玉林市6家医院儿科门急诊处方超说明书用药调查

Survey on off-label drug use of prescriptions in pediatric outpatient and emergency of 6 hospitals in Yulin City

目的调查玉林市6家医院儿科门急诊处方药品超说明书用药情况,以提高和促进玉林市儿童合理用药水平。方法调查玉林市6家医院门急诊的儿科处方,分析儿科各年龄段超说明书用药的发生率和类型,采用单因素Logistic回归模型分析超说明书用药发生的风险因素。结果共抽查900张儿科患者处方,包括2 832条用药医嘱,其中超说明书用药处方132张(14.67%),超说明书用药医嘱143条(5.05%)。超说明书用药类型中居前3位的分别为未提及儿童用药信息(43.13%)、超适应证(31.88%)和超给药频次(16.88%)。超说明书用药发生率前3位的药品分别为注射用单磷酸阿糖腺苷(32.16%)、盐酸溴己新葡萄糖注射液(9.09%)和利巴韦林口服溶液(4.90%)。在处方数量方面,超说明书用药发生率各年龄段差异无统计学意义(P>0.05),在用药医嘱方面差异有统计学意义(P<0.01)。超说明书用药与使用非基本药物呈显著相关性(P<0.01)。结论玉林市6家医院儿科门急诊处方超说明书用药发生率较高,需要严格按照药品说明书规范用药,推荐儿科患者首选国家基本药物,以降低超说明书用药的发生风险。

Objective To analyze and evaluate the prescription off-label drug use in pediatrics outpatient and emergency of 6 hospitals in Yulin City,so as to improve and promote the drugs rational use level for children in Yulin City.Methods The outpatient and emergency prescriptions were collected from 6 hospitals of Yulin city.The category and incidence rate of off-label drug use of prescriptions were analyzed in different ages of children.The risk factors of off-label drug use were discussed and counted by the single factor logistic regression model.Results A total of 900 prescriptions for pediatric patients were selected,including 2 832 prescriptions for medication,of which 132 prescriptions were off-label drug use accounting for 14.67%,and 143 medication records were off-label drug use accounting for 5.05%.The main categories of off-label drug use were no pediatric information(43.13%),off-label indication(31.88%)and frequency of super administration(16.88%).The top 3 drugs with highest incidence rate of off-label drug use were Adenine Arabinoside Monophosphate(32.16%),Bromhexine(9.09%),and Ribavirin Oral Solution(4.90%).There was no significant difference in the incidence rate of prescription off-label drug use in different ages(P>0.05),but the incidence rate of prescription off-label drug use has significant differences in medication records(P<0.01).The risk factors of off-label drug use were positively correlated with non essential drugs usage(P<0.01).Conclusion The incidence of off-label drug use in pediatric outpatient and emergency department of 6 hospitals in Yulin City is relatively high.It is necessary to strictly follow the pharmaceutical instructions and recommend the national essential drugs as the first choice for pediatric patients in order to reducing the risk of off-label drug use.