某院2020年1月至2021年6月重点监控药品临床应用分析

Clinical Application of Key Monitored Drugs in a Hospital from January 2020 to June 2021

目的了解某院重点监控药品的临床应用及监管情况。方法从医院药品信息库中调取2020年1月至2021年6月某院全院药品使用数据,对每月使用金额排名前10的重点监控药品,从不同科室随机抽取30份病例,参照《北京市医疗机构处方专项点评指南(试行)》和《中成药临床合理用药处方点评北京共识》进行处方专项点评。结果使用金额排名前10的重点监控药品包括银杏内酯注射剂、注射用盐酸罂粟碱、丁苯酞氯化钠注射剂、盐酸倍他司汀注射剂(5 mL)等,这10种药品使用金额占全院药品使用总金额的4.47%,占重点监控药品使用总金额的79.22%。共抽取4178份病例,涉及血栓一科、血栓二科、神经内科等科室,处方合理率为71.42%,不合理用药主要体现在适应证不适宜、用法用量不适宜、重复给药、有配伍禁忌或不良相互作用等方面。结论该院重点监控药品的处方合理率不容乐观,后续应持续加强及改进。

Objective To analyze the clinical application and supervision of key monitored drugs in a hospital.Methods The drug use data of the hospital from January 2020 to June 2021 were retrieved from the hospital information system(HIS).For the top 10 key monitored drugs in terms of monthly cost,30 cases of each drug were randomly selected from different departments,and the special evaluation of prescriptions was carried out according to the Guidelines for Special Evaluation of Prescriptions in Beijing Medical Institutions(Trial Implementation)and the Expert Consensus on Prescription Comment of Chinese Traditional Patent Medicine for Promoting the Rational Use of Drugs in Beijing.Results The top 10 key monitored drugs in terms of cost included Ginkgolide Injection,Papaverine Hydrochloride for Injection,Butylphthalide Sodium Chloride Injection,Betalastine Hydrochloride Injection(5 mL),etc.The cost of these 10 drugs accounted for 4.47% of the total cost of drugs used in the hospital and 79.22% of the total cost of key monitored drugs.A total of 4178 cases were selected,involving the Department of Thrombosis Ⅰ,Department of Thrombosis Ⅱ,Department of Neurology and other departments.The qualification rate of the prescriptions was 71.42%.Irrational drug use mainly included inappropriate indications,inappropriate usage and dosage,repeated administration,incompatibility or adverse drug interactions.Conclusion The rational use rate of key monitored drugs in the hospital are not optimistic,which should be continuously strengthened and improved in the follow-up.