住院患者降糖药品应用分析

目的了解我院住院患者降糖药品临床应用情况,为其临床合理用药及规范化管理提供参考。方法选取2009—2012年我院计算机管理系统提供的住院药房降糖药品应用数据,包括药品名称、规格、用量、销售金额等,并计算各药的用药频度(DDDs)。结果 2009—2012年我院口服降糖药中阿卡波糖片(拜糖平)销售金额逐年增加,且居第一名;瑞格列奈(1 mg和2 mg)销售金额逐年增加,且居前三位;罗格列酮分散片销售金额逐年递减。2009—2012年阿卡波糖片(拜糖平)DDDs稳居第一;瑞格列奈(1 mg)和二甲双胍缓释胶囊(山姆士)DDDs居第二和第三位;罗格列酮分散片DDDs逐年下滑。结论我院住院患者降糖药物使用基本合理。     

2020—2022年北京小汤山医院门诊第二类精神药品的使用情况分析

目的 对我院门诊第二类精神药品的使用情况进行分析,促进临床合理用药。方法 对2020—2021年我院门诊第二类精神药销售数量、销售金额、用药频度、药物利用指数、日均费用等进行分析。结果 2020—2021年我院门诊第二类精神药品使用量逐年上升,其中艾司唑仑片连续三年使用量排名第一;酒石酸唑吡坦片销售金额连续三年排名第一;除氨酚羟考酮片和氯硝西泮片用药频度(DDDs)2022年较2021年有所下降,其他第二类精神药品的用药频度呈现逐年上升趋势;药物利用指数大于1的有酒石酸唑吡坦、佐匹克隆胶囊、苯巴比妥片;药物利用指数小于1的有艾司唑仑片、劳拉西泮片、地西泮片。2020—2021年我院第二类精神药品日均费用值基本稳定,艾司唑仑片和酒石酸唑吡坦片使用最多的科室为中西医结合康复科和综合内科。结论 我院门诊第二类精神药品的使用基本合理。     

2011—2014年北京地区慢性乙型肝炎抗病毒治疗核苷酸类药物情况分析

目的了解浙江省永康市第一人民医院2011—2014年核苷酸类药物的使用情况,包括用药金额和用药频度(DDDs)。方法统计浙江省永康市第一人民医院2011—2014年拉米夫定、阿德福韦酯、替比夫定、恩替卡韦的用药金额、用药频度以及排名情况。结果各个用药金额逐年增长,其中恩替卡韦增长最为显著,虽然替比夫定在年增长量上有很大突破但该药品的DDDs一直处于最小,拉米夫定和阿德福韦酯的增长状态较为稳定。结论抗病毒治疗是慢性乙型肝炎治疗的关键,必须严格掌握治疗适应证,谨慎选择核苷酸类药物制定一个合理的治疗方案。     

辽河油田医疗机构抗高血压药应用分析

目的: 调查辽河油田医疗机构抗高血压药的应用情况及服药依从性,探讨其临床用药特点,为临床合理用药提供参考。方法：回顾性调查辽河油田医疗机构2015年2-11月抗高血压药物处方,采用WHO推荐的金额排序法和频度分析法及统计学方法对各类抗高血压药物的销售金额、用药频度( DDDs)、日均费用( DDDc)及联合用药情况进行分析,总结并探讨抗高血压药物的用药特点,同时以高血压患者依从性问卷形式调查分析患者的服药依从性。结果：男性患者均多于女性患者,抗高血压药品种中CCB类均占首位,符合国内外指南的高血压应用情况,应用结构比为CCB类＞ ARB类＞ β -RB ＞ ACEI 类,利尿药应用比例低,联合用药总体比例偏低。CPAT不佳因素,经济原因和文化程度占较大比例。结论：辽河油田医疗机构抗高血压药应用基本合理,利尿剂、联合用药比例偏低,应加强高血压防治指南学习,进一步改进。     

山西医科大学第一医院方便药房2002年-2004年心血管系统用药分析

目的了解医院心血管系统药物的应用状况及趋势.方法采用金额排序和对比分析方法,对山西医科大学第一医院方便药房2002年-2004年病人自费购买口服心血管系统药物前20位排名,按品种、金额及构成比进行统计分析,内容包括心血管系统药物占各年总购药金额百分比,按作用分类所占总心血管系统药物的百分率.结果心血管系统药物数量、品种逐年增加,钙通道阻滞剂年用药金额呈上升趋势,全年药品销量略有下降.结论经济、高效、副反应小的心血管系统药品是病人首选,应加强该系统药品的管理,宣传用药知识,提高合理用药水平.     

我院3年来降糖药物应用分析

对我院2003～2005年降糖药物的用药情况进行了统计分析,包括3年主要品种数量,经营金额,DDD数以及临床的评价.结果3年来降糖药物经营金额明显高于药品经营总金额增长比例,金额数排序为格列吡嗪、格列喹酮、诺和灵30R居前3位.用量和DDDs排序,格列吡嗪、苯乙双胍、二甲双胍、格列喹酮居于前4位.结论糖尿病人逐年增多,呼吁社会各界加大糖尿病的防治力度.     

2011-2014年某传染病医院抗菌药物使用特点分析

目的 为传染病医院抗菌药物临床合理应用监管提供数据支持.方法 对该院2011-2014年抗菌药物使用金额、使用率、抗菌药物使用强度(AUD)、用药频度(DDDs)等进行统计、分析.结果 抗菌药物使用的各项指标呈下降趋势,抗菌药物金额所占百分比由17.71%下降至10%左右,住院患者抗菌药物使用率从69.37%下降至60%左右,AUD也有一定程度下降.药品金额排序中哌拉西林钠/他唑巴坦钠连续3年均排名前2位,抗真菌药伏立康唑胶囊连续3年进入前10位.DDDs排名前10位的药物中每年均有3种药物是艾滋病人常用于抗真菌的药物.结论 通过抗菌药物专项整治活动,该院的抗菌药物使用得到了有效控制,但传染病医院的抗菌药物使用特点需引起决策部门的重视,制定符合传染病医院特点的控制目标.     

我院3年来降糖药物应用分析

对我院2003-2005年降糖药物的用药情况进行了统计分析，包括3年主要品种数量，经营金额，DDD数以及临床的评价。结果：3年来降糖药物经营金额明显高于药品经营总金额增长比例，金额数排序为格列吡嗪、格列喹酮、诺和灵30R居前3位。用量和DDDs排序，格列吡嗪、苯乙双胍、二甲双胍、格列喹酮居于前4位。结论：糖尿病人逐年增多，呼吁社会各界加大糖尿病的防治力度。     

我院门诊高血压患者抗高血压药应用调查分析

目的对我院高血压患者抗高血压药应用情况进行调查,分析抗高血压药应用的合理性。方法统计我院门诊2010~2012年各类降压药消耗量和金额,计算用药频度(DDDs)和药物利用指数(DUI)并进行分析。结果我院抗高血压药的销售金额排于前4位的是硝苯地平缓释片(Ⅱ)、左旋氨氯地平、福辛普利、厄贝沙坦;DDDs排在前四位的是硝苯地平缓释片、左旋氨氢地平、福辛普利、吲哒帕胺;所有调查的高血压药物其DUI≤1。结论门诊抗高血压药物应用基本合理。     

2006～2009年某院口服抗高血压药物的使用情况分析

为了解我院2006—2009年口服抗高血压药物的使用情况,及时发现药品消耗的变化规律,掌握临床用药趋势,为药品的采购、管理和临床合理用药提供参考,我们对我院口服抗高血压药物的使用情况进行了分析。现报告如下。     

2010年度北京市海淀医院抗结核药物的临床应用分析

目的 了解北京市海淀医院抗结核药物的临床应用情况,以便对综合性医院合理应用抗结核药物方案提供参考依据。方法 利用北京市海淀医院计算机信息系统统计2010年度该院各一线抗结核药物使用的总量、金额及用药天数,计算出用药频度（DDDs）、日均费用（DDC）和药物利用指数（DUI）,进行合理用药评价。从2010年度17321例住院患者中检索出使用过一线抗结核药的患者62例,并对这62例患者病历中抗结核药的用药原因、用药方案、用法用量进行分析。结果 北京市海淀医院抗结核一线药物主要有利福平、异烟肼、乙胺丁醇、吡嗪酰胺、硫酸链霉素,5种药物全年总费用合计1988.05元。利福平、乙胺丁醇和吡嗪酰胺的DUI值小于1,分别是0.85、0.86和0.96。使用一线抗结核药62例患者中有48例患者为抗结核治疗用药,其中确诊及临床诊断结核病初治患者32例,抗结核治疗化疗方案选择HRZE方案的比例为43.8%（14/32）,抗结核治疗方案中加用了二线抗结核药左氧氟沙星的比例为79.2%（38/48）。结论 北京市海淀医院抗结核药物用量较少,临床使用规范化比例低,个别药给药剂量不足,今后有待加强对结核病规范化治疗的学习及培训。     

A comparison of post‐stroke hypertension medication use between US Stroke Belt and Non‐Stroke Belt residents

Although hypertension is a contributing factor to higher stroke occurrence in the Stroke Belt, little is known about post‐stroke hypertension medication use in Stroke Belt residents. Through the use of national Behavioral Risk Factor Surveillance System surveys from 2015, 2017, and 2019; we compared unadjusted and adjusted estimates of post‐stroke hypertension medication use by Stroke Belt residence status. Similar levels of post‐stroke hypertension medication use were observed between Stroke Belt residents (OR: 1.09, 95% CI: 0.89, 1.33) and non‐Stroke Belt residents. After adjustment, Stroke Belt residents had 1.14 times the odds of post‐stroke hypertension medication use (95% CI: 0.92, 1.41) compared to non‐Stroke Belt residents. Findings from this study suggest that there is little difference between post‐stroke hypertension medication use between Stroke Belt and non‐Stroke Belt residents. However, further work is needed to assess whether use of other non‐medicinal methods of post‐stroke hypertension control differs by Stroke Belt residence status.     

Evaluation of Adherence to Oral Hypoglycemic Agent Prescription in Patients with Type 2 Diabetes

BACKGROUNDDiabetes is a global health problem that has affected more than 400 million people worldwide. Adherence to treatment is considered to be one of the most impor tant and deterministic factors in the treatment of diabetes. This study investigates medication adherence and factors af fecting it in patients with type 2 diabetes.METHODSThis cross-sectional study investigated 136 patients with type 2 diabetes in 2018-2019. Data collection was done using a checklist that included information on personal characteristics, medication, and healthcare. The collected data were analyzed by statistical tests in SPSS 25 software.RESULTS79.4% of the patients adhered to prescribed medication. Medication adherence had no significant relationship with taking other drugs, fasting blood sugar (FBS), and the daily number of hypoglycemic tablets (p ˃ 0.05). However, adherence to medication was significantly associated with age, gender, income, hemoglobin A1c, medication period, and hypoglycemia (p < 0.05).CONCLUSIONSHigher levels of adherence were` obser ved among females aged below 60 years, with higher income, a hemoglobin A1c level below 7%, a medication period of less than 10 years, and among patients without hypoglycemia. Regarding drug type, adherence levels were lower in people taking glibenclamide.     

The impact of fixed‐dose combination versus free‐equivalent combination therapies on adherence for hypertension: a meta‐analysis

Nonadherence to antihypertensive medication is considered as a reason of inadequate control of blood pressure. This meta‐analysis aimed to systemically evaluate the impact of fixed‐dose combination (FDC) therapy on hypertensive medication adherence compared with free‐equivalent combination therapies. Articles were retrieved from MEDLINE and Embase databases using a combination of terms “fixed‐dose combinations” and “adherence or compliance or persistence” and “hypertension or antihypertensive” from January 2000 to June 2017 without any language restriction. A meta‐analysis was performed to parallel compare the impact of FDC vs free‐equivalent combination on medicine adherence or persistence. Studies were independently reviewed by two investigators. Data from eligible studies were extracted and a meta‐analysis was performed using R version 3.1.0 software. A total of nine studies scored as six of nine to eight of nine for Newcastle‐Ottawa rating with 62 481 patients with hypertension were finally included for analysis. Results showed that the mean difference of medication adherence for FDC vs free‐equivalent combination therapies was 14.92% (95% confidence interval, 7.38%–22.46%). Patients in FDC group were more likely to persist with their antihypertensive treatment, with a risk ratio of 1.84 (95% confidence interval, 1.00–3.39). This meta‐analysis confirmed that FDC therapy, compared with free‐equivalent combinations, was associated with better medication adherence or persistence for patients with hypertension. It can be reasonable for physicians, pharmacists, and policy makers to facilitate the use of FDCs for patients who need to take two or more antihypertensive drugs.     

Pain Treatment of Underserved Older African Americans

Older African Americans who experience pain are especially at high risk of underassessment and undertreatment. This study examined patterns and correlates of pain medication use: severity of pain, medical conditions, and access to care. African Americans aged 65 and older were recruited from 16 churches located in south Los Angeles (N = 400). Structured face‐to‐face interviews and visual inspection of each participant's medications were conducted. More than 39% of participants were aged 75 and older, and 65% were female. Forty‐seven percent used at least one type of pain medication. The frequency of pain medication use according to pharmaceutical class was nonopioid, 33%; opioid, 12%; adjuvant, 9%; and other drug, 8%. Seventy‐seven percent of nonopioids were nonsteroidal anti‐inflammatory drugs (NSAIDs), which 25% of participants with hypertension, 28% with stroke, 26% with kidney disease, and 28% with gastrointestinal problems used. Ninety‐eight percent of participants who used NSAIDs, 98% experienced potentially inappropriate medication (PIM) use, 69% experienced drug duplication, and 65% experienced drug–drug interactions. This study suggests severe mismanagement of pain in underserved older African Americans, particularly those with comorbidity, multiple providers, and limited access to health care. The use of pain medication was associated with drug–drug interactions, drug duplication, and PIM use. The data show that many participants with severe pain are not taking pain medication or experience PIM use. One in four participants was taking NSAIDs, which can cause serious side effects in older African Americans with multiple chronic conditions.     

Inappropriate Medication Use as a Risk Factor for Self-Reported Adverse Drug Effects in Older Adults

OBJECTIVES: To determine the association between inappropriate medication use and self‐reported adverse drug effects (ADEs). DESIGN: Prospective cohort study with three annual mailed surveys. SETTING: Population‐based sample of Iowa Medicare beneficiaries. PARTICIPANTS: Cohort members (n=626) with established mobility disability and complete pharmacy dispensing records, continuous Medicare eligibility, and survey data. MEASUREMENTS: The number of unique drug ingredients dispensed and inappropriate use were assessed for the year before the ADE survey. Inappropriate medication use was defined according to published criteria: contraindicated drugs for elderly people, drug–disease interactions (constructed from linked Medicare claims), drug–drug interactions, and therapeutic duplications. An ADE was defined from the following question: “In the past 12 months, have you experienced an unwanted effect or side effect of a medication?” RESULTS: Of respondents to the ADE survey, 22.0% reported having experienced an ADE in the past year, and 322 (51.4%) received at least one potential inappropriate medication. Factors associated univariately with ADE self‐report were number of medications, number of mobility limitations, any inappropriate medication use, and each of the individual domain appropriateness indicators, as well as number of different domains of inappropriate use. The adjusted odds ratio for developing an ADE was 2.14 (95% confidence interval=1.26–3.65) for those with inappropriate use versus no inappropriate use. CONCLUSION: Efforts to reduce ADEs by reducing medication inappropriateness should be encouraged as a complement to efforts focused on reducing the number of medications prescribed.     

Polypharmacy: Misleading,but manageable

The percentage of the population described as elderly is growing, and a higher prevalence of multiple, chronic disease states must be managed concurrently. Healthcare practitioners must appropriately use medication for multiple diseases and avoid risks often associated with multiple medication use such as adverse effects, drug/drug interactions, drug/disease interactions, and inappropriate dosing. The purpose of this study is to identify a consensus definition for polypharmacy and evaluate its prevalence among elderly outpatients. The authors also sought to identify or develop a clinical tool which would assist healthcare practitioners guard against inappropriate drug therapy in elderly patients. The most commonly cited definition was a medication not matching a diagnosis. Inappropriate was part of definitions used frequently. Some definitions placed a numeric value on concurrent medications. Two common definitions (ie, 6 or more medications or a potentially inappropriate medication) were used to evaluate polypharmacy in elderly South Carolinians (n = 1027). Data analysis demonstrates that a significant percentage of this population is prescribed six or more concomitant drugs and/or uses a potentially inappropriate medication. The findings are 29.4% are prescribed 6 or more concurrent drugs, 15.7% are prescribed one or more potentially inappropriate drugs, and 9.3% meet both definitions of polypharmacy used in this study. The authors recommend use of less ambiguous terminology such as hyperpharmacotherapy or multiple medication use. A structured approach to identify and manage inappropriate polypharmacy is suggested and a clinical tool is provided.     

基因指导降压药物选择与传统用药疗效比较

目的 比较原发性高血压患者在基因检测指导下选择降压药物与传统经验用药的临床疗效.方法 选取2019年08月至2020年08月在唐都医院心内科门诊就诊的166例原发性高血压患者,根据是否在基因检测结果指导下选择降压药物分为基因指导组57例与非基因指导组109例.随访并收集患者的基本资料、用药前后的血压水平、用药种数以及药...     

204例支气管哮喘住院患者用药状况分析

目的总结2011年度支气管哮喘患者住院治疗用药情况。方法调查2011年度符合纳入标准的204例成人支气管哮喘急性发作期住院患者的用药情况。结果 (1)81.86%的患者应用了糖皮质激素,77.45%应用了茶碱类药物,67.16%应用了抗生素,58.82%应用了速效β2受体激动剂(SABA),33.82%应用了抗胆碱能药物,22.55%应用了白三烯受体调节剂,7.84%应用了抗组胺类药物;(2)联合用药:2、3、4、5、6种及6种以上种药物联合分别占5.88%、11.27%、24.51%、25.49%、20.01%;(3)给药途径糖皮质激素雾化吸入、口服和静脉分别占55.09%、1.80%和43.11%;SABA、抗胆碱能药物、ICS+LABA均是吸入给药;抗组胺药、白三烯调节剂及中药均为口服给药。(4)合并感染的患者76例,其中75例使用了抗生素;抗生素药物的使用中氟喹诺酮类所占比例最高,占48.18%。结论我院临床医师对支气管哮喘发作期用药的选择、给药途径、联合用药方案基本遵循《全球哮喘防治创议》(GINA)中的原则,但存在抗生素使用及激素静脉给药比例偏高、联合用药种类偏多的情况,需继续加强学习,更进一步提高认识,更加规范支气管哮喘的临床诊疗,避免抗生素使用不当、用药种类过多的情况发生。