癌痛规范化用药对我院癌痛患者用药及处方质量的影响

The Influence of Standardized Medication of Cancer Pain on Medication and Prescription Quality in Our Hospital

目的分析癌痛规范化治疗对我院麻醉药品合理应用及癌痛处方质量的影响,同时探讨其对患者癌痛用药知识水平、疼痛控制满意度及生活质量的作用效果,以期为相关医疗机构癌痛规范化用药工作模式的推进提供一定的借鉴。方法通过医院信息系统(HIS)收集我院癌痛规范化治疗开展前、后不同种类麻醉药品的消耗量及用药频度(DDDs);随机收集每月肿瘤科麻醉处方40张,统计用药不适宜处方率、超常处方率及不规范处方率;随机选择癌痛规范化治疗开展前、后癌痛患者各70例为研究对象,比较两组患者癌痛用药知识水平、疼痛评分及癌痛治疗满意度的差异。结果癌痛规范化治疗开展后,我院羟考酮缓释片、吗啡片、注射用吗啡的使用量及DDDs均呈上升趋势,而吗啡缓释片、芬太尼透皮贴、哌替啶注射液的使用量及DDDs均呈下降趋势;肿瘤科麻醉药品处方中,用药不适宜处方率、超常处方率及不规范处方率均显著降低(P<0.05);癌痛患者的麻醉药品知识调查评分、各维度疼痛控制满意度均显著升高(P<0.05),疼痛评估影响量表各项评分均显著降低(P<0.05)。结论开展癌痛规范化治疗可显著改善麻醉药品的合理使用率,提高癌痛处方的合格率,提高患者的癌痛用药知识水平、对癌痛治疗的满意度以及生活质量。

Objective To analyze the effects of standardized treatment of cancer pain on the rational use of narcotic drugs and the quality of cancer pain prescription in our hospital,and to explore its effects on the knowledge level of cancer pain medication,pain control satisfaction and quality life of patients,so as to provide some reference for the related medical institutions to promote the cancer pain standardized medication mode.Methods Collect the narcotic drugs dosage,DDDs before and after the standardized treatment of cancer pain was established in our hospital through HIS system.Randomly collect 40 anesthesia prescriptions of oncology department every month,analyze the inappropriate prescription rate,abnormal prescription rate and irregular prescription rate.At the same time,70 patients with cancer pain before and after standardized treatment were randomly collected as the research objects,and their knowledge level,pain scores and treatment satisfactions were analyzed and compared between the two groups.Results After the standardized treatment of cancer pain was established,the dosage and DDDs of oxycodone sustained-release tablets,morphine tablets and morphine for injection were increased.However,the dosage and DDDs of morphine sustained-release tablets,fentanyl transdermal patch and pethidine for injection were decreased.After standardized treatment,the inappropriate prescription rate,abnormal prescription rate and irregular prescription rate were significantly reduced(P<0.05).The score of cancer pain influence scale for patients was also significantly reduced(P<0.05).The rate of satisfaction to pain management and the score of narcotic knowledge were significantly increased(P<0.05).Conclusion Standardized treatment of cancer pain could significantly improve the rational application rate of narcotic drugs and the quality of prescription.It could also improve the patients'understanding of anesthesia drugs,satisfaction to pain control and quality of life.