西北妇女儿童医院2017年儿科门诊处方超说明书用药情况调研
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摘要
目的回顾性分析2017年西北妇女儿童医院儿科门诊患儿超说明书用药情况,分析相关危险因素。方法分层随机抽取我院2017年1～12月儿科门诊处方,根据药品说明书,统计医嘱情况。结果共抽取处方2 631张,分析医嘱4 435条,涉及药品155种。按处方、用药医嘱与药品种类计,超说明书用药发生率分别为61.38%、46.76%、91.61%,用药类型主要包括未提及儿童用药信息(34.28%)、给药频次(28.46%)和剂量(16.42%)3种,发生率居前2位的年龄段为青少年(50.00%)和婴幼儿(47.64%)。结论 2017年我院儿科门诊超说明书用药情况普遍,需进一步规范临床医师用药,促进儿童合理用药。
Objective To retrospectively analyze the situation of off-label drug use in pediatric outpatient department of Northwest Women and Children's Hospital in 2017, and to analyze the related risk factors. Methods Prescriptions of pediatric outpatient clinics in our hospital were randomly selected by stratified sampling from January 2017 to December2017. According to the drug instructions, the situation of medication orders was analyzed statistically. Results A total of 2 631 outpatient pediatric prescriptions were selected and 4 435 prescriptions were analyzed, involving 155 kinds of drugs. According to prescriptions, medication orders and types of drugs, the rates of off-label drug use were 61.38%,46.76% and 91.61% respectively. The types mainly included no information about children's medication(34.28%),frequency of administration(28.46%) and dose(16.42%). The top two age groups were adolescents(50.00%) and infants(47.64%). Conclusion In 2017, the situation of off-label drug use in our hospital was widespread. It is necessary to further standardize the use of drugs by clinicians and promote rational drug use in children.
Objective To retrospectively analyze the situation of off-label drug use in pediatric outpatient department of Northwest Women and Children's Hospital in 2017, and to analyze the related risk factors. Methods Prescriptions of pediatric outpatient clinics in our hospital were randomly selected by stratified sampling from January 2017 to December2017. According to the drug instructions, the situation of medication orders was analyzed statistically. Results A total of 2 631 outpatient pediatric prescriptions were selected and 4 435 prescriptions were analyzed, involving 155 kinds of drugs. According to prescriptions, medication orders and types of drugs, the rates of off-label drug use were 61.38%,46.76% and 91.61% respectively. The types mainly included no information about children's medication(34.28%),frequency of administration(28.46%) and dose(16.42%). The top two age groups were adolescents(50.00%) and infants(47.64%). Conclusion In 2017, the situation of off-label drug use in our hospital was widespread. It is necessary to further standardize the use of drugs by clinicians and promote rational drug use in children.
引文
[1]中华医学会儿科学分会临床药理学组.中国儿科超说明书用药专家共识[J].中华儿科杂志,2016,54(2):101-103.
[2]STAFFORD RS.Regulating off-label drug use-rethinking the role of the FDA[J].N Engl Med,2008,358(14):1427-1429.
[3]CONROY S,CHOONARA I,IMPICCIATORE P,et al.Survey of unlicensed and off label drug use in paediatric wards in European countries[J].BMJ,2000,320(7227):79-82.
[4]PANDOLFINI C,BONATI M.A literature review on off-label drug use in children[J].Eur J Pediatr,2005,164(9):552-558.
[5]PALMARO A,BISSUEL R,RENAUD N,et al.Off-label prescribing in pediatric outpatients[J].Pediatrics,2015,135(1):49-58.
[6]张伶俐,李幼平,曾力楠,等.15国超说明书用药政策的循证评价[J].中国循证医学杂志,2012,12(4):426-435.
[7]PETRA C,LEWIS B,FAVIL,et al.Clinical setting influences off-label and unlicensed prescribing in a paediatric teaching hospital[J].PLoS One,2015,10(3):e0120630.
[8]LAI LL,KOH L,HO JA,et al.Off-label prescribing for children with migraines in U.S.ambulatory care settings[J].J Manag Care Spec Pharm,2017,23(3):382-387.
[9]SCHR?DER C,D?RKS M,KOLLHORST B,et al.Outpatient antidepressant drug use in children and adolescents in Germany between2004 and 2011[J].Pharmacoepidemiol Drug Saf,2017,26(2):170-179.
[2]STAFFORD RS.Regulating off-label drug use-rethinking the role of the FDA[J].N Engl Med,2008,358(14):1427-1429.
[3]CONROY S,CHOONARA I,IMPICCIATORE P,et al.Survey of unlicensed and off label drug use in paediatric wards in European countries[J].BMJ,2000,320(7227):79-82.
[4]PANDOLFINI C,BONATI M.A literature review on off-label drug use in children[J].Eur J Pediatr,2005,164(9):552-558.
[5]PALMARO A,BISSUEL R,RENAUD N,et al.Off-label prescribing in pediatric outpatients[J].Pediatrics,2015,135(1):49-58.
[6]张伶俐,李幼平,曾力楠,等.15国超说明书用药政策的循证评价[J].中国循证医学杂志,2012,12(4):426-435.
[7]PETRA C,LEWIS B,FAVIL,et al.Clinical setting influences off-label and unlicensed prescribing in a paediatric teaching hospital[J].PLoS One,2015,10(3):e0120630.
[8]LAI LL,KOH L,HO JA,et al.Off-label prescribing for children with migraines in U.S.ambulatory care settings[J].J Manag Care Spec Pharm,2017,23(3):382-387.
[9]SCHR?DER C,D?RKS M,KOLLHORST B,et al.Outpatient antidepressant drug use in children and adolescents in Germany between2004 and 2011[J].Pharmacoepidemiol Drug Saf,2017,26(2):170-179.