摘要
目的分析临床药师工作站模式对促进临床合理应用质子泵抑制剂(PPIs)的管控效果。方法建立基于HIS系统的临床药师工作站,临床药师采用电子会诊、药学监护、电子点评、事中干预等手段对PPIs的使用进行管控,选取干预前(2017年1~9月)及干预后(2018年1~9月)本院神内一科、神内二科、神经外科PPIs的相关使用数据,统计分析干预前后PPIs使用率、使用频度、销售金额等指标,并随机抽取干预前后病例60例,对PPIs的不合理使用情况进行分析与评价。结果与2017年同期相比,本院神内一科、神内二科、神经外科PPIs使用率分别由(43.43±5.2)%、(67.93±8.2)%、(67.33±6.3)%下降至(35.6±4.5)%、(55.3%±7.6)%、(60.3±5.6)%,PPIs使用频度(DDDs)分别由(43.4±4.4)、(60.9±5.6)、(112.35±10.5)下降至(37.51±3.0)、(52.36±4.2)、(99.32±8.1);PPIs总销售金额由1034.6万元下降至938.6万元,干预后PPIs的不合理使用情况如用法不规范、用药疗程偏长、重复用药、用量不适宜、无指征用药、溶媒选择不当等均较前明显改善,总体不合理使用率由干预前的38.3%下降至干预后的15.0%,不良反应发生率由23.3%下降至10.0%。结论基于临床药师工作站的工作模式,实现了PPIs的科学化、电子化管控,节省了医疗费用,有效促进了PPIs的合理化使用。
Objective To analyze the effect of clinical pharmacist work station mode on promoting the rational use of proton pump inhibitors(PPIs)in clinical practice.Methods A clinical pharmacist work station based on HIS system was established.Clinical pharmacists used electronic consultation,pharmaceutical care,electronic comment and in-event intervention to control the use of PPIs.Proton suppression was selected from the first Department of Psychiatry,the second Department of Psychiatry and Department of Neurosurgery before and after the intervention(January to September 2017 and January to September 2018 respectively).The usage rate,usage intensity,sales amount and rational use rate of PPIs before and after the intervention were analyzed.Results Compared with the 9 months in 2017,the utilization rates of PPIs in the 3 departments in our hospital decreased from(43.43±5.2)%,(67.93±8.2)%,and(67.33±6.3)%to(35.6±4.5)%,(55.3±7.6)%,and(60.3±5.6)%,respectively.The intensity of PPIs decreased from(43.4±4.4),(60.9±5.6),and(112.35±10.5)to(37.51±3.0),(52.36±4.2),and(99.32±8.1),respectively.The total sales amount of PPIs decreased from10.346 to 9.386 million yuan.The irrational use of PPIs after the intervention,such as non-standard usage,long course of treatment,repeated use of drugs,inappropriate dosage,non-pointer use of drugs,improper choice of solvent,etc.were greatly improved.The overall irrational use rate decreased from 38.3%before the intervention to 15.0%after the intervention,and the incidence of adverse reactions decreased from 23.3%to 10.0%.Conclusion Based on the clinical pharmacist work station,the scientific management and control of PPIs are established,and the rational use of PPIs is effectively promoted.
作者
胡毅翔
雷海波
李伟
郭小兰
刘湘
HU Yi-xiang;LEI Hai-bo;LI Wei;GUO Xiao-lan;LIU Xiang(Xiangtan Central Hospital,Xiangtan Hunan 411100)
出处
《中南药学》
CAS
2019年第8期1346-1349,共4页
Central South Pharmacy
基金
湖南省药学会医院药学——正大天晴研究基金项目(No.Hn2017007)
湘潭市科技局项目(No.ZJ20171001)
关键词
临床药师工作站
质子泵抑制剂
临床合理应用
管控实践
clinical pharmacist work station
proton pump inhibitor
clinical rational application
control practice
