31.308 1 million, 30.058 8 million and 28.043 4 million yuan, with the proportions accounted for total hospital income were 3.26%, 2.84% and 2.29%; the consumption sum of adjuvant drugs were respectively 1.850 0 million, 1.162 5 million and 0.841 1 million yuan, with the proportion accounted for total consumption sums were 5.91%, 3.87% and 3.00%, which was in an decreasing trend; the consumption sums of national essential drugs were respectively 4.198 8 million, 4.335 4 million and 4.612 8 million yuan, with the proportion accounted for total consumption sums were 13.41%, 14.42% and 16.45%, which was in an increasing trend; the application of antibiotics was mainly unrestricted-level, with the constituent ratios of DDDs were respectively 94.34%(182 428/ 193 369 ), 93.89%(191 028/203 461) and 96.21%(225 440/234 317), the constituent ratios of DDDs of restricted-level antibiotics were respectively 5.60%( 10 838/ 193 369), 6.07%(12 358/203 461) and 3.77%( 8 843/ 234 317), which was in great decreasing in 2017. CONCLUSIONS: Medication intervention can relieve expense burden for patients, reduce the application of adjuvant drugs, promote the application of national essential drugs and enhance rationality levels of antibiotics application, which has effectively improved the clinical rational drug application.