抗高血压药物使用情况与不合理用药的干预措施研究

Study on the Use of Antihypertensive Drugs and Intervention Measures of Irrational Drug use

目的:分析我院心内科抗高血压药物使用情况,探讨不合理用药的原因,确保抗高血压用药的合理性。方法:连续入选2018年6月-2020年6月期间在我院心内科治疗的699例高血压患者,利用EXCEL表格对入选病历进行统计,评价其不同性别、年龄段患者抗高血压药物处方占比情况,分析不同种类抗高血压药物使用情况、抗高血压药物占处方比以及药物合理性及利用指数(DUI)、抗高血压药物联合使用情况以及联合用药不合理情况。结果:本次纳入研究的699张处方中,男患者占比多于女患者,且> 64岁年龄段患者的抗高血压类药物处方例数占比最高。心内科抗高血压药物处方中占比最高的药物种类为钙通道拮抗剂(CCB)(36.48%),其次分别为血管紧张素Ⅱ受体阻滞剂(ARB)(20.74%)、血管紧张素转换酶抑制剂(ACEI)(18.17%),β受体阻滞剂(β-RB)(14.88%)以及利尿剂(9.73%)。药物用药频度(DDDs)前10抗高血压药物中包含CCB类5个、ARB类4个、β-RB类1个。其中硝苯地平处方占比最高13.02%,其次为美托洛尔9.16%,DUI值最高为氨氯地平。在699例处方中,使用情况主要分为单独使用(39.77%)、二联使用(32.33%)、三联使用(19.88%)以及四联使用(8.02%)4种。其中单联使用ARB类占比(16.73%)最高,二联使用中CCB+β-RB类占比(8.44%)最高,三联使用中CCB+β-RB+ARB类占比(8.15%)最高。不合理处方27张,占总处方比3.87%。结论:心内科抗高血压药物的使用情况基本符合病情治疗方案,仅存在部分用药不合理情况,应实施有效的干预措施减少用药不合理情况。

Objective: To analyze the use of antihypertensive drugs in the cardiology department of our hospital, explore the reasons for irrational use of drugs, and ensure the rationality of antihypertensive drugs. Methods: 699 patients with hypertension treated in the Department of Cardiology of our hospital from June 2018 to June 2020 were selected as the research object. Excel was used to make statistics on the selected medical records, Evaluated the proportion of antihypertensive drug prescriptions in patients of different genders and ages, analyzed the use of different types of antihypertensive drugs, the proportion of antihypertensive drugs in prescriptions, the rationality and utilization index(DUI), the combined use of antihypertensive drugs, and the unreasonable combined use of antihypertensive drugs. Results: Among the 699 prescriptions included in the study, there were more male patients than female patients, and the number of prescriptions of antihypertensive drugs accounted for the highest proportion of total prescriptions for patients over 64 years of age. The highest proportion of antihypertensive drug prescriptions in the Department of Cardiology was calcium channel blockers(CCB)(36.48%), followed by angiotensin II receptor blockers(ARB)(20.74%) and angiotensin Converting enzyme inhibitors(ACEI)(18.17%), β-receptor blockers(β-RB)(14.88%) and diuretics(9.73%). The top 10 antihypertensive drugs for DDDs include 5 CCB, 4 ARB, and 1 β-RB. Nifedipine prescription accounted for the highest proportion of 13.02%, followed by metoprolol 9. 16%, and the highest Dui value was amlodipine. Among the 699 prescriptions, there were four kinds of usage: single use(39.77%), double use(32.33%), triple use(19.88%) and quadruple use(8.02%). The proportion of ARB in single use(16.73%) was the highest, and CCB in double use was the highest+β-RB accounted for the highest proportion(8.44%), and CCB was the most common in triple use+β-Rb+ARB accounted for the highest proportion(8.15%). There were 27 irrational prescriptions, accounting for 3.87% of the total prescriptions. Conclusion: the use of antihypertensive drugs in cardiology department is basically in line with the treatment plan, and only some of them are irrational. Effective intervention measures should be implemented to reduce the irrational use of drugs.