中药临床药师在规范骨科中成药超说明书用药中的作用探讨

The role of clinical pharmacists of traditional Chinese medicine in regulating off-label use of proprietary Chinese medicine in orthopedics

目的探讨中药临床药师在规范骨科中成药超说明书用药中的作用。方法采取横断面法,将本院2020年7月~2020年12月在骨科使用活血化瘀类中成药治疗的295例患者作为对照组,另将2021年1月~2021年6月在骨科使用活血化瘀类中成药治疗的241例患者作为观察组。对照组采取常规药学干预用药,观察组在常规药学干预基础上由中药临床药师规范骨科中成药超说明书用药。对比两组患者超说明书用药发生率、药品种类、主要存在问题类型及其发生情况、中成药费用。结果观察组超说明书用药发生率56.43%低于对照组的75.25%,超说明书用药药品种类及主要存在问题类型均少于对照组。观察组超功能主治(54.36%)、超疗程(2.07%)、超说明书溶媒(0)发生率均低于对照组(73.22%、15.93%、11.53%)(P<0.05)。观察组中成药总费用(155281.93±1742.31)元及人均中成药费用(644.32±92.34)元均少于对照组的(291945.34±2314.06)、(989.65±121.64)元(P<0.05)。结论中药临床药师通过在常规药学干预基础上规范了骨科中成药超说明书用药行为,降低了医疗风险,保障了患者用药安全和医师权益。

Objective To explore the role of clinical pharmacists of traditional Chinese medicine in regulating off-label use of proprietary Chinese medicine in orthopedics.Methods The cross-sectional method was adopted,295 patients using proprietary Chinese medicines for promoting blood circulation and removing blood stasis from July to December 2020 were selected as the control group,and 241 patients using proprietary Chinese medicines for promoting blood circulation and removing blood stasis from January to June 2021 as the observation group.The control group was given conventional pharmaceutical intervention,and the observation group was medicated on the basis of conventional pharmacological interventions by a clinical pharmacist of traditional Chinese medicine who regulated off-label use of proprietary Chinese medicine in orthopedics.The incidence of off-label drug use,types of drugs,major problem types and their occurrence,and cost of proprietary Chinese medicine of the two groups were compared.Results The incidence of off-label drug use in the observation group was 56.43%,which was lower than 75.25%in the control group,and the types of off-label use of drugs and major problem types were less than those in the control group.The incidence of superfunctional indications(54.36%),supercourse(2.07%)and off-specification solvents(0)in the observation group was lower than those in the control group(73.22%,15.93%and 11.53%)(P<0.05).The total cost of proprietary Chinese medicine in the observation group was(155,281.93±1742.31)yuan and the per capita cost of proprietary Chinese medicine was(644.32±92.34)yuan,which were less than(291945.34±2314.06)and(989.65±121.64)yuan in the control group(P<0.05).Conclusion Clinical pharmacists of traditional Chinese medicine can regulate off-label use of proprietary Chinese medicine in orthopedics through pharmaceutical intervention,reduce medical risks,and protect patients'medication safety and doctors'rights and interests.