多元性管控在儿童辅助用药管理中的实践

Practice of Diversity Control in Management of Adjuvant Medication for Children

目的:规范辅助用药,加强辅助用药的合理应用。方法:安徽省儿童医院(以下简称“我院”)自2018年7月开始,由临床药师与医务科共同参与辅助用药的管控。回顾性分析干预后2018年第3季度至2019年第2季度我院患儿辅助用药的使用数据。结果:通过多元性管控干预,我院辅助用药销售金额占药品总销售金额的比例逐渐降低,由2018年第3季度的11.49%(7402133.19元/64396414.32元)降至2019年第2季度的6.50%(4530593.23元/69751165.47元);其中神经营养类药物的销售金额占药品总销售金额的比例降低最明显,由2018年第3季度的6.77%(4356664.72元/64396414.32元)降至2019年第2季度的4.38%(3053004.97元/69751165.47元),其他类药物的销售金额占药品总销售金额的比例稍有所波动,总体呈降低趋势;脑蛋白水解物口服液的用药频度最高,但未出现集中现象;按照成人限定日剂量(defined daily dose,DDD)计算限定日费用(daily drug cost,DDC),奥拉西坦注射液的DDC最高;根据我院儿童常用量DDD计算DDC,注射用磷酸肌酸的DDC最高。结论:多元性管控后,我院辅助用药的销售金额大幅降低,各项用药数据的波动也较一致,但仍需对个别品种进一步管控。

OBJECTIVE:To standardize the adjuvant drugs and strengthen the rational application of adjuvant drugs.METHODS:Since Jul.2018,the clinical pharmacists and the medical department had jointly participated into the control of adjuvant drugs in Anhui Provincial Children s Hospital(hereinafter referred to as“our hospital”).The application data of adjuvant drugs in children from our hospital from the third quarter of 2018 to the second quarter of 2019 after intervention were retrospectively analyzed.RESULTS:Through diversity control intervention,the proportion of consumption sum of adjuvant drugs in total consumption sum of drugs in our hospital decreased,from 11.49%(7402133.19 yuan/64396414.32 yuan)in the third quarter of 2018 to 6.50%(4530593.23 yuan/69751165.47 yuan)in the second quarter of 2019.The proportion of consumption sum of neurotrophic drugs in total consumption sum of drugs decreased significantly,from 6.77%(4356664.72 yuan/64396414.32 yuan)in the third quarter of 2018 to 4.38%(3053004.97 yuan/69751165.47 yuan)in the second quarter of 2019.The proportion of consumption sum of other drugs in total consumption sum of drugs fluctuated slightly and showed the general decreasing trend.The defined daily dose system of cerebroprotein hydrolysate oral solution was the highest,yet there was no concentration phenomenon.Daily drug cost(DDC)was calculated according to the defined daily dose(DDD)for adults,oxiracetam injection had the highest DDC.DDC was calculated according to the DDD of children in our hospital,and the DDC of creatine phosphate sodium for injection was the highest.CONCLUSIONS:After diversity control,the consumption sum of adjuvant drugs in our hospital is in a significant decreasing tendency,and the fluctuation of various medication data is relatively consistent,yet further control of individual varieties is still needed.