基于PIVAS医嘱管理与审核下质子泵抑制剂的合理用药对比分析

Comparative analysis of rational medication of Proton Pump Inhibitors based on PIVAS medical order management and audit

目的静脉用药调配中心(Pharmacy intravenous admixture service,PIVAS)联合相关部门,通过实施医嘱管理与审核全面推进提升质子泵抑制剂(Proton Pump Inhibitors,PPIs)临床合理应用水平,为质子泵抑制剂合理用药提供参考。方法构建由PIVAS联合各相关部门实施的医嘱管理与审核模式,调取2019年下半年(对照组)的6379份及2020年下半年(观察组)的3449份使用质子泵抑制剂的患者病历,采集患者的相关用药信息,从质子泵抑制剂的使用情况、费用情况、合理用药方面进行评价和对比分析。结果医嘱管理与审核前后,静脉用质子泵抑制剂使用天数方面,对照组的平均使用天数为(5.90±5.011)d,观察组的平均使用天数为(5.73±5.325)d,两组患者的静脉用质子泵抑制剂使用天数差异无统计学意义(P>0.05)。对照组患者的平均住院天数为(10.59±9.228)d,观察组患者的平均住院天数为(10.24±10.026)d,两组患者的住院天数差异无统计学意义(P>0.05)。对照组的次均费用为8369.62元,观察组的次均费用为7792.05元,两组患者的次均费用差异具有统计学意义(P<0.05)。对照组存在不合理用药占对照组总人数的81.55%,观察组存在不合理用药占观察组总患者数的38.27%,实施医嘱管理与审核前后两组的不合理情况比较,差异具有统计学意义(P<0.05)。结论针对质子泵抑制剂临床用药出现的问题,PIVAS联合各相关部门实施医嘱管理与审核,对促进质子泵抑制剂合理应用有积极影响,同时有效节约药品资源和医保资金,降低医疗成本,最终达到安全、有效、经济、合理的治疗目的,但有些环节仍需进一步完善。

Objective The pharmaceutical intravenous admixture service(PIVAS)cooperates with relevant departments to comprehensively promote and improve the clinical rational application level of proton pump inhibitors(PPIs)through the implementation of medical order management and audit,so as to provide reference for the rational use of proton pump inhibitors.Methods 6379 medical records of patients using proton pump inhibitors in the second half of 2019(control group)and 3449 in the second half of 2020(the observation group)were obtained from the medical order management and audit mode built and implemented by PIVAS and all relevant departments to collect relevant drug information and evaluat and analyze the use of proton pump inhibitors,cost and rational drug use.Results Overall,in terms of the number of days of proton pump inhibitors for injection,the control group was(5.90±5.011)d,(5.73±5.325)d in the observation group with no significant difference in injection proton pump inhibitors between the two groups(P>0.05).The time of hospitalization in the control group was(10.59±9.228)d,and(10.24±10.026)d in the observed group with no statistically difference between the two groups(P>0.05).The mean cost was ¥8369.62 in the control group,¥7792.05 in the observation group with significantly different between the two groups(P<0.05).Improper medication accounted for 81.55% of the total number of in the control group,38.27% of the total number of patients in the observation group,and significant differences between the two groups before and after the intervention(P<0.05).Conclusion For the problems of clinical use of the protons pump inhibitors,PIVAS combined with relevant departments implemented medical advice management and review,which has a positive impact on promoting proton pump inhibitors.At the same time,it will effectively save drug resources and medical insurance funds and reduce medical costs.Finally,to achieve the purpose of safe,effective,economic and reasonable treatment,it is of positive and important significance for rational drug use,but some links still need to be further improved.