摘要
目的:了解我院糖皮质激素类药物应用情况并为促进其合理使用提供参考。方法:通过我院病案管理系统、信息管理系统调取国家基本药物制度实施前(2009年7-12月)和实施后(2010年7-12月)使用糖皮质激素类药物的门诊和住院处方,对糖皮质激素类药物的名称、数量、金额、用途、使用科室及用药合理性等方面进行统计分析。结果:共调查国家基本药物制度实施前和实施后的处方各210 000张,实施前涉及使用糖皮质激素类药物的处方共35 578张(占16.94%),实施后涉及使用糖皮质激素类药物的处方共28 703张(占13.67%),所占比例前后比较差异有统计学意义(P<0.05);其中,非基本药物品种如复方丙酸氯倍他索乳膏、复方倍他米松注射液使用比例实施后亦显著下降,差异有统计学意义(P<0.05)。呼吸内科、五官科、骨科、儿科等科室糖皮质激素类药物处方比例在国家基本药物制度实施后显著降低,差异有统计学意义(P<0.05),而神经内科处方比例略有上升。国家基本药物制度实施前使用糖皮质激素类药物的不合理用药处方为2 710张(占7.62%),实施后为1 410张(占4.91%),所占比例前后比较差异有统计学意义(P<0.05);不合理使用原因包括局部治疗滥用、感染性疾病滥用、滥用于退热、预防输液过敏反应、给药剂量不合理等方面,国家基本药物制度实施后得到明显遏制。结论:国家基本药物制度实施后,我院糖皮质激素类药物使用得到了有效控制,部分价格较贵的非基本药物使用比例显著下降,主要相关科室糖皮质激素类药物的处方量得到明显遏制,不合理处方比例也显著降低,临床用药更趋合理,但糖皮质激素类药物应用细节方面还有待进一步规范、完善。
OBJECTIVE：To investigate the application of glucocorticoid drugs in our hospital and provide reference for its rational use. METHODS：According to outpatient and inpatient prescriptions of glucocorticoid drugs in our hospital from case management system and information management system before（Jul.-Dec. 2009）and after（Jul.-Dec. 2010）the implementation of national essential medicine system（NEMS）,the name,quantity,money,application,departments and rationality of use of glucocorticoid drugs were statistically analyzed. RESULTS：There were 210 000 prescriptions before and after the implementation of NEMS for each. 35 578 prescriptions were used glucocorticoid drugs before implementation（16.94%） and 28 703 after implementation（13.67%）,there was significant difference in the proportion（P〈0.05）. Among these,the proportion of non-essential medicine（compound clobetasol propionate ointment and compound betamethasone injection）were significantly decreased,with significant difference（P〈0.05）. After the implementation of NEMS,the proportion of glucocorticoid drugs in departments（respiratory medicine,ENT,orthopedics and pediatrics,etc.）was significantly decreased,with significant difference（P〈0.05）;and in neurology department it was slightly increased. Before the implementation of NEMS,2 710 prescriptions using glucocorticoid drugs were irrational（7.62%）and 1 410 after implementation（4.91%）,there was significant difference in the proportion（P〈0.05）. The reasons of irrational drug use included abuse of local treatment,infectious diseases and fever,prevention of allergic reactions infusion and irrational dosage. It was obviously contained after the implementation of NEMS. CONCLUSIONS：After the implementation of NEMS,the use of glucocorticoid drugs was effectively controlled in our hospital and the proportion of parts of expensive non-essential medicine was significantly decreased. The prescriptions were obviously contained in main related departments and the proportion of irrational prescriptions was significantly decreased. Clinic medication is more reasonable,but the application details of glucocorticoid drugs should be further standardized and improved.
出处
《中国药房》
CAS
北大核心
2015年第12期1645-1648,共4页
China Pharmacy
