静脉用药调配中抗肿瘤药物不合理应用分析

Analysis of the Irrational Drug Use of Intravenous Antineoplastic Agents

关键词:  抗肿瘤药物  不合理用药  静脉用药调配  药师

Key words:  antineoplastic agents  irrational drug use  pharmacy intravenous admixture services  pharmacist

摘要:

目的促进抗肿瘤药物静脉用药的合理性。方法对静脉用药调配中心药师在审核医嘱时发现的抗肿瘤药物不合理用药进行回顾性地分析。结果不合理用药医嘱中选用不合理溶媒占51%,护士不合理执行医嘱占18%,不合理给药方式占15%,不符合药物经济学占9%,不合理给药方案占7%。药师进行临床用药干预后,医生医嘱修改率达98%以上。结论静脉用药调配药师在促进抗肿瘤药物合理用药方面可以发挥重要作用。进一步提高药师审方能力,开展护士用药教育,建立合理用药规范以及医务人员之间的正确沟通至关重要。

Abstract:

OBJECTIVE To enhance the rational drug use of intravenous antineoplastic agents.METHODSRetrospective statistical analysis of irrational drug use of antineoplastic agents, detected by pharmacists during prescription check in Center for Pharmacy Intravenous Admixture Services (PIVAS), were conducted. RESULTSThe main problems were as follows: selection of irrational dilution solution (about 51%), incorrect implementation of doctors′ orders by nurses (about 18%), inappropriate medication route (about 15%), absence of pharmacoeconomic considerations (about 9%) and irrational dosage regimens (about 7%). The modification rate of irrational prescriptions reached more than 98% after clinical interventions by pharmacist. CONCLUSIONPharmacists in PIVAS can play pivotal roles in rational use of intravenous antineoplastic agents. It is essential to further improve the ability of pharmacist in prescription check, conduct medication education to nurses, establish guidelines for rational drug use and strengthen communications among medical staff.