达比加群酯药物利用评价标准的建立与回顾性分析

目的:建立达比加群酯药物利用评价标准(drug use evaluation, DUE),为临床合理应用达比加群酯提供参考。方法:以达比加群酯药品说明书为基础，参考相关指南和文献，通过专家咨询法制订达比加群酯药物利用评价标准，并采用回顾性研究方法，对湖北省某大型三甲医院2021年1-6月使用达比加群酯的住院患者用药进行合理性评价，具体包括适应证、用法用量、联合用药、禁忌证、不良反应监测及药物转换等。结果:共纳入501份病例，完全符合评价标准的合理率为91.42%,不合理应用常见于适应证不适宜(2.2%)和用法用量不适宜(2.0%),同时存在30.3%的联合用药的高风险。结论:建立的达比加群酯的DUE具有较强的科学性、实用性和可行性，该院达比加群酯临床应用中尚存在一些问题，应进一步加强干预，促进临床合理用药。

Establishment and retrospective analysis of the evaluation criteria for drug utilization of dabigatran

OBJECTIVE To establish the drug use evaluation (DUE) criteria for dabigatran, and to provide reference for rational clinical application of dabigatran.METHODS Based on the drug instruction of dabigatran and referring to relevant guidelines and literature, the evaluation criteria for dabigatran utilization were established by expert consultation method. A retrospective study was conducted to evaluate the rationality of dabigatran in inpatients in a large grade A hospital in Hubei province from January to June 2021, including indications, usage and dosage, combination, contraindications, adverse reaction monitoring and drug conversion.RESULTS A total of 501 medical records were included, and the rational rate of fully meeting the evaluation criteria was 91.42% . Unreasonable uses were common in unsuitable indications (2.2%) and unsuitable usage and dosage (2.0%), and there was a high risk for 30.3% combination drug use.CONCLUSION The DUE established for dabigatran is scientific, practical and feasible. There are still some problems in the clinical application of dabigatran in this hospital, and further intervention should be strengthened to promote clinical rational drug use.