综合干预国家重点监控药品临床应用的成效分析

Analysis of Effects of Comprehensive Intervention on the Clinical Application of National Key Monitoring Drugs

目的:了解南通大学附属建湖医院(以下简称“该院”)国家重点监控药品使用情况,为深化改进重点监控药品的临床应用提供参考。方法:该院运用考核、审核、点评及预警系列措施进行干预,并对干预前(2018年第4季度)和干预后(2019年第4季度)重点监控药品的销售金额、用药频度(defined daily dose system,DDDs)、使用率及合理性、规范性进行统计分析。结果:干预后,该院重点监控药品的销售金额占药品总销售金额的比例由干预前的4.38%(2025737.50元/46237198.20元)降至2.75%(1451480.20元/52795033.57元),DDDs同比减少4730.5(干预前为18355.0,干预后为13624.5),其中活血化瘀类药物降幅最大;住院患者使用率由干预前的25.5%(436/1713)降至7.2%(154/2152);适应证不适宜情况改善显著,适应证不适宜病例所占比例由干预前的20.4%(89/436)降至7.1%(11/154)。结论:该院综合干预措施可行有效,能够保障国家重点监控药品的临床应用安全、有效和经济。

OBJECTIVE:To investigate the clinical application of national key monitoring drugs in Jianhu Hospital Affiliated to Nantong University(hereinafter referred to as“the hospital”),so as to provide reference for further improving the clinical application of key monitoring drugs.METHODS:Interventions were performed in the hospital by using a series of assessment,audit,review and early warning measures.Statistical analysis was conducted on consumption sum,defined daily dose system(DDDs),application rate and rationality,standardability of key monitoring drugs before intervention(the 4th quarter of 2018)and after intervention(the 4th quarter of 2019).RESULTS:After intervention,the proportion of consumption sum of key monitoring drugs to the total drugs decreased from 4.38%(2025737.50 yuan/46237198.20 yuan)before intervention to 2.75%(1451480.20 yuan/52795033.57 yuan)after intervention,DDDs decreased by 4730.5 year on year(18355.0 before intervention and 13624.5 after intervention),among which drugs for promoting blood circulation and removing blood stasis showed the greatest decrease.The application rate of antibiotics in inpatients decreased from 25.5%(436/1713)before intervention to 7.2%(154/2152)after intervention.There was significant improvement in inappropriate indications,with the proportion decreased from 20.4%(89/436)before intervention 7.1%(11/154)after intervention.CONCLUSIONS:The comprehensive intervention measures of the hospital are feasible and effective,and can ensure the safety,effectiveness and economy of the clinical application of national key monitoring drugs.