三级甲等精神病院门诊口服第二类精神药品现状分析

Analysis on the status quo of oral administration of class Ⅱ psychotropic drugs in the outpatient department of the third-grade A psychiatric hospital

目的调查和分析本院门诊口服第二类精神药品的使用情况,为促进本院临床的合理用药提供参考。方法通过回顾性调查分析,统计分析我院2018年7月至2019年6月门诊口服精神二类药物处方中的基本情况,如年龄、性别、处方数、处方构成比,并以限定日剂量(DDD)为基数计算用药频度(DDDs)、日均药费(DDC)、排序比(B/A)、药物利用指数(DUI)、平均治疗日数(ATD)。结果在36673例患者中,21~70岁是二类精神药品主要使用人群,占82.11%,1~20岁和71岁以上分别为9.10%和8.79%,女性患者约是男性的2倍;本院门诊常用的精二类药品共有12种,其中处方占比前6的药物中最高的是佐匹克隆,占24.62%,其次是劳拉西泮(24.00%)、奥沙西泮(14.52%)、氯硝西泮(12.06%)、右佐匹克隆(10.17%)、阿普唑仑(6.32%),这6种药物的使用比例占总处方的91.69%;DDDs前三的是佐匹克隆、劳拉西泮以及奥沙西泮;大部分药物DUI值均<1,硝西泮DUI则>1;销售金额排序前三位为奥沙西泮、佐匹克隆、右佐匹克隆;DDC排序前三的是奥沙西泮(10.83)、右佐匹克隆(9.18)、佐匹克隆(5.95);其中6种药品的B/A>1,5种药品的B/A<1,艾司唑仑的B/A=1;统计药物的ATD基本均小于30 d。结论本院在精二类药品的使用上基本是合理的。

Objective To investigate and analyze the use of classⅡpsychotropic drugs in the outpatient department of the third-grade A psychiatric hospital,so as to provide reference for promoting rational medication in our hospital.Methods Through retrospective investigation and analysis,the basic situation of outpatient prescriptions of psychotropic classⅡdrugs in our hospital from July 2018 to June 2019 was statistically analyzed,such as age,gender,number of prescriptions and prescription composition ratio,as well as defined daily dose system(DDDs)calculated based on defined daily dose(DDD),average daily drug cost(DDC),ranking ratio(B/A),drug utilization index(DUI)and average treatment days(ATD).Results Among 36673 patients,82.11%of them aged from 21 to 70 years old,and they mainly used classⅡpsychotropic drugs.9.10%and 8.79%of the patients were from 1 to 20 years old and over 71 years old,respectively.Meanwhile,the number of female patients was about twice that of male patients.There were 12 kinds of psychotropic classⅡdrugs commonly used in the outpatient department of our hospital,among which zopiclone had the highest prescription proportion among the top 6 drugs,accounting for 24.62%,followed by lorazepam for 24.00%,oxazepam for 14.52%,clonazepam for 12.06%,eszopiclone for 10.17%and alprazolam for 6.32%.The proportion of these six drugs used accounted for 91.69%of the total prescription.The top three DDDs were zopiclone,lorazepam and oxazepam.The DUI value of most drugs was less than 1,while that of nitrazepam was greater than 1.The top three sales amounts were oxazepam,zopiclone and eszopiclone.The top three DDC rankings were oxazepam for 10.83,eszopiclone for 9.18 and zopiclone for 5.95.B/A of 6 drugs was greater than 1,B/A of 5 drugs was less than 1,and B/A of estazolam was 1.The ATD of statistical drugs was basically less than 30 days.Conclusion The use of psychotropic classⅡdrugs in our hospital is basically reasonable.