临床二甲双胍不合理用药情况调查分析

Investigation and analysis of irrational use of metformin

目的调查某综合性医院2型糖尿病患者的二甲双胍使用情况,为临床合理用药提供指导依据。方法利用医院美康临床药学管理系统(PASSpharmAssist),调取该院2021年1月~2021年6月出院的2型糖尿病患者病例,并记录患者年龄、性别、体重、血清肌酐、糖化血红蛋白及二甲双胍的应用情况等指标,通过CKD-EPI公式计算患者肾小球滤过率,结合药品说明书及相关指南判断患者二甲双胍使用合理性。结果共收集到2型糖尿病患者2257例,其中使用二甲双胍508例,在使用二甲双胍的患者中,78例患者存在不合理用药情况,不合理率为15.4%,主要不合理用药现象为eGFR<45 ml/(min·1.73 m^(2))患者使用二甲双胍。结论该院2型糖尿病患者使用二甲双胍存在不合理现象,临床医师在日常用药时应仔细阅读药品说明书,并根据说明书中的规定合理用药,注意说明书中的用药禁忌证及用药注意事项,尽量避免禁忌用药的情况。

Objective To investigate the use of metformin in patients with type 2 diabetes in a general hospital,and provides cientific basis for rational use in clinic.Methods We used the PASSpharm Assist to get the patients with type 2 diabetes who were discharged from January 2021 to June 2021.The patients'age,gender,weight,serum creatinine,glycosylated hemoglobin and metformin were recorded,and the glomerular filtration rate was calculated by CKD-EPI formula.Judge the rationality of metformin use in patients in combination with drug instructions and relevant guidelines.Results A total of 2,257 patients with type 2 diabetes were collected,of whom 508 were metformin user.Among the patients who used metformin,there were irrational drug use in 78 patients.The unreasonable rate was 15.4%.The main irrational drug use was metformin in patients with eGFR<45 ml/(min·1.73m^(2)).Conclusion The use of metformin in patients with type 2 diabetes mellitus is unreasonable.Clinicians should read the instructions carefully during daily medication,and make rational use of drugs according to the instructions,pay attention to contraindications and precautions in the instructions,and avoid the use of taboo drugs as far as possible.