西药临床合理用药的安全性问题研究

Study on Safety of Rational Use of Western Medicine in Clinical Practice

目的探讨西药临床合理用药的安全性问题。方法随机抽取2017年1月-2017年10月120张合理用药管理前的西药处方以及2018年1月-2018年10月120张合理用药管理后的西药处方作为研究对象,回顾性分析并记录比较两组药方中用药方法不当、联合用药不当、抗生素滥用、重复用药、合理用药等不安全用药发生情况以及合理用药情况。且简单对比了合理用药管理后住院费用及住院时间的情况。结果对照组有24例(20%)处方用药方法不当,观察组有7例(5.8%)处方用药方法不当,两组相比差异有统计学意义(χ^2=10.705,P=0.001);对照组有26例(21.7%)处方滥用抗生素,观察组有6例(5.0%)处方滥用抗生素,两组相比差异有统计学意义(χ^2=14.423,P<0.001);对照组有20例(16.7%)处方重复用药,观察组有2例(1.7%)处方重复用药,两组相比差异有统计学意义(χ^2=16.214,P<0.001);对照组有90例(75.0%)处方合理用药,观察组有110例(91.7%)处方合理用药,两组相比差异有统计学意义(χ^2=12.000,P=0.001)。观察组处方用药安全性大于对照组。两组四联用药的使用率为0;对照组三联用药为1例,占0.8%,观察组为0例;二联用药中,观察组为37例,占30.8%,对照组为56例,占46.7%;一联用药中,观察组为83例,占69.2%,对照为63例,占52.5%。观察组处方单用药所占例比大于对照组,差异均具有统计学意义(χ^2=7.621,P=0.022)。观察组住院费用、住院时间均少于对照组,差异有统计学意义(P<0.05)。结论实施合理用药管理之后,能够减少西药用药方法不当、滥用抗生素、重复用药及提高合理用药,有助于减少患者抗菌药物费用、住院时间。因此,医院需要实施合理用药管理方式。

Objective To explore the safety of rational use of western medicine in clinical practice.Methods 120 western medicine prescriptions before rational drug use management from January 2017 to October 2017 and 120 western medicine prescriptions after rational drug use management from January 2018 to October 2018 were randomLy selected as research objects.The occurrence and rational drug use of unsafe drugs such as inappropriate drug use methods,inappropriate combined drug use,antibiotic abuse,repeated drug use,rational drug use and the like in the two groups of prescriptions were retrospectively analyzed and compared,and the hospitalization expenses and hospitalization time after rational drug use management were simply compared.Results There were 24 cases (20%) in the control group and 7 cases (5.8%) in the observation group with improper prescription medication.The difference between the two groups was statistically significant (χ^2= 10.705,P = 0.001).There were 26 cases (21.7%) of prescription abuse of antibiotics in the control group and 6 cases (5.0%) of prescription abuse of antibiotics in the observation groupm and the difference between the two groups was statistically significant (χ^2= 14.423,P < 0.001).There were 20 cases (16.7%) in the control group and 2 cases (1.7%) in the observation group with repeated prescriptions,and the difference between the two groups was statistically significant (χ^2 = 16.214, P < 0.001).There were 90 cases (75.0%) in the control group and 110 cases (91.7%) in the observation group.The difference between the two groups was statistically significant (χ^2= 12.000,P =0.001).The prescription medication safety of the observation group is greater than that of the control group.The usage rate of quadruple drugs in the two groups was 0.In the control group, 1 case (0.8%) was treated with triple drugs,while in the observation group,0 cases were treated with triple drugs.In the second combination,37 cases (30.8%) were in the observation group and 56 cases (46.7%) in the control group.In the first combination, 83 cases (69.2%) were in the observation group and 63 cases (52.5%) were in the control group.The proportion of cases in the observation group was higher than that in the control group,and the difference was statistically significant (χ^2= 7.621,P =0.022). The hospitalization expenses and length of stay in the observation group were less than those in the control group,and the difference was statistically significant (P < 0.05).Conclusion The implementation of rational drug use management can reduce improper drug use methods,abuse of antibiotics,repeated drug use and improve rational drug use,which is helpful to reduce the cost of antibacterial drugs and hospitalization time of patients.Therefore,hospitals need to implement rational drug use management.