某院药品不良反应报告的特点及对策研究

Investigation of characteristics and countermeasures of adverse drug reactions reported in a hospital

目的了解重庆市开州区人民医院(我院)药品不良反应(ADR)报告的情况及其特点,为减少ADR的患者危害、保障其用药安全提供参考依据。方法收集我院2017年1月至2021年6月的442例ADR报告,采用Excel软件将患者的性别、年龄、既往史、家族史、药品信息、给药途径、累及系统/器官情况及临床表现、不良反应转归及评价、报告人职业等数据进行统计分析。结果442例ADR报告中,一般的ADR报告360例,严重的ADR报告41例,新的一般的报告33例,新的严重的报告8例;其中,门诊患者ADR报告数远低于住院患者ADR报告数;男女性别比为0.83∶1;≥61岁的老年患者是ADR发生的主要人群,共195例(44.12%);ADR报告主要由静脉给药途径引起的,共318例(71.95%);由抗微生物药物引起的ADR报告113例(25.57%),抗肿瘤药物引起的ADR报告78例(17.65%);涉及皮肤及其附件损害的ADR报告最多,为175例(39.59%);经治疗后ADR结局为痊愈100例(22.62%);好转319例(72.17%)。结论临床医务人员应重点监控特殊人群用药,谨慎选择给药途径,加强抗微生物药物、抗肿瘤药物的ADR监测。

Objective To understand the situation and characteristics of adverse drug reactions(ADR)reported in the People’s Hospital of Kaizhou District of Chongqing,so as to provide a reference basis for reducing the harm to patients in ADR and ensuring their medication safety.Methods A total of 442 cases of ADR reports in our hospital from January 2017 to June 2021 were collected.The data of gender,age,medical history,family history,drug information,route of administration,system/organ involvement and clinical manifestations,ADR outcome and evaluation,and reporter’s occupation in patients were statistically analyzed with Excel software.Results In the 442 ADR reports,there were 360 ordinary ADR reports,41 serious ADR reports,33 new ordinary reports and 8 new serious reports.Among them,the number of ADR reports of outpatients was much lower than that of inpatients;the ratio of male to female was 0.83∶1;the elderly patients with age≥61 years old were the main population of ADR occurrence,with a total of 195 cases(accounting for 44.12%).ADR reports were mainly caused by intravenous route of administration,with a total of 318 cases(accounting for 71.95%).There were 113 cases(accounting for 25.57%)of ADR reports caused by antimicrobial drugs and 78 cases(accounting for 17.65%)of ADR reports caused by antineoplastic drugs.ADR reports involving skin and its accessories were the most frequent,with a total of 175 cases(accounting for 39.59%).After treatment,100 cases(accounting for 22.62%)of ADR outcomes were recovered;319 cases(accounting for 72.17%)of ADR outcomes were relieved.Conclusion Clinical medical staff should focus on monitoring the medications of special populations,carefully choose the route of administration,and strengthen the ADR monitoring of antimicrobial drugs and antitumor drugs.