某院2021年至2023年注射用卡瑞利珠单抗使用情况分析

Use of Camrelizumab for Injection in a Hospital from 2021 to 2023

目的为临床合理使用注射用卡瑞利珠单抗提供参考。方法通过美康合理用药系统、北京嘉和电子病历系统、医院信息系统提取浙江大学医学院附属第二医院歙县分院2021年1月至2023年12月使用注射用卡瑞利珠单抗的患者的资料,建立注射用卡瑞利珠单抗药物利用评价(DUE)标准,据此分析并统计不合理医嘱类型。结果共收集患者313例,其中男(243例、77.64%)多于女(70例、22.36%);年龄33~93岁,以>65岁者居多(189例,60.38%)。医嘱1615份,主要集中在肿瘤内科(1378份、85.33%),主要用于治疗肝细胞恶性肿瘤(441份、27.31%)和食管恶性肿瘤(437份、27.06%)。不合理医嘱类型主要为用药前无基因检测(106份、6.56%),适应证不合理(83份、5.14%),用药剂量信息不全(10份、0.62%),输注顺序不合理(7份、0.43%),且除用药剂量信息不全类型外,肿瘤内科其余3类不合理医嘱占比与非肿瘤内科均有显著差异(P<0.05)。结论该院注射用卡瑞利珠单抗临床用药基本合理,但临床医师仍需加强对药品说明书或权威性循证医学证据的掌握,药师需加强医嘱实时审核,医院应强化质控信息化建设,促进合理用药。

Objective To provide a reference for the rational use of Camrelizumab for Injection in clinical practice.Methods The data of patients who used Camrelizumab for Injection in the Shexian Branch of the Second Affiliated Hospital,Zhejiang University School of Medicine from January 2021 to December 2023 were extracted by the PASSPharmAssist,GOODWILL Electronic Medical Record System and Hospital Information System.The drug use evaluation(DUE)criteria for Camrelizumab for Injection was formulated,on this basis,the types of irrational medical orders were analyzed.Results A total of 313 patients were collected,with more males(243 cases,77.64%)than females(70 cases,22.36%),aged in the range of 33-93 years,with the majority being over 65 years(189 cases,60.38%).Medical orders(1615 ones)mainly involved medical oncology department(1378 orders,85.33%);Camrelizumab for Injection was mainly used to treat hepatocellular malignancy(441 orders,27.31%)and esophageal malignancy(437 orders,27.06%).The main types of irrational medical orders were no gene test before medication(106 orders,6.56%),inappropriate indications(83 orders,5.14%),incomplete information on dosage(10 orders,0.62%),and inappropriate infusion sequence(seven orders,0.43%);the proportion of medical orders with the above irrationalities except incomplete information on dosage in medical oncology department was significantly different from that in non-medical oncology department(P<0.05).Conclusion The clinical use of Camrelizumab for Injection in this hospital is generally rational.However,clinical physicians still need to strengthen their knowledge of drug instructions or authoritative evidence-based medical evidence,pharmacists need to strengthen the real-time review of medical orders,and the hospital should strengthen the information construction of quality control to promote the rational drug use.