摘要
目的建立酮咯酸氨丁三醇药物相关问题(drug-related problems,DRPs)分类标准,评价亳州市人民医院酮咯酸氨丁三醇临床使用的合理性。方法通过医院信息系统,抽取2023年1月至8月住院患者中使用酮咯酸氨丁三醇的所有病历资料,以药品说明书、治疗指南和专家推荐意见等为依据,采用Granada-Ⅱ分类法对住院期间使用酮咯酸氨丁三醇的必要性、有效性及安全性进行评价。针对基线评价中发现的问题进行药学干预,对2023年11月至12月使用该药物的病历进行再评价。结果2023年1月至8月有630例患者使用了酮咯酸氨丁三醇,其中362例(57.46%)患者发生了DRPs,累计发生455例次DRPs,包括285例次DRP5(药物相互作用及配伍禁忌),138例次DRP6(超剂量使用),32例次DRP2(无适应证)。不合理问题具体表现在用法用量、药物相互作用、疗程以及用药指征方面,不合理率分别为57.78%、50.79%、34.76%、20.32%;干预后,2023年11月至12月用药不合理率显著降低,用药指征不符合率为1.88%,用法用量不合理率为8.41%,疗程不合理率为2.26%,药物相互作用不合理率为20.20%,与干预前比较,差异均具有统计学意义(P<0.01)。结论该院酮咯酸氨丁三醇的使用主要在用药安全性方面存在问题,表现为药物相互作用及配伍禁忌和超剂量使用,病历合格率较低。基于Granada-Ⅱ分类法评价药物相关问题并进行药学干预切实可行,可以提高医院用药合理率。
Objective To establish classification criteria for drug-related problems(DRPs)associated with Ketorolac Tromethamine Injections and to provide a reference for the rational use of this injection in clinical practice.Methods Through the hospital information system,all medical records involving ketorolac tromethamine from January 1 to August 31,2023,at Bozhou People’s Hospital were reviewed.By using the Granada-Ⅱclassification framework,necessity,effectiveness,and safety of ketorolac use during hospitalization,referencing product labels,guidelines,and expert consensus were evaluated.Baseline DRPs were identified,and targeted pharmaceutical interventions were implemented.The rational use rate before and after intervention was compared.Results Among 630 medical records,362 cases(57.46%)contained 455 DRPs.The predominant DRP categories were[DRP5(drug interaction/incompatibility)](285 cases),[DRP6(overdose)](138 cases),and DRP2(off-label use)(32 cases).Key irrationalities included dosage(57.78%),drug interactions(50.79%),treatment duration(34.76%),and indication(20.32%).Post-intervention(November-December 2023),the irrational use rate dropped markedly:indication concordance 1.88%,dosage irrationality 8.41%,duration irrationality 2.26%,and interaction irrationality 20.20%,the difference was significantly compared to before the intervention(P<0.01).Conclusion Ketorolac use was mainly compromised by safety issues-chiefly drug interactions,incompatibility,and overdose-resulting in low qualified medical-record rates.Granada-Ⅱclassification coupled with targeted pharmaceutical interventions effectively improved rational use.
作者
狄潘潘
岳云月
夏茹楠
李帅
王志远
贾淑云
梁海
DI Panpan;YUE Yunyue;XIA Ru’nan;LI Shuai;WANG Zhiyuan;JIA Shuyun;LIANG Hai(Department of Pharmacy,the Affiliated Bozhou Hospital of Anhui Medical University,Bozhou 236800,China)
出处
《西北药学杂志》
2025年第6期290-296,共7页
Northwest Pharmaceutical Journal
基金
安徽省重点研究与开发计划项目(编号:2022e07020066)
安徽医科大学校基金资助项目(编号:2023xkj091)。
关键词
酮咯酸氨丁三醇
药物相关问题
药学干预
合理用药
Ketorolac Tromethamine Injections
drug-related problems
pharmaceutical intervention
rational use
