阿哌沙班药物利用评价标准建立和应用

Establishment and Application of Drug Use Evaluation Criteria for Apixaban

目的:建立阿哌沙班药物利用评价(DUE)标准,为临床合理使用阿哌沙班提供参考依据。方法:参考阿哌沙班药品说明书,以及相关指南和文献,采用德尔菲法,从用药指征、用药过程和用药效果等方面建立DUE标准。采用回顾性调查方法,对龙岩市第二医院2021年1~12月使用阿哌沙班的住院患者病历,根据所建立的DUE标准进行用药合理性评价。结果:共纳入501例患者,完全符合评价标准的合理率为28.94%。不合理用药主要为:超说明书用药331例(66.07%)和剂量偏小122例(24.35%),同时存在42例(8.38%)高风险联合用药。共发生27例(5.39%)药品不良反应,其中22例为出血事件,3例为药疹,2例为肝功能异常。结论:建立的阿哌沙班DUE标准有较强的科学性、实用性和可操作性。阿哌沙班在超说明书、用法用量及患者出院用药教育管理方面应加以改善,确保患者用药安全有效。

Objective:To establish the drug use evaluation(DUE)criteria of apixaban,and provide a reference for clinical rational-use of apixaban.Methods:Referring to the apixaban drug domestic instructions and relevant guidelines&literature,through Delphi method,DUE criteria was established for indications,process and effect of medication.A retrospective survey was adopted to evaluate the rationality of medication according to DUE criteria established through the medical records of inpatients using apixaban from January 2021 to December 2021 in the Second Hospital of Longyan.Results:A total of 501 records of inpatients were included,with the rationality of completely meeting the evaluation criteria was 28.94%.The irrational drug use was as follows:off-label medications were 331 records(66.07%),low doses were 122 records(24.35%),and there was a high risk of 42 records(8.38%)combination drug use.There were 27 records(5.39%)of adverse drug reactions,including 22 records of bleeding event,3 records of drug eruption,2 records of abnormal liver function.Conclusion:The DUE criteria of apixaban established is more scientific,practical and feasible.Apixaban should be further improved in off-label medication,Usage&dosage and education&management of drug-use in discharged patients,to ensure the safety and effectiveness of medications for patients.