肾功能不全患者不合理用药医嘱分析

Analysis of Irrational Drug Use in Patients with Renal Insufficiency

目的:通过对本院肾功能不全患者不合理用药医嘱情况进行分析,为该类患者合理用药提供参考。方法:筛取2019年1~12月前置审方因肾功能不全不合理用药问题被药师打回的医嘱,对不合理医嘱的科室分布、药物种类及药师建议的接受率进行统计分析。结果:在药师打回医嘱496条中,老年科不合理用药问题最多,占医嘱30.04%;在不合理用药种类中,抗感染药物比例最大,占46.77%;在药师建议接受率中,由63.64%上升至88.89%,且外科比内科高,有禁忌症使用较用法用量不合理高。结论:肾功能不全患者用药存在一定问题,建议加强事前审方干预、医师培训以及药学服务等多项措施共同干预,促进肾功能不全患者合理用药。

Objective:To analyze the situation of unreasonable drug use in patients with renal insufficiency in our hospital,and to provide reference for rational drug use in this kind of patients.Methods:A retrospective investigation method was used to collect the doctor's orders returned by pharmacists due to irrational use of drugs for renal insufficiency from January to December 2019.The distribution of unreasonable doctor's orders,the types of drugs and the acceptance rate of pharmacists'suggestions were statistically analyzed.Results:Among the 496 orders returned by pharmacists,the department of geriatrics had the most problems of unreasonable drug use,accounting for 30.04%;in terms of the types of unreasonable drug use,anti-infective drugs accounted for 46.77%;the acceptance rate of pharmacists'recommendations increased from 63.64%to 88.89%,by more doctors of surgery than those of internal medicine;and the irrational use were more of contraindications than of usage.Conclusion:There are some problems in drug use in patients with renal insufficiency.It is suggested to strengthen pre-prescription intervention,physician training and clinical pharmacist pharmaceutical care and other measures to promote rational drug use in patients with renal insufficiency.