大黄[庶虫]虫胶囊临床合理用药评价标准的探索及应用

Exploration and application of the evaluation criterion for the clinical rational use of Dahuang Zhechong Capsule

目的探讨大黄[庶虫]虫胶囊临床合理性用药的评价依据,建立其合理用药评价标准,促进临床合理用药。方法参考药品说明书、治疗指南、文献资料等,制定大黄[庶虫]虫胶囊临床合理用药评价标准。根据制定的标准,对中国中医科学院西苑医院2020年1—6月使用大黄[庶虫]虫胶囊的270份门诊处方进行评价,对其适应证、用法用量、联合用药、重复用药等方面进行专项点评,并针对评价发现的问题进行药学干预,然后对2020年10月使用大黄[庶虫]虫胶囊的328份门诊处方进行再次评价。结果2020年1—6月使用大黄[庶虫]虫胶囊的门诊处方用药不合理率为42.22%(114例),其中适应证不适宜有108例(占40%),用法用量不适宜5例(占1.85%),给药途径不适宜1例(占0.37%)。经药学干预,2020年10月再次评价门诊处方,用药不合理率明显降低(4.27%,14例),均为适应证不适宜。结论门诊使用大黄[庶虫]虫胶囊的处方存在一定问题,建立大黄[庶虫]虫胶囊临床合理用药评价标准切实可行。依据合理用药评价标准进行处方专项点评,可发现临床不合理用药的具体情况,从而加强对临床用药的管理,并促进合理用药的宣传和监管。

Objective To discuss the evaluation basis of the clinical rational use of Dahuang Zhechong Capsule and to establish its rationality evaluation criterion to promote the sensible use of Dahuang Zhechong Capsule.Methods The rationality evaluation criterion for Dahuang Zhechong Capsule was formulated by referring to the package insert,treatment guidelines,and other literature.According to the criterion,270 outpatient prescriptions using Dahuang Zhechong Capsule in Xiyuan Hospital,China Academy of Chinese Medical Sciences were reviewed from January to June 2020.The indication,usage and dosage,drug combination,and repeated administration were analyzed.The pharmaceutical intervention was performed to address the problems found in the prescription reviews,and 328 outpatient prescriptions using Dahuang Zhechong Capsule in October 2020 were reevaluated.Results The irrational use rate of Dahuang Zhechong Capsule from January to June 2020 was 42.22%(114 cases),including 108(40%)cases of inappropriate indications,five(1.85%)cases of improper usage and dosage,and one(0.37%)case of inappropriate administration route.However,the pharmaceutical intervention in October 2020 remarkably reduced the irrational use rate of Dahuang Zhechong Capsule(4.27%,14 cases),all of which were inappropriate indications.Conclusion Dahuang Zhechong Capsule is being used irrationally;therefore,establishing an evaluation criterion is required.The specific situation of irrational drug use can be identified by prescription review according to its rationality evaluation criterion to manage its clinical use better and promote its rational use.