湖南省县级以上医疗机构奥司他韦使用现状调查  

Investigation on using oseltamivir in medical institutions at county level and above in Hunan

作　　者：王玉香 毛玉芳[2] 罗美玲[3] 余明东[4] 罗昊[5] 邓志红[6] 殷黎[6] 胡世雄[6] WANG Yu-xiang;MAO Yu-fang;LUO Mei-ling;YU Ming-dong;LUO Hao;DENG Zhi-hongs;YIN Lie;HU Shi-xiongs(Liuyang Municipal Center for Disease Control and Prevention, Changsha,Hunan 430100, China;Changde Municipal Center for Disease Control and Prevention;Changsha Municipal Center for Disease Control and Prevention;Yueyang Municipal Center for Disease Control and Prevention;Xiangtan Municipal Center for Disease Control and Prevention;Hunan Provincial Center for Disease Control and Prevention)

机构地区：[1]浏阳市疾病预防控制中心,湖南长沙430100 [2]常德市疾病预防控制中心 [3]湖南省长沙市疾病预防控制中心 [4]湖南省岳阳市疾病预防控制中心 [5]湖南省湘潭市疾病预防控制中心 [6]湖南省疾病预防控制中心

出　　处：《中国公共卫生管理》2018年第1期83-88,共6页Chinese Journal of Public Health Management

摘　　要：目的了解湖南省县级以上医疗机构奥司他韦药物配备和使用情况,以及临床医师对奥司他韦药物的知晓和用药情况,为制定相应的防控策略提供科学依据。方法采用流行病学现况研究方法,按照省、市、县医疗机构级别分层抽取126家医疗机构,使用自制问卷,现场调查及面对面调查。结果 126家医疗机构中,配备有奥司他韦有108家占85.71%,仅57.94%医疗机构使用过奥司他韦,各医疗机构使用率差异有统计学意义(fisher精确概率法P<0.05)。不同级别医疗机构的使用率省级>市级>县级,三级>二级,差异有统计学意义(P<0.05)。在调查临床医师749人中,对于奥司他韦的适应证、剂型、用量、不良反应、禁忌证、抗病毒药物种类的总知晓率仅为11.75%,培训与总知晓率有统计学意义关联(OR=4.13,95%CI=2.44~6.97)。91.45%的医生认为有必要将奥司他韦纳入基本药物目录、新农合、商业保险范围。结论湖南省县级及以上医疗机构奥司他韦的使用率低,甚至部分医疗机构未配备此药物,临床医师对奥司他韦的认知和了解还不够全面。基本药物目录、新农合、医保、临床用药指引是促进规范合理用药的重要工具,建议加强医师对奥司他韦临床用药方面的培训,建立和完善相关政策制度,促进药物的合理配备和使用。Objective To understand reserve and usage of oseltamivir in medical institutions at county level in Hunan,and the clinician of oseltamivir medication and cognitive,so as to provide scientific basis for the prevention and control strategy.Methods The epidemiological study method was used to extract 126 medical institutions according to the level of provincial,municipal and county medical institutions. Using the self-made questionnaire,field investigation and face-to-face investigation were used to analyze. Results In 126 medical institutions,108 institutions reserved oseltamivir accounted for85. 71%,Only 57. 94% institutions once used oseltamivir. The usage rate of oseltamivir was statistically significant difference of the city state medical institutions（ Fisher exact test P 0. 05）. The utilization rate of medical institutions at different levels： the provincial level the municipal the county level,grade three two,which the difference was statistically significant（ P 0. 05）. The total awareness rate of oseltamivir（ indications,dosage,consumption,contraindications,adverse reactions and antiviral drug types） was only 11. 75%. The total awareness rate of training was significantly associated（ OR = 4.13,95% CI = 2. 44 ~ 6. 97）. 91. 45% of the doctors thought it would be necessary to which bring oseltamivir into essential medicines system,new rural cooperative medical system,commercial insurance coverage. Conclusion The usage rate of oseltamivir in Hunan county level medical institutions is low,and even some medical institutions are not equipped with this medicine,clinicians on cognition and understanding of oseltamivir is not comprehensive. Essential medicines system,new rural cooperative medical system,medical insurance,and clinical medication guidelines are important tools to promote rational medication,it is proposed to strengthen the training of physicians in clinical medication about oseltamivir,establish and improve relevant policies to promote the rational use of drugs and equipment.

关 键 词：奥司他韦 使用 知晓 

分 类 号：R969.3[医药卫生—药理学]