合理用药管理平台在术后注射用非甾体抗炎药的管控实践与干预效果分析

Control Practices and Intervention Effect Analysis of Management Platform for Rational Drug to Post-operative Use of Non-steroidal Anti-inflammatory Drugs with Injection

关键词:  合理用药平台  注射用非甾体抗炎药  干预效果

Key words:  management platform for rational drug  non-steroidal anti-inflammatory drugs with injection  intervention effect

摘要:

目的 通过合理用药管理平台，建立注射用非甾体抗炎药的药品个性化规则，开展处方前置审核和人工审核，从而促进临床合理用药。方法 基于合理用药管理平台，依据说明书、专家共识等，建立注射用氯诺昔康、氟比洛芬酯注射液、酮咯酸氨丁三醇注射液精准数据库，并进行处方分级管理。通过随机抽取合理用药管理平台开发前（2018年7-9月，对照组）和开发后（2018年10-12月，干预组）使用3种药物各100例手术患者，对其使用指征、疗程、给药途径、剂量、给药频次、联合用药、药物不良反应进行合理性评价。对干预前后3个月的使用人次、使用强度及使用金额等方面进行统计与对比分析。结果 3种注射用非甾体抗炎药的不合理医嘱比例显著下降，从干预前的38.54%降至干预后的11.67%，降幅达69.53%。干预组的给药途径、给药剂量、疗程、联合用药和选药不适宜的发生率均明显降低（P<0.01）。2组在使用指征不明、溶媒选择不适宜和不良反应发生率方面差异均无统计学意义。干预后3种药物的使用人次、使用强度和使用金额均显著降低（P<0.05或P<0.01）。结论 应用合理用药管理平台可智能、精准化、个体化服务于临床，提高审核效率，从源头上规范使用注射用非甾体抗炎药，促进药师积极探索新的工作模式，提高医院合理用药水平。

Abstract:

OBJECTIVE To establish and apply the rule of rational drug use of non-tubular anti-inflammatory drugs for injection, conduct pre-prescription and manual audits, and promote rational drug use through the management platform software of rational drug use. METHODS Based on the management platform of rational drug use, instructions, expert consensus and other evidence to precision database and prescription grading management of lornoxicam, flurbiprofen, ketolonine aminosine injection for injection. By randomly selecting 100 surgical patients using the three drugs before (July 2018-September 2018, control group) and after (October 2018-December 2018, intervention group) using the Rational Drug Administration Platform, to evaluate the rationality of the rationality of the indications, the period of treatment, drug delivery way, dose, dosing frequency, combination and adverse drug. To evaluate, analyze and compare for using numbers, defined daily doses and amount used for using the three drugs during three months before and after intervention. RESULTS After the operation of the platform, the proportion of unreasonable medical advice decreased significantly, with a decrease of 69.3%, from 38.54% before intervention to 11.67% after intervention. The incidence of inappropriate route of administration, inappropriate dose, too long course of treatment, inappropriate combination of drugs and inappropriate drug selection in the intervention group was significantly reduced (P<0.01). There was no significant difference between the two groups in the unknown use indications, choice of solvent inappropriate, and the adverse reactions occurred. The number of users, defined daily doses and amount used about the three kinds of drugs were significantly reduced after intervention(P<0.01 or P<0.05). CONCLUSION The application of rational drug use management platform can provide intelligent, precise and individualized service to clinical, improved audit efficiency, standardize the use of non-steroidal anti-inflammatory drugs for injection from the source, and promote the active exploration to new work mode of the pharmacist as well as the level of rational drug use in hospital.