临床药师对某医院2015—2017年抗肿瘤辅助用药的干预对比研究

A comparative study of clinical pharmacists’ intervention on anti-tumor adjuvant drugs in a hospital from 2015 to 2017

目的评价临床药师干预对合理使用抗肿瘤辅助用药的促进效果,为抗肿瘤辅助用药的合理应用提供参考。方法比较2015年1月至2017年12月西安交通大学第一附属医院肿瘤内科1病区(干预组,有专职临床药师开展合理用药工作)与2病区(对照组,无专职临床药师)辅助用药使用金额排名前5的辅助用药使用率、辅助用药费用占比、用药频度(DDDs)、限定日费用(DDC)及药品利用指数(DUI),分析临床药师干预对抗肿瘤辅助用药的合理性促进作用。结果2015-2017年两组的辅助用药使用率及辅助用药费用占比均呈下降趋势。干预组未使用或使用1种辅助用药的占比明显高于对照组(25.56%比17.41%,P=0.001;30.93%比12.96%,P<0.001)。对照组的康莱特注射液及注射用核糖核酸Ⅱ的DDC及使用率偏高。干预组在2015年及2016年的人均辅助药费等指标均明显低于对照组(P<0.05),2017年两组虽差异无统计学意义(P>0.05),但仍提示呈现降低趋势。2017年干预组使用辅助用药的病例数占比、辅助用药费用占总药费的百分比及辅助用药费用占总费用的百分比均低于对照组[48.89%比60.00%,P=0.034;8.24%比16.02%,P=0.026;6.28%比14.04%,P=0.007]。结论临床药师干预能明显降低病人的经济负担,并能有效促进抗肿瘤辅助用药的合理使用。

Objective To evaluate the effect of clinical pharmacists’intervention on the rational use of anti tumor adjuvant drugs,and to provide reference for their rational application.Methods The use rates,sales amount ratios,defined daily dose system(DDDs),defined daily cost(DDC)and drug utilization index(DUI)of the top 5 adjuvant drugs between the 1 ward(Intervention group;clinical pharmacists is responsible for rational drug use)and the 2 ward(Control group;without clinical pharmacists)of the Department of Oncology,The First Affiliated Hospital of Xi'an Jiaotong University from January 2015 to December 2017 were com pared,and the rationality of clinical pharmacists’intervention on the rational use of anti tumor adjuvant drugs were analyzed.Results From 2015 to 2017,the use rate and the sales amount ratios of anti tumor adjuvant drugs in the two groups showed a downward trend.The proportion of patients who did not use or use one adjuvant drug in the intervention group was significantly higher than that in the control group(25.56%vs.17.41%,P=0.001;30.93%vs.12.96%,P<0.001).The DDC and use rate of kan glaite injection and ribonucleic acid for injectionⅡin the control group were higher.In the intervention group,the per capita adju vant drug fee and the other indicators in 2015 and 2016 were significantly lower than those in the control group(P<0.05),and there was no significant difference between the two groups in 2017(P>0.05),but it still showed a downward trend.In 2017,the proportion of cases using adjuvant drugs in the intervention group,the percentage of adjuvant drugs in total drug costs,and the per centage of adjuvant drugs in total expenses were lower than those in the control group[48.89%vs.60.00%,P=0.034;8.24%vs.16.02%,P=0.026;6.28%vs.14.04%,P=0.007].Conclusion Intervention by clinical pharmacists can significantly reduce the economic burden of patients and can effectively promote the rational use of anti tumor adjuvant drugs.