临床药师参与我院部分质子泵抑制剂药物点评分析

Analysis of Comments on Medical Orders of Some PPI Drugs from Clinical Pharmacists in Our Hospital

目的对我院注射用雷贝拉唑钠进行专项医嘱点评,减少注射用雷贝拉唑钠的滥用现象,为促进临床合理使用提供依据,进一步完善我院重点监控药物的管理。方法通过临床合理用药软件系统(PASS系统)抽取2021年11月使用注射用雷贝拉唑钠的住院患者病例,依据相关指南和药物说明书进行点评。结果在系统中查看的140份病例中,有39份病例存在不合理,不合理医嘱百分比为27.86%。其中适应证不适宜和用法用量不适宜为不合理医嘱的主要原因,分别占不合理医嘱百分比74.36%和35.90%。结论我院注射用雷贝拉唑使用存在不合理现象,需进一步加强监管,临床药师对不合理使用医嘱进行有效的干预;点评标准也应依据循证学依据及时更新,同时临床药师应改善工作方法,将原来的事后点评工作模式逐步向加强前置审方工作转变,降低不合理医嘱的发生率。

Objective To make comments on special medical orders of rabeprazole sodium for injection,reduce its abuse,provide the basis for its rational use,and further improve the management of key monitoring drugs in our hospital.Methods Prescription automatic screening system(PASS)for clinical rational drug use was adopted to select the inpatients who received rabeprazole sodium for injection in November 2021,and comments were made in accordance with related guides and drug instructions.Results Among the 140 cases chosen in the system,there were 39(27.86%)cases with irrational medical orders.The main reasons of these irrational medical orders were inappropriate indications and improper usage and dosage,which accounted for 74.36%and 35.90%of these irrational medical orders,respectively.Conclusion Through making comments on medical orders,this study found that there was irrational use of rabeprazole sodium for injection in our hospital.Therefore,it is necessary to further strengthen supervision.Clinical pharmacists should perform effective intervention for irrational medical orders.In addition,the criteria for comments should also be timely updated according to evidence-based medicine.Meanwhile,clinical pharmacists should perfect their work methods and transform their primary post-evaluation work pattern gradually into pre-prescription review one,so as to decrease the incidence rate of irrational medical orders.