某三级甲等综合医院口服抗高血压药合理用药评价  

Evaluation of Rational Use of Oral Antihypertensive Drug in a Grade Ⅲ-A General Hospital

作　　者：黄晓威[1] 沈云珠[2] 傅新阳[1] 洪珊珊[1] 林志航[1] HUANG Xiaowei;SHEN Yunzhu;FU Xinyang;HONG Shanshan;LIN Zhihang(Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou,Fujian,China 362000;The Second Affiliated Hospital of Fujian Medical University,Quanzhou,Fujian,China 362000)

机构地区：[1]福建医科大学附属泉州第一医院,福建泉州362000 [2]福建医科大学附属第二医院,福建泉州362000

出　　处：《中国药业》2022年第8期25-29,共5页China Pharmaceuticals

基　　金：福建省泉州市科技计划项目[2018Z086]。

摘　　要：目的促进口服抗高血压药的合理使用。方法采用限定日剂量(DDD)法,回顾性分析福建医科大学附属泉州第一医院2016年至2020年口服抗高血压药的销售金额、用药频度(DDDs)及限定日费用(DDDc)等指标,总结该类药物的应用情况并评价其合理性。结果2016年至2020年,该院口服抗高血压药的DDDs由586.86万增至976.89万,年均增幅13.73%;销售金额由1866.36万元至2975.42万元,年均增幅12.78%;DDC先由3.18元(2016年)升至3.32元(2018年),后降至3.05元(2020年)。常用的抗高血压药类别为钙通道阻滞剂(CCB)、血管紧张素Ⅱ受体阻滞剂(ARB)、血管紧张素转换酶抑制剂、复方制剂,5年间CCB的DDDs构成比从25.93%增至32.86%,而ARB的DDDs构成比从24.69%降至20.23%,但均稳居前2位。5年间单药的平均DDDc由3.63元降至3.50元,但每年DDDs排序前10位的单药多为进口或合资品种,其DDDc普遍较高。2018年DDDs排序前列的氯沙坦钾片等药品,到2020年已被国家集采药品取代并被挤出前10。结论该院口服抗高血压药的应用基本合理,但临床更倾向于优先选择DDDc较高的进口或合资品种,不利于改善患者的用药依从性。未来临床应优先考虑选择应用方便、质优价廉的药品。Objective To promote the rational use of oral antihypertensive drugs.Methods The sales amount,defined daily dose sum(DDDs)and defined daily dose cost(DDDc)of oral antihypertensive drugs in Quanzhou First Hospital Affiliated to Fujian Medical University from 2016 to 2020 were analyzed by the defined daily dose(DDD)method retrospectively,and the application and rationality of the drug were summarized and evaluated.Results The DDDs of oral antihypertensive drugs in the hospital from 2016 to 2020 increased from 5.8686 million to 9.7689 million,with an average annual growth rate of 13.73%.The sales amount increased from 18.6636 million CNY to 29.7542 million CNY,with an average annual growth rate of 12.78%.The DDDc increased from 3.18 CNY(2016)to 3.32 CNY(2018),then decreased to 3.05 CNY(2020).Calcium-channel blocker(CCB),angiotensin Ⅱ receptor blocking agents(ARB),angiotensin converting enzyme inhibitor(ACEI)and compound preparations were the common used antihypertensive drugs.The proportion of CCB’s DDDs increased from 25.93% to 32.86%,while the constituent ratio of ARB’s DDDs decreased from 24.69% to 20.23%.Both of them were in the top two in the five years.The average DDDc of single drug decreased from 3.63 CNY to 3.50 CNY during the five years,while the imported or joint venture varieties of drugs were in the top ten of DDDs and the DDDc of them were always high.Losartan Potassium Tablets and other drugs ranked at the top of DDDs in 2018,while they had been replaced by national centralized purchase drugs and squeezed out of the top ten by 2020.Conclusion The application of oral antihypertensive drugs in the hospital is basically reasonable,while imported or joint venture drugs with higher DDDc are more likely to be chosen,which has no advantage to improve the patient’s medication compliance.Clinical application of drugs with easy administration,high quality and low price will be the trend in the future.

关 键 词：口服抗高血压药 用药分析 限定日剂量 用药频度 限定日费用 合理用药 药事管理 

分 类 号：R972[医药卫生—药品] R95[医药卫生—药学]