某院唑来膦酸用药合理性评价

Evaluation on the rationality of the application of zoledronic acid in a hospital

目的对云南省第一人民医院唑来膦酸的使用情况进行专项点评和分析,利用处方及医嘱开展专项点评,制定医院唑来膦酸点评标准,为规范合理的使用唑来膦酸提供参考依据,发挥药师在实施药物治疗管理和处方医嘱点评中的作用。方法通过医院临床药学管理系统和电子病历系统查找2021年1—6月使用唑来膦酸的全部用药医嘱,使用4 mg唑来膦酸出院病历318份,使用5 mg唑来膦酸出院病历220份,共538份。从适应证、禁忌证、用药前检查、用药前准备、使用方式、给药频率及联合用药情况进行点评和分析,判断其用药合理性。结果共点评使用4 mg唑来膦酸出院病历318份,其中不合理病历143份,不合理率为44.97%。共点评使用5 mg唑来膦酸出院病历220份,其中不合理病历38份,不合理率为17.27%。主要不合理情况为超说明书用药、用药前准备不完善、联合用药不合理、使用方式不规范、存在用药禁忌证及给药频率不适宜等。结论抽查医院唑来膦酸的使用存在较多不合理问题,医院应加强对唑来膦酸合理用药知识的培训和唑来膦酸使用情况的监督。

Objective Make special comments and analysis on the use of zoledronic acid in the First People′s Hospital of Yunnan Province,and carry out special comments using prescriptions and medical orders.Formulate hospital zoledronic acid evaluation standards,provide reference basis for the standardized and reasonable use of zoledronic acid,and play the role of pharmacists in the implementation of drug treatment management and prescription doctor′s order evaluation.Methods Through the clinical pharmacy management system and electronic medical record system in the hospital,all medical orders for the use of zoledronic acid from January to June 2021 were searched.Among them,318 discharged medical records of 4 mg zoledronic acid and 220 discharged medical records of 5 mg zoledronic acid,a total of 538.From the aspects of indications,contraindications,pre-medication examination,pre-medication preparation,mode of use,frequency of administration and combined medication,the rationality of medication of zoledronic acid was judged.Results A total of 318 discharged medical records related to the use of 4 mg zoledronic acid were reviewed,including 143 unreasonable medical records,with an unreasonable rate of 44.97%.A total of 220 discharged medical records related to the use of 5 mg zoledronic acid were reviewed,including 38 unreasonable medical records,with an unreasonable rate of 17.27%.The main unreasonable conditions are drug use beyond the instructions,incomplete preparation before drug use,unreasonable combination of drug use,nonstandard use method,contraindication of drug use,and inappropriate frequency of drug administration.Conclusion There are many unreasonable problems in the use of zoledronic acid in the selected hospitals.The hospital should strengthen the relevant training on the rational use of zoledronic acid and the supervision on the use of zoledronic acid.