医院门诊质子泵抑制剂超说明书用药  情况调查分析

医院门诊质子泵抑制剂超说明书用药情况调查分析

杨焕芝

昆明市第一人民医院药学部

收稿日期:2018-06-11 修回日期:2018-06-22 出版日期:2018-06-25 发布日期:2018-06-25
基金资助:
云南省教育厅科学研究基金项目

Study on the Off-lable Use of the Proton Pump Inhibitors and Analysis its Influencing Factors in Outpatient Department of Hospital

yanghuanzhi

Department of Pharmacy, Kunming First People''s Hospital, Kunming, Yunnan, China 650021

Received:2018-06-11 Revised:2018-06-22 Online:2018-06-25 Published:2018-06-25

摘要/Abstract

摘要： 目的：调查某医院门诊质子泵抑制剂（proton pump inhibitors，PPIs)超说明书用药情况及其影响因素，为临床合理使用PPIs提供参考。方法：釆用回顾性研究方法，随机抽取某医院2015年使用PPIs的门诊处方2640张，根据最新版药品说明书判断是否超说明书用药。从费用、性别、疾病种类、医师级别、是否联合用药、科室、年龄及PPIs种类方面分析PPIs超说明书用药发生的危险因素，采用χ2检验进行单因素分析，有统计学意义的变量进行多因素Logistic回归分析。结果：门诊PPIs超说明书用药发生率为28.11%，超说明书用药类型主要为超适应证用药。单因素分析结果显示，费用、性别、疾病种类、医师级别、是否联合用药、科室、年龄及PPIs种类是门诊患者PPIs超说明书用药发生的危险因素（P<0.05）。多因素分析结果显示，费用≥389元、女性、不同疾病（野生菌中毒、急性荨麻疹除外）、副主任医师、联合使用糖皮质激素、肾内科、雷贝拉唑和泮托拉唑片剂是门诊PPIs超说明书用药发生的独立危险因素（P<0.05）；消化科、简易门诊和年龄≥25岁是保护因素（P<0.05）。结论：门诊PPIs超说明书用药现象普遍存在，影响超说明书用药发生的因素较多，应从费用、医师级别、联合用药预防应激性溃疡、疾病种类等方面降低PPIs超说明书用药发生率。

Abstract: Objective： To study the extent of off-lable use of PPIs and its influencing factors in outpatient department of a 3-A Grade Hospital and to provide reference for the rational use of PPIs. Methods： A retrospective study was conducted to randomly select 2640 prescription of PPIs in 2015.According to the latest drug instructions，from cost， sex， disease types， grade of physician， whether to combine medication， different clinical departments， age and the kinds of PPIs to determine the risk factors of PPIs for outpatients. Chi-square test was used to analyze the effect of single factor， the variables with statistical significance were analyzed by multi-factor Logistic regression. Results： The incidence rates of off-label drug use accounted for 28.11% for outpatients.The types of off-label drug use was mainly concentrated in the indications. Single factor analysis results showed that the cost， sex， disease types， grade of physician， whether to combine medication， clinical departments， age and the kinds of PPIs were the dangerous factors for off-lable use of PPIs（P<0.05）.Logistics regression analysis results showed that costs≥389， female， different disease (except for wild fungus poisoning， acute urticaria)， associate senior doctor， combing use of glucocorticoid hormone，department of nephrology， rabeprazole and pantoprazole tablets were the independent risk factors， digestive department， simple outpatient and Age≥25 years old were the protection factors（P<0.05）. Conclusion： The phenomenon of PPIs off-label use is widespread in outpatient department of the hospital. There are many influencing reasons for the incidence of PPIs off-label use， we should reduce the incidence of PPIs off-label use from cost， grade of physician， combing medication to prevent stress ulcers， different disease and so on.

杨焕芝. 医院门诊质子泵抑制剂超说明书用药情况调查分析[J]. .

yanghuanzhi. Study on the Off-lable Use of the Proton Pump Inhibitors and Analysis its Influencing Factors in Outpatient Department of Hospital[J]. .

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