摘要
目的:了解广州市妇女儿童医疗中心(以下简称"我院")儿科常用免疫抑制剂的临床使用情况,为儿童患者免疫抑制剂的规范使用提供参考。方法:采用回顾性调查方法,随机抽取2019—2020年我院儿科应用他克莫司、环孢素、吗替麦考酚酯及西罗莫司的处方共3318张。根据相关指南、共识等循证证据,对处方中免疫抑制剂的使用情况进行专项点评。结果:3318张儿科常用免疫抑制剂处方中,有138张处方存在不合理情况,处方不合理率为4.2%;不合理类型主要为联合用药不合理(51张,占不合理处方数的37.0%)、用法与用量不合理(35张,占不合理处方数的25.4%)以及无适应证或超适应证用药(24张,占不合理处方数的17.4%)等。结论:我院仍存在儿童患者免疫抑制剂不合理使用情况。应加强医师、护士及患者环节的用药宣教,重视免疫抑制剂的规范使用和浓度监测,同时持续改进院内处方点评制度,促进临床合理、规范使用免疫抑制剂。
OBJECTIVE: To investigate the clinical use of commonly used immunosuppressant in pediatrics in Guangzhou Women and Children ’s Medical Center( hereinafter referred to as "our hospital "),so as to provide reference for the standardized use of immunosuppressant in children. METHODS: A total of 3 318 pediatric prescriptions with tacrolimus,cyclosporine,mortimecofenate and sirolimus in our hospital from 2019 to 2020 were randomly selected by retrospective investigation. According to the relevant guidelines,consensus and other evidencebased evidence,the use of immunosuppressant in the prescription was specially reviewed. RESULTS: Among 3 318 prescriptions of commonly used immunosuppressant in pediatrics,138 prescriptions had irrational drug use,with irrational rate of 4. 2%. The irrational types were respectively irrational drug combination( 51 prescriptions,accounting for 37. 0% of unreasonable prescriptions),improper usage and dosage( 35 prescriptions,accounting for 25. 4% of unreasonable prescriptions),and without indications or off-label indications( 24 prescriptions,accounting for 17. 4% of unreasonable prescriptions). CONCLUSIONS: There are still some irrational use of immunosuppressant in children in our hospital. It is necessary to strengthen the drug use education among clinicians,nurses and patients,pay attention to the standardized use and concentration monitoring of immunosuppressant,and continuously improve the prescription review system in our hospital to promote the rational and standardized use of immunosuppressant in clinic.
作者
莫小兰
钟岑
钟纬璇
梁业梅
何艳玲
和凡
欧定宏
陈怡禄
MO Xiaolan;ZHONG Cen;ZHONG Weixuan;LIANG Yemei;HE Yanling;HE Fan;OU Dinghong;CHEN Yilu(Dept.of Pharmacy,Guangzhou Women and Children’s Medical Center,Guangzhou Medical University,Guangdong Guangzhou 510623,China;Dept.of Pharmacy,Jinshazhou Hospital,Guangzhou University of Traditional Chinese Medicine,Guangdong Guangzhou 510168,China;College of Pharmacy,Guangdong Pharmaceutical University,Guangdong Guangzhou 510006,China)
出处
《中国医院用药评价与分析》
2021年第6期733-736,共4页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
国家自然科学基金(No.81603203)
广东省中医药局基金(No.20201302)
广东省药学会医院药学研究基金(No.2021A35)
广州市妇女儿童医疗中心儿研所内部基金(No.GWCMC2020LH-3-003)。
关键词
免疫抑制剂
儿童
专项点评
合理用药
Immunosuppressant
Children
Special review
Rational drug use
