某三级医院老年住院患者超说明书用药帕累托分析  

Pareto Analysis of Off-Label Drug Use in Elderly Inpatients in a Tertiary Hospital

作　　者：陈智娴[1] 乔进[2] 陈霞[2] CHEN Zhixian;QIAO Jin;CHEN Xia(Nantong Health College of Jiangsu Province,Nantong,Jiangsu,China 226010;Nantong Third Hospital Affiliated to Nantong University,Nantong,Jiangsu,China 226006)

机构地区：[1]江苏省南通卫生高等职业技术学校,江苏南通226010 [2]南通大学附属南通第三医院,江苏南通226006

出　　处：《中国药业》2023年第17期25-28,共4页China Pharmaceuticals

基　　金：江苏省333高层次人才培养工程资助项目[(2022)3-16-815号];江苏省南通市科技计划指导性项目[MSZ21101]。

摘　　要：目的探讨某三级医院老年住院患者超说明书用药情况,促进老年患者合理用药。方法抽取2021年该院各科室老年住院患者15%的病历,采用帕累托图及其法则分析超说明书用药类型及药品种类,并根据相关指南、专家共识等评价部分药品超说明书用药的合理性。结果共抽取病历2574份,其中超说明书用药病历258份,超说明书用药发生率为10.02%。年龄为76~85岁超说明书用药发生率最高(13.45%),与65~75岁、>85岁超说明书用药情况差异显著(P<0.05)。超说明书用药类型主要因素为超适应证用药(27.13%)、超给药途径用药(25.58%)、超剂量用药(20.16%);超说明书用药涉及药品种类主要为抗菌药物(34.88%)、中药注射剂(17.05%)、抗肿瘤药物(16.28%)。结论医院需针对老年住院患者超说明书用药问题的主要因素制订并完善监管制度,加强药学部门与临床各科室的合作,提高合理用药水平。Objective To investigate the off-label drug use in elderly inpatients in a tertiary hospital,and to promote rational drug use in elderly inpatients.Methods Precisely 15%of the medical records of elderly inpatients in each department of the hospital in 2021 were selected,Pareto chart and its rule were used to analyze the types of off-label drug use and drug varieties involved in the off-label drug use.According to guidelines and expert consensus,the rationality of off-label drug use was evaluated.Results A total of 2574 medical records were selected,including 258 medical records of off-label drug use,with an incidence rate of 10.02%.The incidence of over-instruction drug use in elderly patients aged between 76 and 85 years was the highest(13.45%),which was significantly different from that in elderly patients aged between 65 and 75 years old and>85 years old(P<0.05).The main factors of the types of off-label drug use were over-indication medication(27.13%),over-administration route medication(25.58%),and over-dosage medication(20.16%).The varieties of drugs involved in the off-label drug use were mainly antibiotics(34.88%),traditional Chinese medicine injections(17.05%),and anti-tumor drugs(16.28%).Conclusion In response to the main factors of the problem of off-label drug use in elderly inpatients,the hospital should establish and improve supervision systems,strengthen cooperation between pharmaceutical departments and clinical departments,and improve the level of rational drug use.

关 键 词：老年住院患者 超说明书用药 帕累托分析 

分 类 号：R95[医药卫生—药学]