利伐沙班药物利用评价标准的建立与应用

Establishment and Application of Drug Use Evaluation Standard of Rivaroxaban

目的建立利伐沙班药物利用评价(drug use evaluation,DUE)标准,为临床合理应用利伐沙班提供参考。方法以利伐沙班药品说明书为基础,参考相关指南和文献,并通过与临床专家讨论,从用药指征、用药过程和用药结果3个方面建立DUE标准。采用回顾性调查方法,对福建医科大学附属漳州市医院2018年1月—2019年6月使用利伐沙班的住院患者病历进行评价。结果共纳入591份病历,用药合理率为60.41%,不合理用药情况主要为剂量偏小(27.75%)、超说明书用药(11.50%)和药物相互作用(9.64%)3方面。结论建立的利伐沙班DUE标准有较强的科学性、实用性和可行性,在禁忌证、使用质子泵抑制剂预防利伐沙班相关胃黏膜损伤及超说明书用药的管理方面可进一步优化。

OBJECTIVE To establish the drug use evaluation(DUE)standard of rivaroxaban and provide a reference for the rationally clinical application of rivaroxaban.METHODS Based on the rivaroxaban drug label,related guidelines and literature,combined with clinical expert consultation results,DUE standard from three aspects(indications,medications and medication results)was established.A retrospective survey was conducted to evaluate the inpatients using rivaroxaban from January 2018 to June 2019 in Zhangzhou Affiliated Hospital of Fujian Medical University.RESULTS A total of 591 patients were included,with a medication reasonable rate of 60.41%.The irrational use of drugs was mainly in the low dose(27.75%),off-label medication(11.50%)and drug interactions(9.64%).CONCLUSION The rivaroxaban DUE standard established is scientific,practical and feasible.It can be further optimized in contraindications and use of proton pump inhibitors to prevent rivaroxaban-related gastric mucosal damage and the management of off-label medication.