酒精使用相关障碍患者的超说明书用药分析  

Analysis of off-label prescribing for patients with disorders due to use of alcohol

作　　者：张轩 李思友 郝伟[2] 张鸿鹤 ZHANG Xuan;LI Siyou;HAO Wei(Xiamen Xianyue Hospital,Xiamen Mental Health Center,Xiamen 361012,China)

机构地区：[1]厦门市仙岳医院,厦门市精神卫生中心精神科,厦门361012 [2]中南大学湘雅二医院精神卫生研究所

出　　处：《国际精神病学杂志》2022年第6期1031-1034,共4页Journal Of International Psychiatry

基　　金：福建省卫健委中青年骨干人才培养项目(编号2019-ZQNB-33);厦门市医疗卫生科技计划项目(编号:3502Z20194083)。

摘　　要：目的 了解精神专科医院酒精使用相关障碍住院患者精神药物的超说明书用药情况,分析其必要性与科学性。方法 选取1074例酒精使用相关障碍患者为研究对象,回顾性调查住院期间的精神药物使用情况,依据药品说明书判定其超说明书用药状况,根据我国主要成瘾障碍防治指南分析其超适应证用药的合理性。结果 1074例患者共开具精神药物医嘱3110条,医嘱超说明书总体使用率为83.79%。患者超适应证用药率为77.23%,超适应证用药的主要构成是抗精神病药、抗癫痫药和抗抑郁药使用。上述超说明书使用4/5以上在防治指南中均有推荐。结论 被调查单位精神药物超说明书用药现象普遍存在,但多数符合物质使用障碍防治指南,提示超说明书用药在我国精神科临床中具有较多的临床需求,需尽早制定精神科超说明书用药指导规范。Objective To understand the current situation of off-label use of psychotropic drugs among inpatients diagnosed with disorders due to use of alcohol(DDUA),and to analyze the necessity and rationality of offlabel use of psychiatric drugs.Methods Psychotropic drug prescription-related information was obtained for 1074 patients with DDUA retrospectively.The off-label prescribing rates were estimated based on the drug instructions while the rationality of off-label prescribing usage was justified by independent experts based on the guidelines for prevention and treatment of addiction disorders in China.Results The total prescriptions were 3110 in the 1074 inpatients.The overall off-label use rate was 83.79%.The rate of off-label indication in the total samples was 77.23% Antipsychotics,anticonvulsants,and antidepressants comprised the main components of off-label prescribing.More than 4/5 of the above off-label prescriptions were followed by recommendations in the guidelines.Conclusion It is very common that psychoactive drugs are used with off-label prescribing in the investigated hospital.They are mostly in accord with the guideline of prevention and treatment of addictive disorders.It is suggested that the off-label prescribing in the clinical work of psychiatry in China has considerable clinical demand,so it is urgent to strengthen the off-label prescribing and make the proper policy.

关 键 词：酒精使用相关障碍 超说明书用药 超适应证 

分 类 号：R749.05[医药卫生—神经病学与精神病学]