外用糖皮质激素处方的重复治疗评价

Prescribing evaluation of the therapeutic duplication of topical corticosteroids

目的探究外用糖皮质激素(简称:激素)的重复治疗问题。方法选取2016年12月皮肤科门诊的全部处方84 110张,筛选出含激素处方34 398张。处方同时开具2种或以上含同等或相似强度激素的药品被判定为重复用药。结果激素重复治疗的处方达1 410张(4.1%)。超强效激素和强效激素重复使用占比合计43.3%,其中索咪新尿素乳膏和复方倍他米松乳膏联用占比最多,达26.4%。中效激素重复使用占比合计53.5%,其中复方曲安奈德乳膏和糠酸莫米松乳膏联用占比最多,达27.1%。结论激素重复治疗现象并不少见,医师对激素的相关认知需提高,临床药师应加强处方审核和评价,推动处方精简,提高激素的使用安全。

AIM To study therapeutic duplications of topical corticosteroids ( TCs) in the clinical application of dermatology. METHODS A total of 84 110 prescriptions of dermatology clinics were selected in December 2016 , and 34 398 prescriptions containing TCs were screened out. Prescribing two or more drugs containing the same or similar potency of TCs at the same time was considered therapeutic duplication. RESULTS Of the 34 398 prescriptions containing TCs, 1 410 (4. 1%) were judged to be duplicative. The proportion of reuse of ultra high potency TCs and high potency TCs was 43.3%, in which the proportion of somexin urea cream combined with compound betamethasone cream was the highest, up to 26. 4%. In total, 53. 5 percent of the total amount of the moderate potency TCs was repeated, with the combination of compound triamcinolone acetonide cream and furfurate mormetasone cream taking the largest proportion, up to 27. 1 percent. CONCLUSION Theraputic duplication of TCs is not uncommon clinically. Doctors need to improve their knowledge about classification by potency and adverse reactions of TCs. Clinical pharmacists should strengthen the audit and evaluation of prescriptions, promote prescription streamlining and improve the safety of TCs use.