某肿瘤医院白蛋白结合型紫杉醇合理应用评价标准的建立与应用  

Establishment and application of evaluation criteria on rational use of nab-paclitaxel in a cancer hospital

作　　者：刘芬[1] 龚倩[1] 符一岚[1] 李花 潘勇[1] 伍奕[1] LIU Fen;GONG Qian;FU Yilan;LI Hua;PAN Yong;WU Yi(Department of Pharmacy,Hunan Cancer Hospital,Changsha,Hunan,410013,China)

机构地区：[1]湖南省肿瘤医院药学部,湖南长沙410013

出　　处：《肿瘤药学》2021年第5期624-629,共6页Anti-Tumor Pharmacy

基　　金：湖南省自然科学基金(2018JJ6032);长沙市科技局基金(kq200431)。

摘　　要：目的制定《白蛋白结合型紫杉醇合理应用评价标准》,分析湖南省肿瘤医院白蛋白结合型紫杉醇合理应用情况,为临床合理用药提供参考。方法参考药物利用评价(DUE)标准建立方法,结合中国、日本等国以及FDA白蛋白结合型紫杉醇药品说明书、NCCN指南、CSCO指南等,制定白蛋白结合型紫杉醇DUE标准,评价本院108例患者的白蛋白结合型紫杉醇应用情况。结果白蛋白结合型紫杉醇不合理应用主要表现在:适应症不合理51例(47.2%)、用法用量不合理43例(75.4%)、联合用药不合理10例(17.5%)、治疗周期内血常规监测不合理73例(67.6%)、止吐预处理不合理47例(43.5%)。超适应症使用比较普遍。108例点评病例中,符合说明书适应症9例(8.3%)、超适应症使用99例(91.7%),其中有循证医学证据的超适应症48例(48.5%)。结论本院建立的白蛋白结合型紫杉醇DUE标准有较好的实用性,可为临床合理用药提供参考。ObjectiveTo establish the evaluation criteria on rational use of albumin-bound paclitaxel(nab-paclitaxel),and analyze the application of nab-paclitaxel in Hunan Cancer Hospital so as to provide reference for rational use of nabpaclitaxel.MethodsReferring to drug utilization evaluation(DUE)criteria,the DUE criteria of nab-paclitaxel was established on the base of the specification approved by CFDA,FDA and PMDA,and NCCN and CSCO guidelines.And the use of nab-paclitaxel in 108 patients was evaluated according to the criteria.ResultsThe main unreasonable applications of nab-paclitaxel were as follows:51 cases(47.2%)were unreasonable in indications,43 cases(75.4%)in usage and dosage,10 cases(17.5%)in combination,73 cases(67.6%)in routine blood monitoring during treatment period,and 47 cases(43.5%)in pretreatment for vomit-stopping.Off-label use was also common.Among the 108 reviewed cases,9 cases(8.3%)had nab-paclitaxel used in line with the indications,but off-label use occurred in 99 cases(91.7%),including 48 cases(48.5%)of off-label use with evidence.ConclusionThe established DUE criteria of nab-paclitaxel had a good practicability and were conducive to promote rational drug use in the clinic.

关 键 词：白蛋白结合型紫杉醇 药物利用评价 合理用药 

分 类 号：R926[医药卫生—药学]