苏州大学附属太仓医院现有国家重点监控药品使用情况分析

Analysis on the use of national key monitoring drugs in Taicang Hospital Affiliated to Suzhou University

目的分析苏州大学附属太仓医院现有国家重点监控药品使用情况,为促进临床合理用药提供参考。方法收集苏州大学附属太仓医院2019年8月-2020年4月国家重点监控药品目录中涉及的药品相关数据,记录本院重点监控药品使用品种及临床科室分布,重点监控药品用药频度(DDDs)、日均费用(DDC)、销售金额与排序比(B/A),重点监控药品的医嘱点评合格情况。结果第一批《目录》一共有20种药品,涉及的品种为13种(占65%)。大多数科室使用重点监控药品的品种与其对应疾病相符。DDDs排序前5位分别为:长春西汀(进口)、奥拉西坦(倍清星)、前列地尔、依达拉奉(必存)、丹参川芎嗪;DDC排前5位分别为:依达拉奉(必存)、鼠神经生长因子(苏肽生)、单唾液酸四己糖神经节苷脂(哈药)、奥拉西坦(倍清星)、奥拉西坦(欧兰同);销售金额排前5分别为:依达拉奉(必存)、奥拉西坦(倍清星)、长春西汀(进口)、奥拉西坦(欧兰同)、前列地尔。部分品种涉及两种规格,临床使用也有不同偏好。但大多数药品的B/A比值接近或等于1,同步性较好。共点评例数3427例,合格例数3157例(占92.12%)。不合理医嘱数为282个,其中最突出的两个问题为:适应证不适宜(占48.9%)和用法、用量不适宜(占38.7%)。管控前总金额为4921208.11元,药占比为2.4%;管控后分别为3130114.34元、1.62%。结论本院重点监控药品的使用情况基本合理,但仍需采取积极有效的监管措施,进一步促进重点监控药品的合理使用。

Objective To analyze the current state key monitoring drug use in Taicang Hospital Affiliated to Suzhou University,so as to provide reference for promoting clinical rational drug use.Methods The drug related data of Taicang Hospital Affiliated to Suzhou University from August 2019 to April 2020 were collected.The drug use varieties and clinical departments distribution,DDDs,DDC,B/A,and the qualified doctor’s advice were recorded.Results There were 20 kinds of drugs in the first batch of"Catalogue",involving 13 kinds(65%).Most departments use the key monitoring drugs in accordance with their corresponding diseases.The top five DDDs were vinpocetine(imported),oxiracetam(Beiqingxing),alprostadil,edaravone(Bicun),Salvia miltiorrhiza Ligustrazine;the top five DDC were edaravone(Bicun),rat nerve growth factor(threonidasen),monosialotetrahexosylganglioside(Harbin medicine),oxiracetam(Beiqingxing),oxiracetam(olanzapine);the top five in terms of sales amount were edaravone(Bicun),oxiracetam(Beiqingxing),vinpocetine(imported),oxiracetam(Orlando)and alprostadil.Some varieties involve two specifications and have different preferences for clinical use.But the B/A ratio of most drugs is close to or equal to 1,and the synchronization is good.The total number of cases was 3427,and the qualified cases were 3157(92.12%).The number of irrational medical orders was 282,among which the two most prominent problems were inappropriate indications(48.9%)and inappropriate dosage(38.7%).Before the control,the total amount was 4921208.11 yuan,and the proportion of drugs was 2.4%;after the control,it was 3130114.34 yuan and 1.62%respectively.Conclusion The use of key monitoring drugs in our hospital is basically reasonable,but we still need to take positive and effective regulatory measures to further promote the rational use of key monitoring drugs.