摘要
目的:调查贵州省全身用糖皮质激素(GCs)的使用现状,评价当前GCs相关管理措施的效果。方法:基于贵州省药事管理质量控制中心,采用问卷调查全省各医疗机构GCs的使用情况。采用χ~2检验和方差分析进行单因素分析,Logistic回归和多元线性回归模型分析影响GCs使用的相关因素。结果:全省最终纳入271家已开展诊疗服务的医疗机构。2018年贵州省各医疗机构全身用GCs人均使用量为10.19 mg/人次(按氢化可的松计算),且三级医院的最高(25.69 mg/人次)。共有51家医疗机构(占18.82%)将普通感染退热止痛作为全身用GCs的主要适应证,且这种现象在基层乡镇卫生院尤为突出。目前常用的GCs管理措施在各医疗机构的执行力度不足,且多因素分析结果显示,这些干预措施对于促进GCs的合理使用效果不佳。结论:贵州省GCs不合理使用现象较为突出,因此是未来药事管理质控工作的重点管控品种,特别是要严格把控GCs应用的指征。
OBJECTIVE To investigate the current status of the use of systemic glucocorticoids(GCs)in Guizhou Province and evaluate the effect of current management measures related to GCs.METHODS Based on the Quality Control Center of Guizhou Pharmacy Administration,a questionnaire survey was conducted on the use of GCs in medical institutions throughout the province.Univariate analysis was performed usingχ~2 test and analysis of variance,and logistic regression and multiple linear regression models were used to analyze the factors associated with the use of GCs.RESULTS 271 medical institutions have been included.In 2018,the per capita use of GCs for systemic use in medical institutions in Guizhou Province was 10.19 mg/person(calculated as hydrocortisone),which was the highest in tertiary hospitals(25.69 mg/person).A total of 51 medical institutions(18.82%)considered fever and pain caused by common infections as the main indications for GCs for systemic use,and this phenomenon was particularly prominent in grass-roots township hospitals.At present,the implementation of commonly used GCs management measures in medical institutions is insufficient,and the results of multivariate analysis show that these interventions are not effective in promoting the rational use of GCs.CONCLUSION The status of irrational use of GCs in Guizhou Province is alerting,especially in GHC.It is necessary to restrict the indication for GCs use and improve current management interventions.
作者
张家兴
熊世娟
徐畅
高玲
李莲华
陈琦
谢娟
ZHANG Jia-xing;XIONG Shi-juan;XU Chang;GAO Ling;LI Lian-hua;CHEN Qi;XIE Juan(Department of Pharmacy,Guizhou Provincial People’s Hospital,Guizhou Guiyang 550002,China;Chinese EvidencebasedMedicine Center,Sichuan University,Sichuan Chengdu 610041,China)
出处
《中国医院药学杂志》
CAS
北大核心
2020年第2期219-224,共6页
Chinese Journal of Hospital Pharmacy
关键词
糖皮质激素
药事管理
贵州省
调查研究
glucocorticoid
pharmacy administration
Guizhou province
survey research
