基于帕累托图分析精神科超说明书用药现状  

Analysis of the Current Situation of Off-label Drug Use of Psychiatric Department Based on Pareto Chart

作　　者：曾俊芬[1] 鲁建武[1] Zeng Junfen;Lu Jianwu(Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院,武汉430060

出　　处：《药物流行病学杂志》2020年第6期409-412,共4页Chinese Journal of Pharmacoepidemiology

摘　　要：目的:采用帕累托图分析某院精神科超说明书用药现状。方法:随机抽取2018年600份医嘱,采用帕累托图及其法则分析超说明书用药类型、超说明书药品种类,计算超说明书用药构成比。根据Thomson分级从有效性,推荐级别和证据等级三方面对超说明书用药合理性进行分析。结果:600份医嘱中超说明书用药医嘱共122份,超说明书用药率为20.33%。对超说明书用药类型进行统计分析,发现主要因素为超适应证用药、超适应人群,次要因素为超用法用量,一般因素为超注意事项。对不同种类药品超说明书用药情况进行分析,发现超说明书用药主要因素为抗精神病类药、脑血管病及促智药,次要因素为抗癫痫及惊厥药,一般因素为镇静催眠药。122份超药品说明书中合理医嘱共83份,占超说明书药品的68.03%。结论:超药品说明书用药具有一定的合理性和不可避免性,医疗机构应加强超说明的监管,保证药品合理使用。Objective:To analyze the current situation of off-label drug use in psychiatry of a hospital by pareto chart analysis.Methods:A total of 600 medical orders of 2018 were randomly selected.Pareto chart and its rule were used to analyze the types and drug varieties,to calculate the composition ratio of off-label drug use.According to Thomson’s classification,the rationality of off-label drug use was analyzed from three aspects:effectiveness,recommendation grade and evidence level.Results:122 orders were off-label drug use among 600 orders,the rate was 20.33%.With statistical analysis of the types of off-label drug use,the main factors were over indications and over applicable people,the secondary factors were over usage and dosage,the general factors were over points for attention.By analyzing the drug varieties of offlabel drug use,it was found that the main factors were antipsychotic drugs,cerebrovascular diseases and intellectual drugs,the secondary factors were antiepileptic and convulsive drugs,and the general factors were sedative and hypnotic drugs.There were 83 reasonable orders in 122 off-label drug use,accounting for 68.03%of the total.Conclusion:It is reasonable and inevitable to off-label drug use.Medical institutions should strengthen the supervision of the instructions to ensure the rational use of drugs.

关 键 词：超说明书用药 精神科 帕累托图 合理用药 

分 类 号：R95[医药卫生—药学]