我院辅助治疗药物临床使用管理模式的建立

摘要

目的:规范辅助治疗药物的临床使用.方法:建立我院辅助治疗药物的临床使用管理模式,统计管理工作开展前后辅助治疗用药的销售金额及不合理用药情况,评估管理效果.结果:我院建立的辅助治疗药物的管理模式包括确定辅助治疗药物目录、建立管理制度并确立其使用基本原则;再借助各药物用量排名并充分利用循证医学证据等进行用药点评;制定辅助治疗药物不合理用药(超适应证、超剂量、超疗程)等情况的分类处置原则等.经过1年多的管理实践,我院辅助治疗药物使用日益规范,辅助治疗药物占全部药品销售金额由管理前(2014年8月-2015年7月)的20.90％降至管理后(2015年8月-2016年7月)的15.99％(降低约5％);与2015年8月比较,2016年8月在93个辅助治疗药物中有48个品种销售金额降幅超过15％,不合理用药现象明显减少.结论:我院建立的辅助治疗药物临床使用管理模式有效促进了临床合理用药、降低了医疗费用.%OBJECTIVE:To standardize the clinical use of adjuvant therapy drugs. METHODS:To establish the clinical use management mode of adjuvant therapy drugs in our hospital and summarize the usage amount and irrational drug use of adjuvant therapy drugs before and after implementing the management,and the management effect was assessed. RESULTS:The manage-ment mode of adjuvant treatment drugs in our hospital included ensuring the directory for adjuvant therapy drugs,establishing the management system and ensuring its basic principles,then conducting drug use review with the ranking of drug dosages and mak-ing full use of evidence-based medical evidence,as well as developing principle of classification disposal for the irrational drug use (off-indications,overdose,ultra treatment) of adjuvant therapy drugs. After more than one year of management practice,the use of adjuvant therapy drugs in our hospital is increasingly standardized. The sales amount of adjuvant therapy drugs to all drugs was reduced from 20.90％ before management(Aug. 2014-Jul. 2015)to 15.99％(reduced by 5％)after management(Aug. 2015-Jul. 2016). Compared with Aug. 2015,the sales amount of 48 varieties in the 93 adjuvant therapy drugs was dropped more than 15％in Aug. 2016,and irrational drug use decreased obviously. CONCLUSIONS:The established management mode of adjuvant thera-py drugs in our hospital has effectively improved clinical rational drug use and reduced medical costs.