我院质子泵抑制剂临床合理应用评价

Evaluation of Rational Clinical Application of Proton Pump Inhibitors

目的促进质子泵抑制剂(PPIs)的临床合理应用。方法以药品说明书、相关指南和共识为评价标准,通过医院信息管理系统抽取某三级综合医院2016年每月30份使用PPIs的医嘱,共360份,针对其适应证、药物选择、给药时机、用法及用量、溶剂、疗程进行评价。结果共发现不合理医嘱29例,占8. 06%;第1,2,3,4季度不合理率分别为4. 17%(15/360),2. 22%(8/360),1. 11%(4/360),0. 56%(2/360),差异有统计学意义(χ~2=15. 4,P <0. 001),其中第2,3,4季度均低于第1季度(P <0. 05),第4季度合理率最高;不合理用药类别为治疗应用无适应证(4例),预防应用无适应证(9例),选择药物不合理(5例),给药时机不合理(1例),用法及用量不合理(1例),溶剂选择不当(2例),疗程不合理(7例)。结论 PPIs临床应用广泛,通过综合干预后,其合理使用率逐季提高,但仍需加强监管,促进临床合理用药。

Objective To promote the rational clinical application of proton pump inhibitors (PPIs). Methods With drug instructions, rel-evant guidelines and consensus as evaluation standard, a total of 360 PPIs prescriptions were extracted from a tertiary general hospital every month in 2016 through hospital information system (HIS), 30 cases per month. The indications, drug selection, timing of adminis-tration, usage and dosage, solvents and course of treatment were evaluated. Results A total of 29 cases of unreasonable medical advice were found, accounting for 8. 06%. The unreasonable rates of the first, second, third and fourth quarter were 4. 17%(15/360),2.22%(8/360), 1. 11%(4/360),0. 56%(2/360), the difference was statistically significant(X^2 = 15. 4, P < 0. 001). The unreasonable rates of the second, third and fourth quarters were lower than that of the first quarter ( P < 0. 05)? and the fourth quarter had the highest reasonable rate. The unreasonable drug use types were treatment application without indications (4 cases), prevention application without indications (9 cases), unreasonable drug selection (5 cases), unreasonable time of administration (1 case), unreasonable use and dosage (1 case), improper solvent selection(2 cases), unreasonable course of treatment(7 cases). Conclusion PPIs are widely used in clinic. After comprehensive intervention, the rational use rate of PPIs is increasing seasonally. However, supervision should be strengthened to promote rational drug use in clinic.