某院住院患者使用质子泵抑制剂的调查分析与合理性评价

Analysis and Evaluation of the Proton PumpInhibitors for Clinical Utilization in A Hospital

目的调查分析我院质子泵抑制剂的临床使用实际情况,并对该类药品注射剂处方进行合理性评价,旨在促进临床规范化用药。方法利用药品使用信息系统提取质子泵抑制剂(PPIs)使用数据,对PPIs用药频度(DDDs)、限定日费用(DDC)等指标进行统计分析。用医院处方点评系统,提取使用PPIs注射剂的患者病历信息,回顾性分析PPIs使用情况及合理性。结果我院PPIs注射剂型的DDDs较低,DDC较高,用药金额占比较高,且使用金额排名前十的科室中外科使用量居多。随机抽调进行专项点评的536份住院病例中,不合理使用病例共计224份,不合理病例占比达41.79%,其中无指征用药病例占比32.28%,主要为外科预防应激性溃疡无指征用药,用法用量不合理病例占比6.34%,给药疗程不合理病例占比4.29%。结论PPIs注射剂的临床使用存在无指征用药、特殊人群用药超剂量给药、溶媒配伍不合理、给药疗程过长等不恰当用药,临床药师应结合科室用药特点加强精准干预,进一步规范PPIs的临床使用。

Objective This study aimed to investigate the actual clinical use of proton pump inhibitors(PPIs)in our hospital,and to evaluate the rational use of injectable PPI prescriptions,so as to promote standardized clinical use of PPIs.Methods The use data of PPIs were extracted from the drug use information system,and the defined daily doses(DDDs)and defined daily cost(DDC)of PPIs were statistically analyzed.The medical records of patients who received injectable PPIs were extracted from the hospital prescription review system.The use of PPIs and its rationality were retrospectively analyzed.Results The DDDs of injectable PPIs in our hospital were relatively low and the DDC was high,indicating the amount of drug consumption was high.Most of the top 10 departments in terms of consumption amount were surgical departments.Among the 536 hospitalized cases randomly selected for special review,224 cases were inappropriate use of PPIs,accounting for 41.79%.Thereinto,32.28%were unindicated drug use,mainly for the surgical prevention of stress ulcer,6.34%were irrational usage and dosage,and 4.29%were unreasonable course of drug administration.Conclusion In the clinical use of injectable PPIs,there were some irrational use,such as unindicated requisitions,excessive dosage for special populations,unreasonable solvent compatibility,and long course of drug administration.Clinical pharmacists should strengthen precise intervention based on the characteristics of department medication,and further standardize the clinical use of PPIs.