基于Granada-Ⅱ分类法评价艾多沙班用于住院患者的药物相关问题

Evaluation of drug-related problems in the use of edoxaban for inpatients based on Granada-Ⅱclassification method

目的探讨我院住院患者使用艾多沙班的药物相关问题(Drug-related problems,DRPs),为临床合理使用艾多沙班提供参考。方法通过医院信息系统抽取2023年7-12月我院收治的使用艾多沙班的全部住院病历,共534份,以说明书为主要依据,结合相关指南和权威文献,建立艾多沙班临床使用评价标准,采用Granada-Ⅱ分类法,从必要性、有效性和安全性3个方面对临床使用艾多沙班的DRPs进行评价。结果抽取的534份住院病历中,存在DRPs的有473例(占88.58%),累计发生DRPs 741次,人均发生DRPs 1.7次。按照Granada-Ⅱ分类法的分类原则,其中必要性问题(DRP2)348次,有效性问题(DRP3+DRP4)121次,安全性问题(DRP5+DRP6)272次。DRPs主要为骨科(尤其是关节专科和创伤骨科)患者静脉血栓栓塞症(VTE)预防无适应证和预防疗程偏长。结论我院住院患者使用艾多沙班的DRPs主要是必要性问题和安全性问题,应采取相关干预措施,促进其临床合理使用。

Objective To explore the drug-related problems(DRPs)in the use of edoxaban for inpatients in our hospital,and provide references for the rational use of edoxaban in clinical practice.Methods A total of 534 medical records of inpatients using edoxaban admitted to our hospital from July to December 2023 were extracted from hospital information system.Based mainly on the instructions and referring to relevant guidelines and authoritative literature,evaluation criteria for the clinical use of edoxaban were established.The Granada-Ⅱclassification method was used to evaluate the DRPs in the clinical use of edoxaban from three aspects:necessity,effectiveness,and safety.Results Among the 534 extracted medical records of inpatients,473(88.58%)had DRPs,with a cumulative occurrence of 741 DRPs and an average of 1.7 DRPs per person.According to the classification principles of the Granada-Ⅱclassification system,there were 348 necessity problems(DRP2),121 effectiveness problems(DRP3+DRP4),and 272 safety problems(DRP5+DRP6).DRPs were mainly for VTE prevention without indications and with longer prevention courses in department of orthopedics(especially in department of joint specialties and trauma orthopedics).Conclusion The DRPs in the use of of edoxaban by inpatients in our hospital is mainly a matter of necessity and safety,and relevant intervention measures should be taken to promote its rational clinical use.