摘要
目的:调查儿童重症患者超说明书用药现状,分析可能的超说明书用药危险因素,为促进儿科重症监护病区合理用药提供参考。方法:分层随机抽取西北妇女儿童医院2019年儿科重症监护病区的医嘱,根据药品说明书,判断是否为超说明书用药。分析不同年龄段、不同科室、不同级别医师、不同种类药品的超说明书用药发生率。分析超说明书用药与患儿基本信息(年龄、性别)、医师级别和药品信息(基本药物、高警示药物)的相关性。结果:共纳入患儿864例,医嘱13 926条,药品200种,超说明书用药发生率分别为87.27%、53.02%和56.00%。新生儿、女性患儿、高职称医师、基本药物、高警示药物存在较高的超说明书用药风险(P<0.05)。结论:儿童重症患者超说明书用药情况普遍存在,新生儿、女性患儿、高职称医师、基本药物、高警示药物为超说明用药的危险因素。药师需发挥用药指导作用,协助医师规避风险用药,促进重症患儿用药安全合理。
Objective: To investigate the application status of off-label drug use in children from pediatric intensive care unit(PICU), and to analyze the risk factors of off-label drug use, so as to provide reference for promoting the rational drug use in PICU. Methods: Medical orders were selected from the PICU of Northwest Women’s and Children’s Hospital in 2019 through the proportionate stratified random sampling method, and off-label drug use was judged according to the drug instructions. The incidences of off-label drug use in different age groups, departments, levels of clinicians and different kinds of drugs were analyzed. Correlation between off-label drug use and children’s basic information(age, gender), levels of clinicians and drug information(essential drugs, high-alert drugs) was analyzed. Results: A total of 864 children were enrolled, including 13,926 medical orders and 200 kinds of drugs. The incidence of off-label drug use was respectively 87.27%, 53.02% and 56.00%. Newborns, female children, clinicians with high professional titles, essential drugs and high-alert drugs had higher risks of off-label drug use(P<0.05). Conclusion: Off-label drug use is widespread in children from PICU. Newborns, female children, clinicians with high professional titles, essential drugs and high-alert drugs are risk factors of off-label drug use. Pharmacists are supposed to play a role in guiding rational drug use, assisting clinicians in avoiding drug use risks and promoting the safe and rational drug use in critically ill children.
作者
赵凯
田振
赵芳
沈怡萱
李思维
常瑛
Zhao Kai;Tian Zhen;Zhao Fang;Shen Yixuan;Li Siwei;Chang Ying(Northwest Women’s and Children’s Hospital,Shaanxi Xi’an 710061,China;Guangzhou Women and Children’s Medical Center,Guangdong Guangzhou 510623,China)
出处
《儿科药学杂志》
CAS
2021年第10期28-32,共5页
Journal of Pediatric Pharmacy
基金
陕西省卫生计生科研基金项目,编号2016D056。