某三甲医院门急诊超说明书用药情况调查及分析

Survey and analysis of off-labeled drug usage in the outpatient and emergency departments of a 3A grade hospital

目的调查某院门急诊西药超说明书使用情况,分析存在的主要问题及影响因素,并提出对策建议。方法回顾性分析某院2017年6月至2018年6月实施处方点评的门急诊处方4 290张,根据药品说明书对每张处方的用药记录进行分析,判断其医嘱用药是否为超说明书使用,分析超说明书用药类型、不同年龄段的超说明书使用情况等。结果 4 290张处方中,超说明书用药处方86张(2.00%),主要类型包括超适应证(42.70%)、超给药频次(31.46%)、超给药途径(12.36%)等,其中18岁以下患者的超说明书用药共7例,占8.14%。结论由本次调查可知,医院门急诊超说明书用药情况基本处于合理范围,但要加强标准化的管理,逐步完善信息化管理,以进一步降低患者用药风险,提高用药合理性。

Objective To investigate the status of off-labeled drug use in the outpatient and emergency department of a hospital and to analyze the main problems,influencing factors and provide relevant suggestions.Methods 4 290 prescriptions with comments from the outpatient and emergency departments of a hospital from June 2017 to June 2018 were retrospectively analyzed.By referring to medicine specification,the medication administration records of every prescription were analyzed to determine if there was off-label usage of medicines,the medication type of off-label usages and off-label usages of medicine among different age groups.Results Among the 4 290 prescriptions,86 cases(2.00%)were found of off-label usage,with major types being super-indications(42.70%),excessive drug frequency(31.46%)and beyond the route of medication(12.36%)and so on.There were 7 cases of off-label prescriptions(8.14%)were for children under 18 years old.Conclusion Through the survey,off-labeled drug usage was within reasonable limits among patients experiencing outpatient service and emergency treatment.Standardized and information-based management of drug usage are needed to further lower medication risks of patients and improve rational drug application.