我院因药品不良反应导致患者再人院的发生率和严重性评价

摘要

目的:评价我院因药品不良反应(ADR)导致患者再入院的发生率和严重性.方法:收集并记录我院2008年4月3日-12月7日,临床药师与主治医师共同查房时收治的所有患者的姓名、性别、年龄、既往疾病史、既往用药史、此次入院原因及患者入院时各项指标,分析患者此次入院是否与ADR有关,若怀疑为ADR所致,则填写ADR报告表,并详细分析其严重性、相关性和可预防性.结果:644名入院患者中,24名患者因ADR再入院,占总入院人数3.73%.ADR最常受累器官或系统是胃肠道系统(41.70%).其次是血液系统(16.70%)和肝胆系统(12.50%).在引起再入院的药品中,抗菌药物占首位(29.17%),其次是中草药或中成药(29.17%)、非甾体类抗炎药(16.67%)、心血管系统药(8.33%)和蒙药(8.33%)等.24名因ADR住院患者经济损失共约12万元.平均每位患者费用约5 000元,患者最低费用为695元,最高费用18 976元.结论:因ADR导致患者再次住院对患者健康和经济都造成巨大影响;抗菌药物和中药是关注的重点;医师和临床药师对于患者的住院用药及出院用药应给予详尽的交待,使患者能够正确服用药物,提高依从性,避免院外ADR的出现,提高疗效.%OBJECTIVE:To eveluate the incidence and severity of admission due to adverse drug reactions (ADR) in our hospital. METHODS: General information of admitted patients by ward round of clinical pharmacist and physician during Apr. 3rdDec. 7th in 2008 were collected and recorded in respect of name, gender, age, medical history, medication history, admissive cause and index prior to admission. Then we analyzed if adverse drug reactions led to admission. If ADR led to admission, ADR reports were recorded to analyze the severity, relevance and preventability of ADR. RESULTS: Of 644 inpatients, 24 patients were admitted in hospital again resulting from ADR, accounting for 3.73％. The most frequent system or organs involved in ADR were gastrointestinal system (41.70％), hematological system (16.70％), liver and billiary system (12.50％). The most suspected drugs were antibiotics (29.17％), followed by TCM (29.17％), NSAIDs(16.67％ ), cardiovascular agents (8.33％) and mongolian medicine (8.33％). 24 readmitted patients resulting from ADR spent out 120 000 yuan. The average cost of each patient was 5 000 yuan. The minimum cost was 695 yuan and the maximum cost was 18 976 yuan. CONCLUSION: In our study, ADR leading to readmission damage the health and economics of hospitalized patients. The most suspect el drugs are antibiotics and TCM. So doctors and pharmacists must warn patients of taking medicine properly in or out of hospital to improve compliance, so as to avoid the incidence of ADR out of hospital and improve therapeutic efficacy.