2015—2017年上海市8家基层医疗机构口服降糖药物利用评价

Utilization evaluation of oral hypoglycemic drugs in 8 primary health care institutions in Shanghai from 2015 to 2017

目的通过调查2015—2017年上海市崇明区8家基层医疗机构(以下简称"崇明区8家医院")口服降糖药的应用现状,评价利用情况及用药趋势,为临床合理用药提供参考。方法采用金额排序分析和用药频度分析方法,对崇明区8家医院2015—2017年口服降糖药的用药金额、用药频度(DDDs)和限定日费用(DDC)等进行回顾性统计分析。结果 2015—2017年崇明区8家医院口服降糖药的使用总金额和DDDs总体呈逐年增长趋势,用药金额排序列前3位的分别为格列美脲、阿卡波糖、吡格列酮;DDDs排序列前3位的分别为格列美脲、二甲双胍、吡格列酮。2015—2016年DDC排序列前3位的依次为阿卡波糖、瑞格列奈、那格列奈,2017年DDC排序列前3位的是阿卡波糖、沙格列汀和西格列汀,而二甲双胍、格列美脲3年的DDC均较低;用药金额排序与DDDs排序的比值(B/A)在0.33～2.50之间。结论格列美脲、二甲双胍及吡格列酮是崇明区8家医院2015—2017年最常用的品种,口服降糖药的应用基本合理,临床更倾向于选择每日服用一次的长效口服降糖药。

Objective To evaluate the utilization status and trend of oral hypoglycemic drugs by investigating its application in 8 primary health care institutions in Chongming district of Shanghai(hereinafter referred to as“8 hospitals in Chongming”)from 2015 to 2017,and to provide reference for rational clinical medication.Methods Retrospective statistical analysis was conducted on the drug consumption sum,defined daily dose system(DDDs)and daily drug cost(DDC)of oral hypoglycemic drugs in 8 hospitals in Chongming from 2015 to 2017 by the method of consumption sum sequencing analysis and defined daily dose system analysis.Results From 2015 to 2017,the drug consumption sum and DDDs of oral hypoglycemic drugs in 8 hospitals in Chongming increased year by year.The top three ranking drugs of consumption sum were Glimepiride,Acarbose and Pioglitazone and the top three ranking drugs of DDDs were Glimepiride,Metformin and Pioglitazone.The top three DDC sequences from 2015 to 2016 were Acarbose,Repaglinide and Nateglinide,and the top three DDC sequences in 2017 were Acarbose,Saxagliptin and Sitagliptin.The total DDC of Metformin and Glimepiride were lower.The ratio(B/A)of the drug consumption sum sequencing and DDDs sequencing was between 0.33 and 2.50.Conclusion Glimepiride,Metformin and Pioglitazone were the most commonly used drugs from 2015 to 2017 in 8 hospitals in Chongming.The application of oral hypoglycemic drugs is basically reasonable,and the clinic prefers to use long-acting once-daily oral hypoglycemic drugs.