2023年某三甲医院抗肿瘤相关药物医嘱合理使用情况分析
Analysis of rational use of medical orders of antitumor related drugs in a third-class hospital in 2023
刘阳 1姚志红 1刘英 1杨娟 2钟婷 2蔡建华 2任志强1
作者信息
- 1. 湖南省益阳市中心医院药学部临床药学科,湖南益阳 413000
- 2. 湖南省益阳市中心医院肿瘤科,湖南益阳 413000
- 折叠
摘要
目的 分析抗肿瘤相关药物临床使用的合理性,为规范医师处方行为、促进合理用药提供参考.方法 2023年每季度抽取90份益阳市中心医院使用抗肿瘤药物的住院患者病历,共抽取360份病历进行点评,对其使用情况进行分析与评价.结果 抗肿瘤药物及其辅助性药物存在不合理使用现象.在不合理医嘱病历中,50岁以上患者占72.12％,科室主要分布于肿瘤一区、肿瘤二区、普外三科,共占73.08％;按药物品种分布,不合理率排名前四为帕洛诺司琼(27.92％)、多西他赛(17.53％)、紫杉醇(白蛋白结合型)(11.04％)、福沙匹坦(7.79％);存在的问题主要是预处理不适宜、用法用量不适宜、给药途径不适宜、止呕强度不适宜、溶媒体积不适宜等5个方面;通过临床药师实时干预与医疗质量考评相结合,医嘱不合理率(以病历统计)由2022年的35.56％下降到2023年的28.89％.结论 通过开展医嘱点评工作,可发现临床用药的不足之处,及时采取干预措施,可改善临床合理用药水平.
Abstract
Objective To analyze the rationality of clinical use of antitumor related drugs,and to provide reference for regu-lating physicians'prescribing behavior and promoting rational drug use.Methods In 2023,90 medical records of hospital-ized patients using antitumor drugs in Yiyang Central Hospital were selected every quarter,and a total of 360 medical records were reviewed to analyze and evaluate their use.Results There were irrational use of antitumor drugs and their aux-iliary drugs.Patients over 50 years old accounted for 72.12％of the unreasonable medical orders,and the departments were mainly distributed in the First Tumor Area,the Second Tumor Area and the Third General Surgery Department,accounting for 73.08％.According to the distribution of drug varieties,the top four irrational rates were Palonosetron(27.92％),Doc-etaxel(17.53％),Paclitaxel(albumin-bound)(11.04％)and Foxapitant(7.79％).The existing problems mainly include five aspects:inappropriate pretreatment,inappropriate usage and dosage,inappropriate route of administration,inappropriate anti-vomiting intensity and inappropriate solvent volume.Through the combination of real-time intervention by clinical pharmacists and medical quality evaluation,the unreasonable rate of medical orders(based on medical records)decreased from 35.56％in 2022 to 28.89％in 2023.Conclusion The deficiencies of clinical drug use can be found through the review of medical orders,and timely intervention measures can improve the level of clinical rational drug use.
关键词
抗肿瘤/医嘱/合理用药/药师/用药分析Key words
Antitumor/Medical order/Rational drug use/Pharmacist/Medication analysis引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据