某院静脉用药调配中心抗肿瘤药物不合理医嘱评价结果分析

Analysis of evaluation results of unreasonable medical orders for antitumor drugs in pharmacy intravenous admixture service of a hospital

目的探讨某院静脉用药调配中心抗肿瘤药物不合理医嘱的原因,根据不合理的原因制定个性化的对策,规范患者合理、安全用药。方法收集某院2023年静脉用药调配中心抗肿瘤药物不合理医嘱的记录共258条,统计这些不合理医嘱的药物种类、科室分布,以及记录不合理医嘱的原因,并采取针对性的措施,减少不合理医嘱。结果统计分析显示,某院2023年静脉用药调配中心抗肿瘤药物不合理医嘱共258张,其中放疗科、肿瘤科、胸外科的不合理医嘱比率占前三位,分别为32.17%、21.71%、20.16%;不合理类型中溶媒选择不合理的占比最高,为43.41%,其次分别为溶媒用量、浓度不合理,用药剂量不合理,用药顺序不合理,配伍不当,其他,占比分别为29.07%、15.50%、5.04%、4.26%、2.71%。112张抗肿瘤药物溶媒选择不合理医嘱中,注射用依托泊苷溶媒选择不合理最多,占比为33.04%。75张抗肿瘤药物溶媒用量、浓度不合理医嘱中,注射用吉西他滨溶媒用量、浓度不合理最多,占比为24.00%。40张抗肿瘤药物用药剂量不合理医嘱中,复方苦参注射液超量使用最多,占比为40.00%。结论评价静脉用药调配中心抗肿瘤药物不合理医嘱发生具体原因,加强合理用药管理,采取针对性的措施,可保障抗肿瘤药物合理应用。

Objective To investigate the causes of unreasonable medical orders for antitumor drugs in the pharmacy intravenous admixture service of a hospital,and to formulate personalized countermeasures according to the unreasonable reasons,so as to standardize rational and safe drug use for patients.Methods A total of 258 records of unreasonable medical orders for antitumor drugs were collected from the the pharmacy intravenous admixture service of a hospital in 2023.The types of drugs and the distribution of departments for the unreasonable medical orders were counted,the reasons for the unreasonable medical orders were analyzed,and targeted measures were taken to reduce the unreasonable medical orders.Results Statistical analysis showed that in 2023,there were 258 unreasonable medical orders for antitumor treatment in the pharmacy intravenous admixture service of a hospital,among which the unreasonable medical orders of radiotherapy department,oncology department and thoracic surgery department accounted for the top three,which were 32.17%,21.71%and 20.16%,respectively,the proportion of unreasonable solvent selection was the highest,43.41%,followed by unreasonable solvent dosage and concentration,unreasonable drug dosage,unreasonable drug sequence,improper compatibility and others,accounting for 29.07%,15.50%,5.04%,4.26%and 2.71%,respectively.Among the 112 medical orders of unreasonable solvent selection of anti-tumor drugs,the improper selection of etoposide solvent for injection was the most,accounting for 33.04%.Among the 75 medical orders of unreasonable solvent dosage and concentration of anti-tumor drugs,the improper use of gemcitabine solvent for injection was the most,accounting for 24.00%.Among the 40 medical orders of unreasonable drug dosage of anti-tumor drugs,the over-use of compound matrine injection was the most,accounting for 40.00%.Conclusion To evaluate the specific causes of unreasonable medical orders of antitumor drugs in the pharmacy intravenous admixture service,strengthen rational drug use management,and take targeted measures can ensure the rational use of antitumor drugs.