基于合理用药系统的药物滥用主动监测及人群特征分析

Active drug abuse monitoring and population characteristics analysis based on rational drug use system

目的探索利用美康合理用药系统开展药物滥用主动监测的方法,并分析药物滥用的人群特征。方法利用美康合理用药系统制订主动监测方案,利用其大处方分析功能,统计2021年7月1日至2022年7月1日门(急)诊患者多次就诊并开具重点监测药物的情况,对可疑滥用药物患者回顾性分析其既往病史、用药史,结合患者随访确定药物滥用情况。结果在纳入研究的580病例中,可疑依赖患者252例,经病历回顾和患者随访后确定药物滥用0例、药物依赖113例,其中男性52例(46.0%)、女性61例(54.0%);药物依赖患者的年龄为(64.1±15.1)岁,年龄>65岁的共58例(51.3%),40-65岁的共46例(40.7%),年龄≤40岁的共9例(8.0%);合并慢性疾病的有63例(55.8%)。依赖药物有阿普唑仑56例(49.6%)、地西泮7例(6.2%)、佐匹克隆3例(2.7%)、氨酚双氢可待因2例(1.8%)、氯硝西泮2例(1.8%),2种及以上药物依赖的有43例(38.1%);82例(72.6%)用药1-3年,27例(23.9%)用药3-6年,4例(3.5%)用药10年以上。结论利用美康合理用药系统可进行药物滥用主动监测,药物滥用预警率高,较传统报送模式优势明显。药物依赖以女性多见,发生时间大多在用药1-3年之内,年龄>65岁、合并有慢性疾病的患者更容易发生药物依赖。

AIM To explore a method of active drug abuse monitoring utilizing the Meikang rational drug use system and analyze the population characteristics of drug abuse patients.METHODS The active monitoring plan was formulated with the Meikang rational drug use system,and the major prescription analysis function was used to make statistics on the multiple visits of outpatient(emergency)patients to prescribe key monitored drugs from July 1,2021 to July 1,2022.The past medical history and drug use history of patients suspected of drug abuse were retrospectively studied,and the diagnosis of drug abuse was determined combined with patient follow-up.RESULTS Among the 580 cases included in the study,252 patients were suspected of dependence,and 0 cases of drug abuse and 113 cases of drug dependence were identified after medical history review and follow-up,of which 52 cases(46.0%)were male and 61 cases(54.0%)were female.The age of patients with drug dependence was(64.1±15.1)years old,with 58 cases(51.3%)aged more than 65 years old,46 cases(40.7%)aged from 40 to 65 years old,and 9 cases(8.0%)aged≤40 years old.There were 63 cases(55.8%)with chronic diseases.There were 56 patients(49.6%)dependent on alprazolam,7 patients(6.2%)dependent on diazepam,3 patients(2.7%)dependent on zopiclone,2 patients(1.8%)dependent on paracetamol dihydrocodine,2 patients(1.8%)dependent on clonazepam,and 43 patients(38.1%)dependent on two or more drugs.82 cases(72.6%)were treated for 1 to 3 years,27 cases(23.9%)for 3 to 6 years,and 4 cases(3.5%)for more than 10 years.CONCLUSION Meikang rational drug use system can be used for active monitoring of drug abuse.The early warning rate of drug abuse is high,which has obvious advantages over traditional reporting mode.Drug dependence is more common in women,the occurrence time is mostly within 1 to 3 years of drug use.It is more likely to develop drug dependence for patients who is older than 65 years old with co-existing chronic diseases.