门诊眼科处方超说明书用药的原因及对策分析

Analysis of causes and countermeasures of off-label drug use in outpatient ophthalmic prescription

目的 分析本院门诊眼科处方超说明书用药的原因,并制定相应对策。方法 利用整群抽样法收集2450张门诊眼科患者处方,其中超说明书用药干预前处方1230张、干预后处方1220张。分析干预前后超说明书处方情况,并对比干预前后超说明书处方占比。结果 干预前的1230张处方中超说明书处方116张,其中超用药适应证处方52张(4.23%),超单次给药剂量处方19张(1.54%),超给药频次处方19张(1.54%),超用药途径处方15张(1.22%),其他处方11张(0.89%)。干预后的1220张处方中超说明书处方7张,其中超用药适应证处方4张(0.33%),超单次给药剂量处方1张(0.08%),超给药频次处方2张(0.16%)。干预前超说明书处方占比为9.43%(116/1230),干预后超说明书处方占比为0.57%(7/1220),干预后超说明书处方占比显著低于干预前,差异具有统计学意义(P<0.05)。结论 通过对门诊眼科处方超说明书用药的原因实施必要分析,明确其产生的原因,并制定以及落实对应措施,可减少超说明书用药。

Objective To analyze the causes of off-label drug use in outpatient ophthalmic prescription and formulate corresponding countermeasures.Methods A total of 2450 prescriptions were collected by cluster sampling,including 1230 prescriptions before and 1220 prescriptions after intervention for off-label drug use.The off-label prescriptions before and after intervention were analyzed,and the proportion of off-label prescriptions before and after intervention was compared.Results Among 1230 prescriptions before intervention,116 prescriptions were off-label,including 52 prescriptions(4.23%)were over indications,19 prescriptions(1.54%)were over single dose,19 prescriptions(1.54%)were over frequency of administration,15 prescriptions(1.22%)were over route of administration,and 11 prescriptions(0.89%)were others.Among the 1220 prescriptions after intervention,7 were off-label prescriptions,among which 4 prescriptions(0.33%)were over indications,1 prescription(0.08%)was over single dose,and 2 prescriptions(0.16%)were over frequency of administration.The proportion of off-label prescriptions before intervention was 9.43%(116/1230),and that after intervention was 0.57%(7/1220).The proportion of off-label prescriptions after intervention was significantly lower than that before intervention,and the difference was statistically significant(P<0.05).Conclusion Through the necessary analysis of the causes of off-label drug use in outpatient ophthalmic prescriptions,the causes of off-label drug use can be clarified,and corresponding measures can be formulated and implemented to reduce off-label drug use.