剖宫产围术期药师合理用药干预效果评价及成本-效果分析

Effect evaluation and cost-effectiveness analysis on intervention of rational drug use by pharmacists in perioperative period of cesarean section

目的对剖宫产围术期药师合理用药干预效果评价及成本-效果进行分析,促进合理用药。方法随机抽取干预前(2017年4月~2018年3月)100份剖宫产病例作为干预前组,以及药师参与干预后(2018年4月~2019年3月)100份剖宫产病例作为干预后组,进行回顾性评价分析。结果干预后围术期抗菌药物选择合理率由75%提升至93%(χ~2=12.05,P=0.00),抗菌药物预防给药时机合理率由79%提升至95%(χ~2=11.32,P=0.00),术后用药时长合理率由67%提升至92%(χ~2=19.18,P=0.00)。成本-效果分析结果显示,干预后抗菌药物成本-效果比(C/E)由0.26下降至0.06,药品费用C/E由16.97下降至9.89。结论无论是从干预效果分析还是药物经济学评价,均体现出药师干预可有效促进剖宫产围术期抗菌药物的合理使用。

Objective To analyze the effect evaluation and cost-effectiveness on intervention of rational drug use by pharmacists in perioperative period of cesarean section,so as to promote rational drug use.Methods A total of 100 cases of cesarean section before the intervention(from April 2017 to March 2018)were randomly selected as the pre-intervention group,and 100 cesarean section cases after the pharmacist participated in the intervention(from April 2018 to March 2019)were selected as the post-intervention group for retrospective evaluation and analysis.Results After intervention,the rational rate of antibiotic selection in perioperative period increased from 75%to 93%(χ2=12.05,P=0.00),the rational rate of time points of prophylaxis use of antimicrobial increased from 79%to 95%(χ2=11.32,P=0.00),and the rational rate of medication time of the preventive application of antibacterials increased from 67%to 92%(χ2=19.18,P=0.00).The results of cost-effectiveness analysis showed that the cost-effectiveness ratio(C/E)of antibiotics decreased from 0.26 to 0.06 after intervention,and the C/E of drug costs decreased from 16.97 to 9.89 after intervention.Conclusion Both the analysis of intervention effect and the evaluation of pharmacoeconomics show that pharmacists intervention could effectively promote the rational use of antibiotics in perioperative period of cesarean section.