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目的:为临床合理应用蔗糖铁注射液提供参考。方法:参考相关文献和指南,通过药学和临床专家讨论与修订,从用药指征、用药过程、用药结果3个方面建立蔗糖铁注射液的药物利用评价(DUE)标准,制订并实施干预措施。随机抽取2016年2月蔗糖铁注射液使用总金额排名前5位科室中的56例患者为干预前组,再分别随机抽取相应科室2016年4、6月出院患者作为第1阶段干预组(40例)和第2阶段干预组(53例),比较3组患者干预前后蔗糖铁注射液使用符合标准率及合理性。结果:经过2个阶段干预后,第1阶段干预组和第2阶段干预组患者“用药前监测血清铁蛋白等相关缺铁性指标”“溶剂剂量选择”“给药频率符合标准”“贫血症状好转或贫血相关指标改善”的符合率均显著高于干预前组,差异有统计学意义(P<0.05);第2阶段干预组患者“相互作用符合标准”的符合率显著高于第1阶段干预组,差异有统计学意义(P<0.05)。第2阶段干预组患者综合合理率为77.34%,显著高于干预前组的41.07%和第1阶段干预组的47.50%,差异有统计学意义(P<0.05)。结论:我院建立的蔗糖铁注射液DUE标准有较强的可操作性和实用性,临床药师的有效干预解决了临床用药过程中存在的问题,促进了临床用药的合理性,减少了药品不良反应的发生。
OBJECTIVE: To provide reference for rational use of Iron sucrose injection. METHODS: Refrring to related literatures and gaideline, through pharmacy and clinical expert discussion and revision, DUE standard for Iron sucrose injection was established from medication indication, medication duration and medication results, the intervention measures were formulated and implemented. 56 patients were randomly collected from top 5 departments in the list of total amount of Iron sucrose injection in Feb. 2016 as pre-intervention group; discharged patients were randomly collected from relevant department in Apr. and Jun. 2016 as first stage intervention group (40 cases) and second stage intervention group (53 cases), respectively. The proportion of Iron sucrose injection meeting the criteria as well as rationality were compared before and after intervention, respectively. RESULTS: After two stages of intervention, pre medication monitoring serum ferritin-related iron deficiency indexes, solvent dosage selection, DDDs, the proportion of anaemia improvement or anaemia-related indexes improvement meeting the criteria in the first stage intervention group and second stage intervention group were all significantly higher than pre-intervention group, with statistical significance (P<0.05). The proportion of patient interaction meeting the criteria in the second stage intervention group was significantly higher than first stage intervention group, with statistical significance (P<0.05). The comprehensive rational rate of second stage intervention group was 77.34%, which was significantly higher than 41.07% of pre-intervention group and 47.50% of first stage intervention group, with statistical significance (P<0.05). CONCLUSIONS: DUE standard for Iron sucrose injection have great operability and practicability. Clinical pharmacists’intervention effectively dispose the problems of clinical drug use, promote the rationality of clinical drug use and reduce the incidence of ADR.
蔗糖铁注射液药物利用评价标准合理用药干预措施
Iron sucrose injectionDUE standardRational drug useIntervention
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