某院普瑞巴林临床应用情况分析

Analysis of the clinical application of pregabalin in a hospital

目的规范普瑞巴林的临床应用。方法利用某院合理用药系统(PASS),分别调阅2022年1月~12月门诊和住院使用普瑞巴林的处方(1397张)和医嘱(322条),统计其临床使用情况并逐一进行点评。结果使用普瑞巴林的患者多为中老年人,门诊的女性患者较病区多,全院使用率最高的科室是神经内科。点评结果显示普瑞巴林使用不合理情况:门诊处方172张(12.31%),病区医嘱62条(19.25%),主要集中在适应证不适宜和用法用量不合理,门诊还存在临床诊断书写不规范和重复用药的现象。超适应证用药情况:门诊579例(41.45%),病区191例(59.32%),主要是普瑞巴林用于治疗各种疾病伴发的周围性和中枢性神经病理性疼痛、焦虑症、癫痫、不宁腿综合征等,但超说明书用药管理不佳。结论某院使用普瑞巴林的合理性尚可,超适应证用药情况普遍,但超说明书用药管理并不到位。临床医师应按规范开具处方和医嘱,临床药师严格事前审方和事后点评,协助医院落实超说明书用药管理,促进临床规范用药。

Objective Standardize the clinical application of pregabalin.Methods Using the rational drug use system(PASS)of our hospital,the outpatient prescriptions(1397)and ward doctor's orders(322)of pregabalin from January to December 2022 were retrieved,and their clinical use was counted and reviewed one by one.Results Most of the patients using pregabalin were middle-aged and elderly,there were more female patients in the outpatient clinics than in the ward,and the department with the highest utilization rate in the hospital was neurology.The results of the pregabalin review showed that 172(12.31%)of unreasonable prescriptions were used in outpatient clinics,and 62(19.25%)of medical orders were used in wards.The unreasonable use mainly focuses on inappropriate indications and unreasonable usage and dosage,and there were still irregularities in clinical diagnosis writing and repeated medication in outpatient clinics.Off-label drug use:579 patients(41.45%)in outpatient clinics and 191 patients(59.32%)in wards,mainly using pregabalin to treat peripheral and central neuropathic pain associated with various diseases,anxiety,epilepsy,restless leg syndrome and so on,but off-label medication management was not in place.Conclusion The use of pregabalin in our hospital is reasonable,off-label medication is common,but off-label drug use management is not in place.Clinicians should issue prescriptions and medical orders in accordance with specifications,and clinical pharmacists should strictly review prescriptions beforehand and make comments afterwards,assist hospitals in implementing off-label drug use management,and promote clinical standardization of drug use.