我院抗高血压药物的处方、药物使用情况及联合用药的合理性分析

Analysis of prescription, usage of antihypertensive drugs and rationality of combined medication in our hospital

目的分析我院抗高血压药物的处方、药物使用情况,为临床合理用药提供参考。方法查阅整理2015年6月至2018年6月我院门诊部使用的1 197张抗高血压药物处方,统计各类抗高血压药物的使用情况及联合用药情况,并分析三年间我院高血压药物的用药频度、销售金额等相关数据。结果抗高血压药物处方占比为11.90%(1 197/10 058),患者年龄大多>65岁(53.97%);抗高血压药物使用频度最高的种类为钙通道拮抗剂(CCB)(37.76%),其次为血管紧张素Ⅱ受体阻滞剂(ARB)(22.14%)、血管紧张素转换酶抑制剂(ACEI)(17.13%);使用频度和销售额最高的为CCB和ARB,增长最明显的为复方制剂;具体用药处方占比及DDDs值最高的为硝苯地平、氨氯地平及厄贝沙坦,其中氨氯地平、奥美沙坦及非洛地平DUI值>1,存在用药不合理现象;单一用药处方319张(26.65%),联合用药处方878张(73.35%),联合处方以二联为主,共728张(60.82%),其中使用频率最高的是CCB+ARB,共144张(16.40%),其次为CCB+β-RB,共103张(11.73%);不合理处方126张(10.53%),其中保钾利尿剂与ARB/ACEI不合理联用现象最多,处方共53张,占不合理处方42.06%。结论我院抗高血压药物使用情况基本符合治疗方案,仅有部分联合用药不合理情况,应进行合理有效的干预以减少不合理用药情况。

Objective To analyze the prescription, usage of antihypertensive drugs in our hospital, so as to provide reference for rational drug use in clinic. Methods A total of 1 197 prescriptions of antihypertensive drugs used in our outpatient department from June 2015 to June 2018 were consulted and sorted out. The usage and combined medication of various antihypertensive drugs were counted, and the related data of the frequency of drug use and sales amount of antihypertensive drugs in our hospital during the past three years were analyzed. Results The proportion of prescriptions for antihypertensive drugs was 11.90%(1 197/10 058), and most patients were over 65 years old(53.97%). The most frequently used drugs were calcium channel blocker(CCB)(37.76%), followed by angiotensin Ⅱ receptor blockers(ARB)(22.14%) and angiotensin converting enzyme inhibitors(ACEI)(17.13%). The drugs with the highest frequency of use and the highest sales were CCB and ARB, and compound preparation had the most obvious increase. The drugs with highest proportion of specific prescriptions and DDDs were nifedipine, amlodipine and irbesartan, in which the DUI of amlodipine, olmesartan and felodipine were more than 1, and there were unreasonable drug use. There were 319 pieces of single medication prescriptions(26.65%), 878 pieces of combined medication prescriptions(73.35%), of which 728 pieces of double combinations were the main method(60.82%), among them, CCB+ARB was the most frequently used, totaling 144 pieces(16.40%), followed by CCB+β-RB, totaling 103 pieces(11.73%). There were 126 pieces of unreasonable prescriptions(10.53%), among them, the unreasonable combination of potassium-preserving diuretics and ARB/ACEI was the most common, with 53 pieces prescriptions, accounting for 42.06% of unreasonable prescriptions. Conclusion The use of antihypertensive drugs in our hospital basically conforms to the current treatment plan, and only part of the combined medication is unreasonable. Rational and effective intervention should be carried out to reduce the unreasonable use of drugs.