某院妇产科门诊超说明书用药情况调查与分析

Investigation and Analysis of Off-Label Drug Use in Outpatient Department of Obstetrics and Gynecology in a Hospital

目的为妇产科临床合理用药提供参考。方法提取2017年4月医院妇产科门诊的1460张处方,排除灭菌注射用水、0.9%氯化钠注射液、5%/10%葡萄糖注射液等非治疗医嘱,根据药品说明书,对超说明书处方、医嘱、用药类型、科室、用药依据进行统计。结果妇产科门诊超说明书用药情况较普遍,生殖医学中心最多(34.63%),超适应证用药最常见(59.81%);中成药及西药中其他类和孕激素类药超说明书用药较多;大部分超说明书用药有相应指南、共识或循证医学文献支持,证据级别较有说服力。结论该院妇产科门诊超说明书用药发生率较高,绝大部分有相关证据支持,但还需进一步加强管理,规范临床用药。

Objective To provide reference for rational drug use in outpatient department of obstetrics and gynecology. Methods Totally1 460 prescriptions from the outpatient department of obstetrics and gynecology in our hospital in April 2017 were extracted. Non-therapeutic orders such as the Sterile Water for Injection,0. 9% Sodium Chloride Injection and 5%/10% Glucose Injection were excluded. According to the drug label,the prescriptions,medical orders,types of medication,departments and basis of medication of off-label use were counted and analyzed. Results The off-label drug use in the outpatient department of obstetrics and gynecology was common,which was respectively highest in the Reproductive Medicine Center( 34. 63%),and medication without indication was the most common( 59. 81%). The off-label drug use mostly occurred in the other types of drugs and hormone medicine of Chinese patent drugs and Western medicines,most of the off-label drug use was supported by relevant guidelines,consensus or evidence-based medical literature,and the level of evidence was more convincing. Conclusion The incidence of off-label drug use is relatively high in outpatient department of obstetrics and gynecology in our hospital,and most of them have relevant evidence to support,but we need to further strengthen the management and standardize clinical drug use.