摘要
目的:评价实施综合干预措施对我院呼吸科人血白蛋白使用的影响,促进临床合理用药。方法:根据人血白蛋白说明书、相关指南及文献,按照循证药学方法建立我院呼吸科人血白蛋白使用评价标准,采取医嘱审核、处方点评、信息系统权限设置等技术措施和绩效考核手段对人血白蛋白的使用进行综合干预。调取2015年1-6月(干预前组,226例)、2016年1-6月(干预后组,148例)使用人血白蛋白的患者处方,对人血白蛋白总使用量、人均使用量、平均使用时间、适应证、禁忌证、合理性等进行统计分析,并比较干预前后两组患者人血白蛋白的使用情况。结果:患者的人血白蛋白总使用量、人均使用量、平均使用时间分别由干预前的18 350 g、(81.2±71.3)g、(7.8±7.2)d,下降至干预后的7 584 g、(51.2±48.3)g、(4.7±2.1)d;患者使用人血白蛋白不符合《人血白蛋白、非蛋白胶体溶液及晶体溶液使用指南》规定的适应证比例、违背禁忌证使用人血白蛋白的比例分别由干预前的80.1%、50.0%下降至干预后的39.9%、16.9%;用药前血清白蛋白浓度≥35 g/L、≥30~<35 g/L、≥20~<25 g/L组患者人数干预前组明显多于干预后组,<20 g/L、≥20~<25 g/L组患者人数干预后组明显多于干预前;合理使用人血白蛋白的患者比例由干预前的16.8%上升至干预后的52.7%,以上指标干预前后比较,差异均有统计学意义(P<0.05)。结论:综合干预措施可有效降低人血白蛋白在适应证、疗程等方面的不合理使用及比例等,提高临床合理使用水平。
OBJECTIVE： To evaluate the effects of interventions on the use of human serum albumin in respiratory department of our hospital, and to promote rational clinical drug use. METHODS： According to package inserts, related guideline and litera- tures of human serum albumin, the evaluation standard of human serum albumin use in respiratory department of our hospital was es- tablished with evidence-based medicine method. The comprehensive intervention of human serum albumin use was carried out by means of medical order review, prescription comment, permission setting of information system and performance evaluation. The prescriptions of patients receiving human serum albumin were collected during Jan.-Jul. 2015 （pre-intervention group, 226 cases） and Jan.-Jul. 2016 （post-intervention group, 148 cases）. Those prescriptions were analyzed statistically in respects of total amount of human serum albumin, per capita amount, average duration, indications, contraindications and rationality, etc. The utilization of human serum albumin was compared between 2 groups before and after intervention. RESULTS ： The total amount of human serum albumin, per capita amount and average duration decreased from 18 350 g, （81.2±71.3）g, （7.8i7.2）d before intervention to 7 584 g, （51.2±48.3 ）g, （4.7±2.1）d after intervention, respectively. The proportion of not in line with the indication stated in Guidelines for Use of Human Serum Albumin, Non-protein Colloidal Solution and Srystalline Solution, the proportion of being contrary to contrain- dication decreased from 80.1%, 50.0% before intervention to 39.9%, 16.9% after intervention, respectively. The number of pa- tients with serum albumin concentration ≥ 35 g/L, ranged ≥30- 〈 35 g/L or ranged ≥20- 〈 25 g/L before medication in pre-inter- vention group was more than post-intervention group; the number of patients with serum albumin concentration〈20 g/L or ranged 20-25g/L in post-intervention group was more than pre-intervention group. The proportion
出处
《中国药房》
CAS
北大核心
2017年第32期4565-4569,共5页
China Pharmacy
基金
江苏省药学会-百特生物药学基金科研项目(No.010)
关键词
人血白蛋白
综合干预措施
合理用药
临床药师
呼吸科
Human serum albumin
Comprehensive intervention
Rational durg use
Clinical pharmacists
Respiratory department
