萍乡市氨溴索药物使用多中心回顾性研究与循证药学评价

Multicenter Retrospective Study and Evidence-based Pharmaceutical Evaluation of Ambroxol Drug Use in Pingxiang City

目的:多中心回顾性研究萍乡市氨溴索药物超说明书使用情况,为循证评价其临床中超说明书给药的合理性,为规范化管理提供依据。方法:回顾性纳入2015年8月-2017年8月萍乡市3家公立综合医院使用氨溴索的全部门诊处方与住院医嘱,将药品说明书作为标准,统计各科室用药情况,并计算各科室的药物利用指数(DUI)、处方日剂量(PDD),分析超说明书用药发生率,评价超用药程度。结果:共纳入使用氨溴索药物总例次84 937例,各科室均有超说明书用药情况,发生率为23.79%(20 206/84 937),其中,超途径用药为10.32%,主要为雾化吸入,发生率最高科室为妇产科(48.17%);超剂量用药为13.47%,发生率最高科室为心胸外科(62.49%)。PDD超规定的科室为儿科、ICU、心血管内科、急诊科、内科、心胸外科、外科。结论:萍乡市氨溴索药物超说明书用药情况普遍,其用药情况的必要性、安全性、有效性等尚无定论,仍需进一步前瞻性多中心对照试验验证。

Objective:A multi-center retrospective study of the use of ambroxol drugs in Pingxiang City for the rational use of clinically over-specified drug delivery and evidence-based management for evidence-based evaluation.Method:The prescriptions and inpatient orders of ambroxol used in three public general hospitals in Pingxiang City from August 2015 to August 2017 were retrospectively included.The drug instructions were used as the criteria to calculate the drug use in each department,the drug utilization index(DUI)and prescription daily dose(PDD)of each department were calculated,the incidence of drug use beyond the instructions was analyzed and the degree of drug use was evaluated.Result:84 937 patients with ambroxol were included in the study,the incidence of over-prescribed drug use was 23.79%(20 206/84 937).Among them,10.32%were in the over-prescribed drug use,mainly in aerosol inhalation,the highest incidence was in obstetrics and Gynecology(48.17%).The over-dose drug use was 13.47%,and the highest incidence was in cardiothoracic surgery(62.49%).PDD super-specified departments are pediatrics,ICU,cardiovascular medicine,emergency department,internal medicine,cardiothoracic surgery and surgery.Conclusion:The clinical situation of ambroxol drug in Pingxiang City is widespread,the necessity,safety and effectiveness of the drug use are still inconclusive,and further prospective multicenter controlled trials are needed.