老年住院患者注射用红花黄色素超说明书用药分析及干预

目的 分析老年住院患者注射用红花黄色素超说明书用药情况并干预，降低老年人用药风险，促进临床合理使用。方法 分析老年住院患者注射用红花黄色素超说明书用药现状，通过对其超说明书用药的临床研究和文献进行检索评价后，制定注射用红花黄色素超说明书用药规则，采取软件智能审核与临床药师审核互补的方式对超说明书用药情况进行点评干预。随机抽取2018年1-6月（干预前）和2018年7~12月（干预后）老年住院患者使用注射用红花黄色素病历各480份，评价超说明书用药干预效果。结果 老年住院患者超说明书使用注射用红花黄色素问题严重。涉及的超说明书用药类型主要有超适应症用药、超溶媒、配伍禁忌和超注意事项，干预后各类型超说明书用药例数均明显下降，超说明书用药医嘱比例由干预前的56.61%下降至16.21%，不良反应上报数量由干预前的8例降至干预后的3例。结论 老年住院患者注射用红花黄色素超说明书用药情况普遍存在，利用合理用药软件实时监测与临床药师审核互补的方式可以显著减少超说明书用药。

Analysis and intervention of the off label use of safflor yellow injection in elderly inpatients

Objective To analyze and intervene the off-label use of safflor yellow injection in elderly inpatients, and to reduce the risk of drug use and promote its appropriate use.Methods The current situation of the off-label use of safflor yellow injection in elderly inpatients was analyzed. Clinical researches and literature reviews on off-label use of safflor yellow injection were searched and evaluated systematically, and then its reasonable medication rules were developed. To evaluate and intervene the drug use by using a rational drug use software management system audit automatically and clinical pharmacist audit manually. A total of 480 cases of inpatients of safflor yellow injection used from January-June in 2018 (before intervention) and from July-December in 2018 (after intervention) was taken randomly to evaluated the intervention effect on its off-label use.Results Off-label use of safflor yellow injection was serious. The types of off-label use were mainly focused on over indication, over solvent, contraindication and over precaution, after intervention, the situation of off-label use decreased significantly, the proportion of off-label use decreased from 56.61% before intervention to 16.21%, and the number of adverse reactions reported decreased from 8 cases before intervention to 3 cases after intervention.Conclusion Although off-label use of safflor yellow injection was serious, the complementary way of rational drug use software informatized real-time monitoring and clinical pharmacist audited manually may be utilized to reduce the phenomenon.