重点监控药品政策对样本地区辅助用药使用的影响研究  

Influence of Key Monitoring Drugs Policy on the Change of Adjuvant Drugs in Sample Area

作　　者：梁广楷 扶宇 李俊蕾[1] 覃思蓓 伊欣 管晓东[1,2] 邵宏[1,2] 聂小燕[1,2] 史录文[1,2] LIANG Guang-kai;FU Yu;LI Jun-lei;QIN Si-bei;YI Xin;GUAN Xiao-dong;SHAO Hong;NIE Xiao-yan;SHI Lu-wen(School of Pharmaceutical Sciences,Peking University,Beifing 100191,China;International Research Center of Medicinal Administration,Peking University,Beijing 100191,China)

机构地区：[1]北京大学药学院,北京100191 [2]北京大学医药管理国际研究中心,北京100191

出　　处：《中国药学杂志》2018年第18期1613-1618,共6页Chinese Pharmaceutical Journal

摘　　要：目的探究安徽省、四川省重点监控药品政策对样本地区辅助用药使用的影响,为促进辅助用药合理使用、完善与推进重点监控药品管理政策提供依据。方法本研究以各省监控目录形成的重点监控药品库为基础,通过辅助用药遴选标准,结合安徽省、四川省的监控目录,考虑药品典型性、数据可获得性等特征,分别遴选出安徽省8种样本药品、四川省10种样本药品作为研究对象,进一步提取安徽省3家三级医院2014年11月至2017年9月的月度数据、四川省成都市9家三级医院2014年一季度至2017年一季度的季度数据。研究通过有对照的间断时间序列(interrupted time-series,ITS)模型,分析样本药品用量与金额的变化。结果(1)安徽省2015年11月实施重点监控药品政策后,辅助用药的使用趋势由上升转为下降,其用量(β_3=-0.035,P<0.001)、金额(β_3=-0.025,P<0.05)均显著下降;(2)安徽省2016年1月实施的监控措施对辅助用药用量(β_3=-0.010,P>0.1)、金额(β_3=-0.001,P>0.1)下降的影响无统计学差异。(3)四川省2016年一季度实施重点监控药品政策后,辅助用药使用的下降趋势扩大,其用量(β_3=-0.045,P<0.001)、金额(β_3=-0.037,P<0.001)的下降均有显著性差异。结论安徽省、四川省重点监控药品政策的实施可以有效控制大部分辅助用药的使用,使其用量、金额显著下降。OBJECTIVE To examine the influence of key monitoring drugs policy in Anhui province and Sichuan province on the change of adjuvant drugs for promoting its rational use and providing a basis for policy formulation. METHODS Based on the key monitoring drug libraries formed in the monitoring catalogs of all the provinces, combining with the key monitoring drug catalogs in Anhui province and Sichuan province, this study selected the characteristics of drug-typicality and data availability through the selection of adjuvant drug selection criteria. Eight drugs of Anhui province and 10 drug of Sichuan province were selected as research objects. The study extracted monthly data from 3 hospitals in Anhui province from November 2014 to September 2017 and quarterly data from 9 hospitals in Chengdu, Sichuan province in the first quarter of 2014 to the first quarter of 2017. Interrupted Time Series （ITS） model was used to analyze the changes of dosage and amount of sample drugs and reference drugs. RESULTS ①After the implementation of the key monitoring drugs policy in Anhui province in November 2015, the us- age trend of adjuvant drugs changed from rising to declining, with a significant decrease in the dosage （β3 = -0. 035, P 〈 0. 001 ） and amount （β3 = - 0. 025, P 〈 0.05 ）. ②The monitoring measures implemented by Anhui province in January 2016 had no significant difference on the decrease of the dosage of adjuvant drugs （ β3 = - 0. 010, P 〉 0.1 ） and the amount of money （β3 = -0. 001, P 〉 0. 1 ）. ③After the implementation of the key monitoring drugs policy in the first quarter of 2016 in Sichuan Province, the declining trend of the use of adjuvant drugs was widened with a decrease of the dosage （β3 = - 0. 045, P 〈 0. 001 ） and the amount （ β3 = - 0. 037 ,P 〈 0. 001 ）. CONCLUSION The implementation of key monitoring drugs policy in Anhui province and Sichuan province can effectively control the use of most adjuvant drugs, with a significantly decrease of the dosage and amo

关 键 词：重点监控药品 辅助用药 间断时间序列分析 政策效果评价 

分 类 号：R954[医药卫生—药学]