基于医嘱审核循环体系的建立某院PPIs的使用情况分析  

Analysis on the use of PPIs based on the established medical order review cycle system in a hospital

作　　者：张智琪[1] 王玮[1] 虞勋[1] 朱建国[1] ZHANG Zhi-qi;WANG Wei;YU Xun;ZHU Jian-guo(Pharmacy Department,First Affiliated Hospital of Soochow University,Jiangsu Suzhou 215000,China)

机构地区：[1]苏州大学附属第一医院药学部,江苏苏州215000

出　　处：《中国医院药学杂志》2022年第5期555-559,569,共6页Chinese Journal of Hospital Pharmacy

摘　　要：目的:通过全医嘱点评、临床宣教、医嘱审核、数据分析相结合的医嘱审核体系的建立,进行苏州大学附属第一医院质子泵抑制剂(proton pump inhibitors, PPIs)的医嘱专项审核后,分析该院PPIs审核前后使用情况,评价医嘱审核的效果。方法:基于医嘱审核循环体系统计2020年1月至2021年3月5个季度使用PPIs的医嘱,分析医嘱被退回的原因,比较各季度PPIs人均使用费用及人均使用天数变化趋势,评价PPIs使用的各影响因素的显著性差异。结果:2020年1月至2021年3月该院使用PPIs的全部医嘱共64 842例,其中男性患者36 777例,≥60岁的患者36 062例,预防性使用的医嘱47 450例。PPIs使用不适宜的情况主要有"给药频次不适宜""给药疗程不适宜""药品剂型或给药途径选择不适宜"。按季度分析PPIs整体及预防使用的人均天数及人均费用均呈下降趋势。注射剂型预防使用的比例及人均费用呈下降趋势,而口服剂型预防使用的比例无明显趋势,人均费用呈上升趋势。2020年第二季度PPIs的平均使用天数与2020第一季度无明显差异(P>0.05),使用费用、医嘱干预情况、使用剂型差异均有统计学意义(P<0.05)。2021年第一季度与2020年第一季度PPIs的使用情况相比,使用费用、使用天数、医嘱干预情况及使用剂型差异均有统计学意义(P<0.05)。结论:CERA医嘱审核模式,能有效降低用药安全隐患、提升临床合理用药意识、减少临床不合理用药情况,是值得推广的一项有效措施。OBJECTIVE To evaluate the effects of medical order review on the use of PPIs in the First Affiliated Hospital of Soochow University by comparing the use of PPIs before and after the establishment of medical review system including full medical advice comments, clinical education, medical order review and data analysis(CERA).METHODS Five quarters of doctor’s orders for PPIs use were collected from January 2020 to March 2021 based on the established midical order review cycle system, the reasons for returned medical orders were analyzed, and the change trend of cost per capita use and number of days per person of PPIs were compared among the quarters.RESULTS A total of 64 842 patients were ordered to use PPIs in the hospital, among them, 36 777 were male patients, 36 062 cases were aged ≥60 years, and 47 450 cases were prescribed for preventive use. The unsuitable use of PPIs mainly included unsuitable administration frequency, administration course, drug dosage form or administration route.The number of days per capita and the cost per capita use of the overall or the preventive use of PPIs showed a decreasing trend in the quarterly analysis. The proportion of injectable dosage forms for preventive use and the per capita cost showed a decreasing trend, there was no significant trend in the proportion of oral dosage forms for prophylactic use, and cost per capita was on the rise. The average number of days for PPIs use in the second quarter of 2020 did not differ significantly from that in the first quarter of 2020(P>0.05), but there were significant differences in the use cost, medical intervention and dosage form(P<0.05). PPIs use in the first quarter of 2021 compared to that in the first quarter of 2020, there were significantly statistical differences in the use cost, number of days, medical intervention and dosage form(P<0.05).CONCLUSION The CERA medical order review mode can effectively reduce potential drug safety risks, enhance the awareness of rational clinical drug use and reduce clinical unreasonalbe

关 键 词：质子泵抑制剂 医嘱审核 审核规则 

分 类 号：R350.50[医药卫生—基础医学]