静脉用抗肿瘤药不合理应用及干预方式分析

Analysis of unreasonable application and intervention of intravenous antineoplastic drugs

目的分析静脉用抗肿瘤药不合理应用及干预方式。方法抽取13285张静脉用抗肿瘤药方,根据药品说明书、工具书、参考文献等资料对其中的不合理用药医嘱进行分类,然后分析不合理用药占比和更正医嘱占比。分析药师干预前后的变化,并统计静脉用抗肿瘤药不合理医嘱数量和不合理用药类型。结果 (1)统计2016~2018年静脉用抗肿瘤药不合理医嘱数量,共13285张静脉用抗肿瘤药物的医嘱,其中不合理用药的医嘱共265张、占1.99%,更正医嘱共204张、占76.98%。(2)统计2016~2018年静脉用抗肿瘤药不合理用药类型,主要包括溶剂选用不当、溶剂用量不当、给药频次不当、给药途径错误、配伍禁忌、给药顺序不当、执行医嘱错误,其中占比最高的类型为溶剂选用不当(39.62%),最低的类型为执行医嘱错误(1.13%)。结论静脉药物配置中心对抗肿瘤药物的使用进行规范干预,可以有效地提高抗肿瘤药物的合理使用率和安全程度,从而减少抗肿瘤药物不合理使用事件和用药成本。

Objective To analyze the unreasonable application and intervention of intravenous antitumor drugs.Methods 13285 intravenous antineoplastic prescription were selected and classified according to drug instructions,reference books and other materials.Then the proportion of irrational drugs and corrected orders were analyzed.The changes before and after intervention of pharmacists was analyzed,and the number of irrational orders and types of irrational use of intravenous antineoplastic drugs was counted.Results(1)The number of unreasonable medical orders for intravenous antineoplastic drugs in 2016~2018 was counted.There were 13285 medical orders for intravenous antineoplastic drugs,including 265 unreasonable orders,accounting for 1.99%,and 204 corrected orders,accounting for 76.98%.(2)The types of irrational use of intravenous antineoplastic drugs in 2016~2018 were analyzed,including improper selection of solvents,improper dosage of solvents,improper frequency of administration,wrong route of administration,incompatibility,improper order of administration and wrong execution of doctor’s orders.Among them,improper selection of solvents accounted for the highest proportion(39.62%)and wrong execution of doctor’s orders accounted for the lowest proportion(1.13%).Conclusion Regular intervention of pharmacy intravenous admixture services in the use of antineoplastic drugs can effectively improve the rational use rate and safety of antineoplastic drugs,thereby reducing irrational use events and drug cost of antineoplastic drugs.