医院住院患者质子泵抑制剂临床不合理应用分析

Analysis of the Proton PumpInhibitors (PPIs) Unreasonable ApplicationSituation in Inpatient

目的:通过回顾性分析我院质子泵抑制剂(proton pump inhibitors,PPIs)不合理应用情况,探讨其干预策略,提高临床用药水平。方法:通过药事安全信息系统和医院信息管理系统,收集我院2018年10~12月使用PPIs住院患者126例,按照本院的《质子泵抑制剂临床合理应用指南》的要求,对PPIs进行专项点评,综合“出院诊断、手术级别、病程记录”等判断PPIs的用药合理性。结果:使用PPIs的126例病例中,预防用药106例(84.13%),治疗用药20例(15.87%);合理用药50例(39.68%),不合理用药76例(60.32%)。其中不合理用药类型主要包括适应证/遴选药品不适宜52例(68.42%)、药品剂型或给药途径不适宜/有配伍禁忌或者不良相互作用15例(19.74%)、其他用药不适宜9例(11.8%)。结论:针对PPIs临床不合理应用情况,应加强医务人员合理用药知识宣讲,并通过审核处方、医嘱点评等措施及时发现不合理用药情况并积极干预,以确保患者安全、合理用药。

Objective:By retrospectively analyzing the irrationality of proton pump inhibitors(PPIs)in our hospital,exploring their intervention strategies,improving the level of rational drug use.Methods:Through the pharmaceutical safety information system and hospital information management system,126 inpatients who used PPIs in our hospital from October to December 2018 were collected.In accordance with the requirements of the“Guidelines for the Rational Use of Proton Pump Inhibitors”in our hospital,combined with“discharge diagnosis,surgical grade,and course records”,comment on the rationality of PPIs.Results:Among the 126 cases using PPIs,106 cases(84.13%)were used for prevention,20 cases(15.87%)were used for treatment,50 cases(39.68%)were used rationally,and 76 cases were used irrationally(60.32%).The dosage form and route of administration were inappropriate,or there were contraindications and adverse interactions in 15 cases(19.74%),and other medications were inappropriate in 9 cases(11.8%).Conclusion:In view of the clinical irrational application of PPIs,it is necessary to strengthen knowledge of rational drug use by medical staff,and through measures such as checking prescriptions and comment on medical advice,discover unreasonable drug use in a timely manner and actively intervene to ensure patient the safety and rationality of medication.